From the Guidelines
The most effective treatment for a shingles outbreak is antiviral medication, such as acyclovir or famciclovir, administered within 72 hours of rash onset, as it accelerates cutaneous healing and reduces acute pain severity. According to the study by 1, two nucleoside analogs, acyclovir and famciclovir, have been approved by the FDA for treating herpes zoster (HZ). The study found that if administered within 72 hours of rash onset, acyclovir has accelerated the rate of cutaneous healing and reduced the severity of acute pain in adults who have HZ.
Key Treatment Considerations
- Antiviral medications should be started as soon as possible, ideally within 72 hours of rash onset, to maximize their effectiveness.
- Pain management is crucial and can be achieved with over-the-counter options like acetaminophen or ibuprofen for mild pain.
- Topical treatments like calamine lotion or colloidal oatmeal baths can help soothe the rash.
- Keeping the affected area clean and covered prevents secondary infection and transmission.
- Patients should avoid scratching the rash and isolate from pregnant women, newborns, and immunocompromised individuals until lesions crust over.
Special Considerations
- Those experiencing eye involvement, widespread rash, or who are immunocompromised should seek immediate medical attention as they may require more aggressive treatment.
- The use of cool compresses may provide additional relief for patients with a shingles outbreak.
- It is essential to note that while the study by 1 provides guidance on the treatment of shingles, the specific treatment regimen may vary depending on individual patient needs and circumstances.
From the FDA Drug Label
The recommended dosage of valacyclovir hydrochloride for treatment of herpes zoster is 1 gram 3 times daily for 7 days Therapy should be initiated at the earliest sign or symptom of herpes zoster and is most effective when started within 48 hours of the onset of rash.
The recommended treatment for a shingles outbreak is valacyclovir hydrochloride 1 gram taken 3 times daily for 7 days. Therapy should be initiated at the earliest sign or symptom of herpes zoster and is most effective when started within 48 hours of the onset of rash 2.
From the Research
Treatment Options for Shingles Outbreak
- Antiviral medications such as acyclovir, famciclovir, and valacyclovir are effective in treating shingles outbreak 3, 4, 5
- These medications are most effective when started within 72 hours after the onset of the rash 3, 4, 6
- The addition of an orally administered corticosteroid can provide modest benefits in reducing the pain of herpes zoster and the incidence of postherpetic neuralgia 3
- For patients with postherpetic neuralgia, narcotics, tricyclic antidepressants, or anticonvulsants may be used to control neuropathic pain 3
- Capsaicin, lidocaine patches, and nerve blocks can also be used in selected patients 3
Recommended Treatment Regimens
- Valacyclovir 1000 mg 3 times daily for 7 days is a recommended treatment regimen for herpes zoster 5
- Acyclovir 800 mg 5 times daily for 7 days is also effective, but valacyclovir may alleviate zoster-associated pain and postherpetic neuralgia faster 5
- Famciclovir 500 mg 3 times daily for 7 days is another option, with similar efficacy to valacyclovir 5