Antiviral, Cream and OTC Medications for Shingles Treatment and Pain Relief

Shingles is a disease that affects the sensory nerves but presents like a skin infection or rash. 1 in 3 people are likely to get the disease at some point in their lives. It is caused by the varicella-zoster virus, the same virus that causes chicken pox. This means that anyone who has ever had chicken pox is at risk of getting shingles.

Common shingles symptoms are a painful rash and blisters. The symptoms develop on a localized body area and only affect one side of the body. For example, shingles may affect only one eye or occur on one side of the chest. Commonly affected areas are the lower abdomen, chest and face. The disease can however affect any part of the body; see shingles on the breast symptoms for example.

Most shingles patients recover without complications, sometimes even without medications. The problem is that going without medications and treatment puts one at risk of shingles complications such as post-herpetic neuralgia. It also makes it more likely that the causative virus will be transmitted to healthy individuals. There are a variety of medications and forms of treatment that can be used to manage shingles. They include antiviral drugs, pain relievers, over the counter products and natural treatments.

Antiviral medications for shingles

Since shingles is a viral infection, it is not surprising that antiviral drugs are primarily used for treatment. Antiviral medications for shingles do not necessarily cure the disease. They do, however, succeed in relieving its symptoms as well as shortening the recovery period. Commonly used antiviral drugs include:

Acyclovir (Zorivax)

Acyclovir for shingles works best when given within 72 hours of the first symptoms. It mainly is given in oral form, an 800mg dose to be taken 5 times in a day for 7-10 days. By the time that period is over, shingles blisters will have crusted over. Acyclovir has been shown to be effective and safe, specifically for people with HIV whose immune systems may be compromised.

It works by inhibiting synthesis of viral DNA. In patients with recurring shingles, acyclovir can be used for prevention. In that case, lower doses will be prescribed for longer periods of time. Serious outbreaks may be treated with intravenous acyclovir.

Famciclovir (Famvir)

Famciclovir is prescribed in oral doses of 500mg to be taken thrice a day for 7 days. This is almost the same period it takes for shingles blisters to break open and crust over. Like it is with acyclovir, the drug is best taken within 72 hours after the first symptoms appear.

Valacyclovir (Valtrex)

Valacyclovir works pretty much the same like acyclovir. It is actually a better version of acyclovir. When taken, the drug is broken down to acyclovir, a process that allows more of the active ingredient to be available in the body. Valtrex for shingles is prescribed in oral doses of 1g to be taken thrice a day for 7 days. It is well tolerated and fairly effective.

Foscarnet (Foscavir)

Foscarnet is rarely used for shingles treatment. The drug is considered in the case of the shingles virus not responding to acyclovir, valacyclovir and famciclovir. In essence, these three drugs work almost the same. This means that where one drug is not effective, the other probably will also not be.

Acyclovir, valacyclovir and famciclovir are best given when shingles is still in its earliest stages. See how does shingles start symptoms or early symptoms of shingles for help with early diagnosis. Patients are advised to seek medical attention as soon as symptoms appear.

Over the counter medications for shingles

NSAIDs or non-steroidal anti-inflammatories are common over the counter medications for shingles. Examples of NSAIDs include naproxen, ibuprofen and diclofenac. They work by relieving pain and reducing fever.

Paracetamol is also a choice to consider. It works by improving flu-like symptoms common during shingles outbreaks. Paracetamol is tolerable to most people but should not be taken inappropriately. Adults can take up to 4g but not an excess of 1g in less than four hours. Patients should get directions from a pharmacist before use. If you are already taking medications for flu or cold, avoid taking paracetamol, as it may already be contained in those medications.

Other than NSAIDs and paracetamol, aspirin is also used as an over the counter drug for shingles. NSAIDs and aspirin are not recommended for children and young adults with viral infections. In fact, a pharmacist should always be consulted before taking either NSAIDs or aspirin. This is especially true in people with a history of:

  • Kidney problems
  • Indigestion
  • Allergic reactions to medications
  • Heart problems
  • Dehydration
  • Asthma
  • Stomach issues

People with compromised immune systems or who are taking medications for chronic diseases and those who have had recent surgery should all check with their pharmacists before using NSAIDs or aspirin. It is also important to note that both these medications come with a number of side effects which may include indigestion, difficulty breathing and prolonged bleeding.

Topical medications are also commonly used, mostly to relieve pain and sometimes reduce irritation. A good example is capsaicin cream. Capsaicin is a substance found in red pepper. It is said to relieve nerve pain caused by shingles. In fact, a home remedy can be made from red pepper extract. Capsaicin mostly comes in form of creams and ointments but can be found in patches. Shingles treatment cream that contains capsaicin should not be used in the eyes. Dermatome map shingles pictures can help.

To reduce pain intensity due to shingles, a numbing medicine such as lidocaine can prove effective. Lidocaine is found in certain creams, patches, powders, sprays and lotions. It can also be used in form of ointment for shingles.

Other medications for shingles

Other than antiviral drugs, doctors also often prescribe other medications for shingles. They include the following.

Tricyclic antidepressants:

As the name suggests, these medications are commonly used to treat depression. In the case of shingles, they work by stimulating production of neuro-transmitting hormones, the likes of serotonin. This significantly reduces shingles pain, especially when post-herpetic neuralgia is involved. Before using antidepressants as medications for shingles nerve pain, a doctor should be consulted.

