Is ultraviolet (UV) light exposure or tanning useful for treating Herpes Zoster?

Tanning is Not Recommended for Treating Herpes Zoster

Tanning or ultraviolet (UV) light exposure is not recommended for the treatment of herpes zoster (shingles) and may potentially worsen outcomes.

Evidence Against Tanning for Herpes Zoster

Current dermatology guidelines do not support the use of tanning or recreational UV exposure for treating herpes zoster. The British Association of Dermatologists explicitly recommends against sun tanning and tanning beds during phototherapy treatments 1. While this recommendation is primarily directed at patients receiving controlled phototherapy for conditions like mycosis fungoides, the principle applies to herpes zoster as well.

Guidelines for phototherapy emphasize that:

• Uncontrolled UV exposure can increase the risk of skin cancer
• Tanning beds should not be used during medical treatments
• Patients should minimize purposeful exposure to sunlight 1

Potential Risks of UV Exposure with Herpes Zoster

Uncontrolled UV exposure through tanning may:

• Increase skin inflammation in already compromised skin
• Potentially worsen herpes zoster lesions
• Increase photosensitivity, especially if taking antiviral medications
• Elevate the risk of post-herpetic complications
• Lead to increased skin damage in the affected areas

Medical Phototherapy vs. Recreational Tanning

It's important to distinguish between:

1. Medical phototherapy: Controlled, targeted UV treatment administered by healthcare professionals
2. Recreational tanning: Uncontrolled UV exposure through tanning beds or sun exposure

While there is some limited research suggesting potential benefits of controlled medical phototherapy for herpes zoster 2, this is fundamentally different from recreational tanning:

Medical Phototherapy	Recreational Tanning
Controlled dosage	Uncontrolled exposure
Targeted application	General exposure
Medical supervision	No medical oversight
Specific wavelengths	Broad spectrum UV
Timed sessions	Variable duration

Evidence for Controlled Phototherapy

There is limited evidence that controlled broad-band UVB phototherapy administered by medical professionals might help reduce the incidence and severity of postherpetic neuralgia when used in the acute stage of herpes zoster 2. One study showed that patients receiving UVB phototherapy plus antiviral medication had better pain relief outcomes than those receiving antivirals alone.

However, this treatment:

• Must be administered by healthcare professionals
• Follows specific protocols (starting with 20 mJ/cm² and gradually increasing)
• Is combined with appropriate antiviral therapy
• Is not equivalent to recreational tanning

Recommended Treatments for Herpes Zoster

Instead of tanning, the standard of care for herpes zoster includes:

1. Antiviral medications: Start within 72 hours of rash onset

   • Acyclovir, valacyclovir, or famciclovir

2. Pain management:

   • Analgesics (acetaminophen, NSAIDs)
   • Neuropathic pain medications if needed (gabapentin, pregabalin)
   • Topical lidocaine for localized pain

3. Supportive care:

   • Keep lesions clean and dry
   • Loose-fitting clothing to minimize irritation
   • Cool compresses for comfort

Conclusion

While controlled medical phototherapy might have a role in herpes zoster management under specific protocols and medical supervision, recreational tanning or uncontrolled UV exposure is not recommended and may potentially worsen outcomes. Patients with herpes zoster should follow standard medical treatment protocols and avoid tanning beds or excessive sun exposure.