Embarrassing Illnesses

There is no cure for shingles, but with treatment your symptoms can be eased.

If you develop the shingles rash, you should try to keep the rash as clean and dry as possible. This will help to reduce the risk of your rash becoming infected with bacteria. Wearing loose-fitting clothing may also help you to feel more comfortable.

Painkilling medication

To help ease the pain that is caused by shingles, you may be prescribed a painkilling medicine (analgesic). Some painkillers that are used to treat shingles pain, such as paracetamol or ibuprofen, are available over the counter (OTC). Other, stronger painkillers may have to be prescribed to you by your GP.

Do not take ibuprofen if you currently have stomach or kidney problems or if you have had in them in the past. You should also avoid taking this medication if you have severe liver disease. Ibuprofen may also be unsuitable for you if you have asthma or if you are pregnant. Ask your GP or pharmacist if you are unsure.

Antidepressants

If you have severe pain as a result of shingles you may be prescribed an antidepressant medicine.

Antidepressants are commonly used to treat depression but they can also be useful in helping to manage pain that is caused by shingles. Antidepressants may be particularly useful if you have been experiencing severe or prolonged pain.

The antidepressants that are used to treat shingles pain are known as tricyclic antidepressants. Tricyclic antidepressants work by affecting the levels of certain chemicals within your body. The most commonly prescribed tricyclic antidepressants are amitriptyline, imipramine and nortriptyline.

Side effects of tricyclic antidepressants may include:

• constipation,
• difficulty urinating,
• blurred vision,
• dry mouth,
• weight gain, and
• drowsiness.

If you have shingles you will usually be prescribed a much lower dose of tricyclic antidepressants than if you were being treated for depression. You should be aware that it will normally take several weeks before you start to feel the antidepressants working.

Anticonvulsants

As with antidepressants, anticonvulsants are most commonly associated with being used to treat another condition; epilepsy. Anticonvulsants are often used to help control seizures.

However, anticonvulsants can also help to manage nerve pain. They work by stabilising electrical nerve activity within your brain. Gabapentin is the most commonly prescribed anticonvulsant for shingles pain.

Side effects of gabapentin may include:

• drowsiness,
• dizziness, and
• swollen ankles.

As with antidepressants, you will have to take gabapentin for several weeks before you start to feel it working.

Antiviral medication

As well as painkilling medication, some people with shingles may also be prescribed an antiviral medicine.

This type of medicine cannot kill the shingles virus but it can help to stop it multiplying. Antiviral medicine may help to reduce the severity of your shingles, particularly if you take it in the early stages of the condition.

Antiviral medicines are most effective when they are taken within 72 hours of your rash appearing. Commonly prescribed antiviral medicines include aciclovir, valaciclovir and famciclovir. You will usually have to take this type of medicine for seven days.

If you are over 50 years of age, and you have the symptoms of shingles, it is likely that you will be prescribed an antiviral medicine. You may also be prescribed antiviral medication if you have:

• symptoms that affect your eyes,
• a weakened immune system,
• a rash on parts of your body other than your torso, such as your neck, arms or legs,
• moderate to severe pain, or
• a moderate to severe rash.

Pregnancy and antiviral medication

If you are pregnant and you have shingles, it is likely that your GP will discuss your case with a specialist in order to decide whether the benefits of antiviral medication significantly outweigh any possible risks.

Children and antiviral medication

As children normally only experience mild symptoms of shingles, they will not usually require antiviral medication. They also only have a small risk of developing complications, such as postherpetic neuralgia, which means that antiviral medicines are not likely to be of significant benefit.

Should I keep my child off school?

If your child has shingles, you should only keep them away from school if the rash is weeping (oozing fluid) and cannot be covered or if they are feeling unwell. If the rash is only on their body and can be covered by clothing, there is little risk of your child passing on the infection.

Adults can also return to work as soon as they feel well enough, provided that the rash can either be covered or the blisters have dried up.