There are several effective treatments for shingles. Drugs that fight viruses (antivirals), such as acyclovir (Zovirax), valacyclovir (Valtrex), or famciclovir (Famvir), can reduce the severity and duration of the rash if started early (within 72 hours of the appearance of the rash). In addition to antiviral medications, pain medications may be needed for symptom control. Both nonsteroidal anti-inflammatory medications and narcotic pain-control medications may be used for pain management in shingles.
The affected area should be kept clean. Bathing is permitted, and the area can be cleansed with soap and water. Cool compresses and anti-itching lotions, such as calamine lotion, may also provide relief. An aluminum acetate solution (Burow's or Domeboro solution, available at your pharmacy) can be used to help dry up the blisters and oozing.
In May 2006, the U.S. Food and Drug Administration (FDA) approved the first vaccine for adult shingles. The vaccine, developed by Merck laboratories and known as Zostavax, is approved for use in adults ages 60 and over who have had chickenpox. The shingles vaccine contains a booster dose of the chickenpox vaccine usually given to children. Tests over an initial four-year period showed that the vaccine significantly reduced the incidence of shingles in these older adults. The single-dose vaccine was shown to be more than 60% effective in reducing shingles symptoms and it reduced the incidence of postherpetic neuralgia (PHN, see above) by at least two-thirds. Studies are ongoing to evaluate the effectiveness of the vaccine over a longer term.
There are certain contraindications to receiving the shingles vaccine. People with weakened immune systems due to immune-suppressing medications, cancer treatment, HIV disease, or organ transplants should not receive the shingles vaccine because it contains live, weakened viral particles. There is not enough information available from researchers to decide at this point whether Zostavax may be beneficial in people younger than 60 years of age.
Since the chickenpox vaccine is now recommended for children, the incidence of chickenpox has been reduced. This is also expected to reduce the incidence of shingles in adults in the future as these vaccinated children age.
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