Topical corticosteroids:

Corticosteroids are anti-inflammation medications. They are usually considered when treating shingles affecting ear or eye. The medications may also increase the efficiency of antiviral medications. Due to their potential side effects, a doctor should be consulted before use.

Antiepileptic drugs:

Antiepileptic drugs work by reducing the rate at which signals are fired in neurons. It is believed that shingles pain is caused by over-active nerves which have healed abnormally after being damaged by herpes zoster virus. And since shingles pain is not caused by external stimuli, reducing neuro-signals can reduce the pain.


Examples in this category of shingles medications include Neurontin, Epitol and Lyrica. They mostly are used to treat seizures but may be used for prolonged shingles nerve pain.

Pain relievers:

For mild shingles outbreaks, pain relievers can be bought over the counter. Prolonged shingles pain however requires stronger prescription pain killers, like opioids. It should be remembered that opioids are potentially addictive. In fact, many deaths related to opioid overdose are reported every year.


Antibiotics are not common medications for shingles. They are only considered when there is risk of getting a bacterial infection due to the shingles blisters.

Home treatments and remedies for shingles

We can’t completely cover all medications for shingles without mentioning home treatments. We don’t use home treatments to cure shingles. In fact, not any one of the mentioned medications are used as a complete cure. Treatments are aimed at shortening recovery period as well as rendering shingles symptoms less severe. Below are several natural remedies for shingles that may help.

Cool compress:

Cool compress has for a long time been used to ease the pain associated with a number of skin conditions and diseases. You may find that shingles affected areas can feel painful even at the lightest touch. With a cool compress, affected areas are rendered slightly numb so that pain is significantly reduced. Some people use ice directly. If that proves too harsh for your case, try soaking a piece of cloth in cold water and compressing it on affected areas for 15 minutes. Other than relieving pain, a cool compress helps keep shingles blisters clean to avoid bacterial infections.

Oatmeal baths:

Oatmeal baths excel in relieving itchiness. For best results, add 1 or 2 cups of colloidal oatmeal to cool bath water. Soak in the bath water for 15 minutes before rinsing with fresh water. Relief provided by oatmeal baths is not long-lasting, so the treatment has to be repeated occasionally. Best results can be achieved by starting treatment at the onset of first signs of shingles.

Baking soda:

Like colloidal oatmeal, baking soda works by relieving itching. You can add baking soda to bath water or prepare a paste to apply directly. Baths are more practical when treating shingles on the inner thigh or the buttocks.

Apple cider vinegar:

Apple cider vinegar is commonly used to prevent bacterial infections and reduce inflammation. Shingles pain relief apple cider vinegar can also be taken advantage of. Before using apple cider vinegar, ensure to dilute it with water or carrier oil such as olive oil. It also should not be used on open blisters or broken skin.

Essential oils:

Essential oils are always options to take into consideration where skin integrity is involved. They not only reduce skin irritation but may also prevent scar formation after recovery from shingles. Essential oils should not be used before being diluted with carrier oils.

Self-care measures:

Expect for recurring shingles, the major challenge during a shingles outbreak is tolerating the symptoms. How long does shingles last untreated? Shingles lasts for 2-4 weeks. Without treatment, the period can extend to 5 weeks. Self-care measures that may shorten recovery period include:

Loose clothing:

Shingles presents with a number of symptoms that mimic a skin infection. These include blisters and rash. Wearing tight clothing worsens the symptoms and restricts aeration. Sweat may also worsen itching especially when blisters have broken open.


Applying a thin layer of Vaseline to affected areas can further help reduce irritation caused by friction from clothes. To keep the applied Vaseline in place, you can cover with a cotton bandage.

Cool baths:

Warm baths are not a good choice during a shingles outbreak. They may increase the intensity of pain and skin irritation.

Avoid scratching:

Itching during a shingles outbreak starts even before the rash and may persist for several weeks. While it can prove intolerable, scratching only worsens the situation.

Patients can also try homeopathic cure for shingles. This option may greatly help when dealing with recurring shingles. A professional should be consulted.

Medications to prevent shingles

There is not much that can be done to prevent shingles. This is partly because its risk factors are not yet clearly defined. The widely accepted fact is that the disease is caused by reactivated chicken pox virus. Can you get shingles if you never had chicken pox? No. If you never had chicken pox, your first encounter with varicella-zoster virus will cause chicken pox and shingles thereafter.

In 2006, FDA approved Zostavax as the first shingles vaccine. The drug is given in one shot. It remains effective for about 5 years. Zostavax is recommended for people over the age of 50 years. It is a living vaccine and therefore may cause compilations in people with serious immune issues. Currently, a booster is not available but is being investigated.

Another shingles vaccine that may be longer lasting than Zostavax was approved in 2017. The vaccine is named Shingrix. It is a nonliving vaccine and therefore can be used in people with compromised immunity. The vaccine is given in two shots, 2-6 years apart.

Vaccines do not necessarily prevent a disease from occurring. They however ensure that the disease vaccinated against will not cause severe symptoms if it is to occur. Can you die from shingles? While shingles may cause some complications, death is rarely one of them. Inflammation in the brain is one of the potentially dangerous complications. It occurs in only about 1% of all shingles causes.