From the Guidelines
For early-stage shingles pain relief, nonadherent dressings are recommended to reduce bacterial superinfection and pain, as well as to promote healing. When it comes to managing shingles in the early stages, particularly for pain relief, the approach should prioritize minimizing irritation and preventing infection. According to the European Dermatology Forum consensus in collaboration with the European Academy of Dermatology and Venereology 1, the use of nonadherent dressings is advisable for covering extensive erosive lesions. This approach is beneficial for several reasons:
- Reduces bacterial superinfection
- Decreases pain
- Promotes healing
It's also important to handle blisters with care:
- Small and medium blisters should be left intact
- Larger blisters may be punctured and drained, but the blister roof should be left in place as it acts as a natural dressing
- If a blister is already broken, only the loose, fluttering skin should be removed
In terms of specific dressings, while the provided evidence does not directly mention shingles but discusses the management of bullous pemphigoid, the principle of using nonadherent dressings to reduce pain and promote healing can be applied to shingles management as well, especially considering the goal of minimizing discomfort and preventing complications. Therefore, the focus should be on using dressings that are gentle on the skin and do not adhere to the rash, allowing for the healing process to proceed without additional irritation. Over-the-counter pain relievers and cool, wet compresses can also be used to complement topical treatments for pain relief.
From the Research
Best Dressing for Shingles in Early Stages to Help with Pain Relief
- The use of hydrocolloid dressing has been reported to help with pain control in herpes zoster reactivation, as seen in a case report where the application of hydrocolloid dressing led to rapid improvement of pain control 2.
- Hydrocolloid dressing may be considered in patients suffering from severe neuropathic pain in shingles, especially in severe cases, although further clinical studies are recommended 2.
- Other treatment options for shingles and postherpetic neuralgia include antivirals, topical analgesics, opioid analgesics, tricyclic antidepressants, and gabapentin, often used in combination for adequate pain relief 3, 4, 5.
- Early treatment with antivirals such as acyclovir, valacyclovir, or famciclovir within the first 72 hours of the onset of the rash can reduce the duration of the herpetic rash and zoster-associated pain 4, 6.
- The efficacy of gabapentin in preventing postherpetic neuralgia is unclear, with a study showing no significant relief from acute herpetic pain or prevention of postherpetic neuralgia 3.