Shingles (Herpes Zoster) (cont.)

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How is shingles diagnosed?

Shingles can often be diagnosed by your doctor based upon the distinctive appearance and distribution of the characteristic shingles rash. A painful, blistering rash that is localized to defined dermatomes is highly suggestive of shingles. Blood work or other testing is usually not necessary. Diagnosing shingles before the appearance of the rash or in cases of zoster sine herpete (zoster without rash) can be challenging. In cases where the diagnosis is unclear, laboratory tests are available to help confirm the diagnosis. Depending on the clinical situation, testing can be done using either blood work (to detect antibodies to the varicella zoster virus) or by specialized testing of skin lesion samples.

What is the treatment for shingles?

The treatment for shingles is aimed at diminishing the effects of the virus, as well as pain management. There are several medications that can be used, and your doctor will discuss the best treatment options for your particular situation. The vast majority of cases of shingles can be managed at home. In some cases, people with an impaired immune system or individuals with severe symptoms and/or complications may require hospital admission.

Antiviral medications (medications used to combat viral infections) are used against the varicella zoster virus. These medications help shorten the course of the illness and decrease the severity of the illness. They may also help prevent the potential complications sometimes encountered with shingles. They are most effective when started within 72 hours of the first appearance of the rash. There are several antiviral medications that can be used, including acyclovir (Zovirax), famciclovir (Famvir), and valacyclovir (Valtrex). In certain situations, intravenous (IV) antiviral medication may need to be administered.

Pain medication can be used to help relieve discomfort caused by the rash, which can sometimes be severe. For some individuals with mild pain, over-the-counter analgesics such as acetaminophen (Tylenol) or ibuprofen (Motrin or Advil) may be all that is needed. Individuals with more severe pain may require stronger opioid pain medication.

Over-the-counter antihistamine medication such as diphenhydramine (Benadryl) may help alleviate the localized itching.

The use of corticosteroid medications, such as prednisone, is controversial in the treatment of shingles.

Medically Reviewed by a Doctor on 11/18/2013

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