From the Guidelines
Prednisone is not recommended for treating internal shingles due to its potential to suppress the immune system and worsen the condition. The provided evidence [ 1 ] discusses the use of prednisone in treating bullous pemphigoid, a different condition, and does not support its use in internal shingles.
Key Points to Consider
- Internal shingles requires prompt treatment with antiviral medications like acyclovir, valacyclovir, or famciclovir, which should be started within 72 hours of symptom onset [ 1 ].
- Prednisone, a corticosteroid, can suppress the immune system, potentially allowing the virus to spread more easily in cases of internal shingles.
- The use of prednisone in treating internal shingles is not supported by the provided evidence [ 1 ] and may even be harmful.
- Treatment of internal shingles typically involves hospitalization with intravenous antivirals and close monitoring to prevent serious complications affecting organs like the lungs, brain, or liver.
Important Considerations
- If you suspect internal shingles, seek immediate medical attention as it can lead to serious complications.
- Antiviral medications are the primary treatment for internal shingles, and their use should be guided by a healthcare professional.
- The potential benefits and risks of using prednisone in treating internal shingles should be carefully weighed, and its use should be avoided due to the lack of evidence supporting its effectiveness and the potential for harm [ 1 ].
From the Research
Treatment of Internal Shingles with Prednisone
- The use of prednisone in combination with antiviral medications for the treatment of internal shingles has been studied in several clinical trials 2, 3.
- A study published in 2018 found that combination therapy with valacyclovir, methylprednisolone, and pregabalin had better efficacy compared to valacyclovir and pregabalin, and valacyclovir alone in the management of acute herpes zoster neuralgia 2.
- Another study published in 1996 found that combined acyclovir and prednisone therapy can improve quality of life in relatively healthy persons older than 50 years of age who have localized herpes zoster 3.
- The studies suggest that prednisone may be beneficial in reducing the pain and improving the quality of life of patients with internal shingles, especially when used in combination with antiviral medications.
Comparison with Other Treatments
- A systematic review and meta-analysis published in 2022 found that prodrugs such as famciclovir and valaciclovir were more effective than acyclovir in treating postherpetic neuralgia among patients with herpes zoster 4.
- A study published in 2003 found that valacyclovir was more effective than acyclovir in hastening the healing of zoster-associated pain and postherpetic neuralgia 5.
- The varicella zoster virus vaccine has been shown to decrease the incidence of herpes zoster and is approved for adults 50 years and older 6.