Antivirals: A treatment for shingles

Shingles is a painful condition that lasts for several weeks. There’s no cure, but antiviral medications can help heal the sores and blisters more quickly. 

Antivirals are only available from a healthcare professional. To get the most benefit from these medications, people start them as soon as possible after noticing the shingles rash. Getting a quick diagnosis of shingles can therefore help you to heal faster. 

You can use OTC medication to reduce symptoms like itching and pain. 

As you experience shingles, you can ease discomfort through home treatments like oatmeal baths, reducing stress, and eating more healthily. 

Shingles overview 

Shingles usually lasts 3 to 5 weeks. It comes from the varicella-zoster virus, which also causes chickenpox. Symptoms of shingles include:

• a painful skin rash on one side of the body
• blisters filled with fluid
• skin numbness, tingling, or itching
• burning or shooting pain
• chills, headache, stomach upset, or fever

Some people experience long-term pain after a bout of shingles. This is called post-herpetic neuralgia. 

The recombinant zoster vaccine (Shingrix) can prevent shingles. It’s 90% effective, according to the U.S. Department of Health and Human Services. You can’t take the shingles vaccine if you are currently experiencing shingles, but you can take it after you have recovered to stop it from coming back.

Antiviral medications are the first-line treatment option for shingles. Other medications can help treat symptoms and side effects. 

OTC antivirals

Antiviral medication is only available by prescription in the U.S. Therefore, there are no OTC antivirals.

There are OTC treatments that may help relieve symptoms of shingles.

• pain medications like acetaminophen (Tylenol) and ibuprofen (Advil)
• capsaicin cream (Zostrix) or a combination lidocaine and prilocaine (Emla) for lesions
• anti-itch medicines like diphenhydramine (Benadryl)
• antibiotics like bacitracin combination products (Polysporin, Neosporin)

These treatments will not shorten the duration of shingles but can reduce symptom severity. Antibiotics may help prevent secondary infection.

Prescription antivirals 

Antiviral medications can shorten the duration of shingles. They can also make symptoms less severe. Antivirals work best if you start taking them 1 to 3 days after the shingles rash appears.

There are three antivirals for shingles: acyclovir (Sitavig, Zovirax), valacyclovir (Valtrex), and famciclovir (Famvir).

Acyclovir

The usual course of acyclovir for shingles is 800 mg, 5 times per day for 5 days. The medication should help the blisters heal more quickly and reduce pain.

The possible side effects are:

• vomiting, diarrhea, or upset stomach
• dizziness, fatigue, or agitation
• joint pain, hair loss, or vision changes

Acyclovir is available as a tablet, capsule, or liquid. 

Valacyclovir

Valacyclovir reduces pain and itching and helps to heal sores from shingles. The course of valacyclovir is 3 times per day for 7 days. 

The possible side effects of this medication are:

• vomiting, stomach upset, or diarrhea
• headaches
• constipation

Valacyclovir comes as a tablet.

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Famciclovir

Famciclovir speeds the healing process of shingles blisters and sores. It also reduces common symptoms such as pain, burning, and itching. The usual course for the medication is 3 times per day for 7 days.

Some possible side effects of famciclovir are:

• painful menstrual periods
• headaches, nausea, vomiting, or diarrhea
• gas or stomach pain
• rash or itching
• tiredness 

This medication comes as a tablet.

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Other treatment options 

Since antiviral treatment is most effective in the early stages of shingles, you may want to consider seeing a healthcare professional as soon as possible after you notice a rash. 

In addition to antivirals, other prescription medicines for shingles may include:

• corticosteroids such as prednisone (Rayos) and prednisolone (Orapred) to reduce inflammation
• opioids such as tramadol (Ultram) or oxycodone (Oxaydo) to reduce severe pain
• antibiotics such as mupirocin (Bactroban) to prevent infection

Home treatment can also help increase comfort and reduce symptoms. Some options include:

• wearing loose clothing with natural fibers to reduce skin irritation
• taking oatmeal baths and using calamine lotion to reduce skin itch
• applying cool washcloths to blisters to reduce pain 
• keeping the rash clean and covered to prevent the spread of shingles
• avoiding scratching the rash area to prevent infection and scarring
• resting and engaging in moderate exercise
• avoiding stress and eating healthily

There is no cure for shingles, but home treatment can help ease symptoms.

Summary

Antiviral medications are first-line treatments for shingles. The typical antiviral course is 1 week. These medications are only available on prescription. They help improve symptoms and help shingles blisters to heal more quickly. 

OTC treatments for shingles focus on reducing pain, itching, and inflammation. You may also consider trying home remedies to ease symptoms. A healthcare professional can also recommend medication to prevent infection.

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