Shingles
Shingles
14 Tips to Combat the Pain
Sharp, burning pain crackles like static along a nerve route in your body. Angry red blisters rise from the pain site several days later. When the bumps blister and then turn cloudy, you realize this is no ordinary rash.
You've got shingles, a viral infection of a nerve.
Blame it on the chickenpox you had as a child. The varicella zoster (VZ) virus, the same invader that caused you such misery before, never really left your system. Until now, your immune system has done great rendering the VZ virus completely inactive. And even now, that mighty immune system of yours is keeping the virus from wreaking havoc throughout your system. But that's small comfort when you're in pain. Depending upon how severe your case of shingles is, the pain can continue even after your blisters heal.
This VZ virus, also known as herpes zoster, is a member of the notorious herpes clan. The word "zoster" means belt in greek, and until you suffer from shingles, you probably won't appreciate just how appropriately named it is.
What can you do to make yourself as comfortable as possible while your body heals?
AT THE OUTSET
Here is what the experts recommend for the beginning stages of shingles.
Reach for pain relief. Jules Altman, M.D., a private practitioner in Warren, Michigan, and clinical professor of dermatology at Wayne State University, favors extra-strength Tylenol, an aspirin substitute.
Give yourself a boost. Both your immune system and your nerves will benefit from extra doses of vitamin C and vitamin B-complex, says dermatologist John G. McConahy, M.D., of New Castle, Pennsylvania. He advises his shingles patients to take 200 milligrams of vitamin C five or six times a day to build immune power and a vitamin B-complex supplement to regenerate and rebuild nerve cells. (Of course, don't take this or any vitamin therapy without your doctor's okay and supervision.)
Dr. McConahy also tells his patients to take a multivitamin tablet that contains zinc.
Try lysine. A number of studies show that the amino acid lysine can help inhibit the spread of the herpes virus. Not all studies on lysine point to that conclusion, however.
Taking lysine supplements at the onset of shingles can't hurt and might help, says Leon Robb, M.D., director of the Robb Pain Management Group in Los Angeles, California.
FOR SHINGLES BLISTERS
Once blisters appear, there are several ways you can get relief.
Do nothing. Leave the blisters alone unless your rash is really bad, says Dr. Robb. "You can retard healing if you irritate the skin by applying too many skin creams and ointments."
Make a calamine liniment. This recipe comes from James J. Nordlund, M.D., a professor and chairman of the Department of Dermatology at the University of Cincinnati College of Medicine. You might be able to get your local pharmacist to make it for you.
Add to calamine lotion, 20 percent isopropyl alcohol and 1 percent each of phenol and menthol. If the phenol is too strong or the menthol too cool, dilute the liniment with equal parts of water.
"Use this as often as you want in the course of a day until the blisters are dried and scabbed over, says Dr. Nordlund. Then don't use it anymore." Instead, switch to a lotion that contains phenol and menthol, such as Nutriderm.
Try a chloroform/aspirin paste. Dr. Robb favors this remedy, which comes from Robert King, M.D., of Syracuse, New York.
Mash two aspirin tablets (not aspirin substitutes) into a powder. Add 2 tablespoons of chloroform and mix. Put the paste onto the affected area with a clean cotton ball. You can apply the paste several times a day. You can also ask your pharmacist to make this mixture for you.
How does it work? The chloroform is said to dissolve soap residue, oil, and dead cells in the skin. That leaves the aspirin to soak into the skin folds and desensitize the affected nerve endings. You should begin to feel better in 5 minutes. The relief can last for hours, and often days.
MEDICAL ALERT
Prevent Irreversible Nerve Damage If your shingles pain is more than you can stand, see your doctor. This is no time for stoicism. Ignore your discomfort and you could end up with irreversible nerve damage and years of pain, says Leon Robb, M.D. Remember, shingles is not a skin disease but a viral infection of a nerve. Doctors typically treat the early stages of shingles with acyclovir or a steroid drug. Acyclovir slows reproduction of the varicella zoster virus and shortens the course of infection. What it doesn't seem to prevent is post-herpetic neuralgia, the nerve pain that lingers after the skin heals. Some physicians believe that steroid drugs like prednisone can prevent that pain; others are unconvinced. The technique that Dr. Robb favors is injecting a nerve block in the appropriate place. "If you block the sympathetic nerves supplying the area of pain, you can provide definite and dramatic relief to over 75 to 80 percent of patients," he says. Yet help is available for chronic sufferers of post-herpetic neuralgia. One method involves implanting a small electrical device in the spine that can deliver a pain-masking shock to the appropriate site when stimulated by an external transmitter. |
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Apply a wet dressing to severe eruptions. Take a washcloth or towel, dip it in cold water, squeeze it out, and apply it to the affected area, says Dr. Nordlund. "The cooler it is, the better it feels. This is similar to putting on ice when you burn yourself," he says.
Don't fan the flames. Avoid anything that will make your blistered skin hotter. Heat will just macerate the skin, says Dr. Robb.
Sink into a starch bath. If you have shingles on your forehead, skip to the next tip. But if the problem is below your neck, this can help. Just throw a handful of cornstarch or colloidal oatmeal, such as Aveeno, into your bathwater and settle in for a good soak, says Dr. Nordlund. "But be extra careful not to slip on the bottom of the tub.
"People find this helpful, although the relief may not last long," he adds. "I often have my patients do this 20 minutes before bed, then they take something for the pain to help them sleep."
Zap the infection with hydrogen peroxide. If the blisters become infected, try dabbing them with hydrogen peroxide. You don't need to dilute it. Straight out of the bottle is fine, says Dr. Robb.
Or use an antibiotic ointment. But be careful about which one you choose. Neomycin and neosporin are notorious as skin sensitizers, says Dr. Nordlund. Polysporin or erythromycin are better choices.
Hold the Zostrix until the blisters are gone. This will usually be about two months. Zostrix is an OTC remedy for shingles pain. Its active ingredient is capsaicin, a derivative of the red pepper used to make chili powder and cayenne pepper. Scientists believe it works by blocking the production of a chemical needed to transmit pain impulses between nerve cells.
Using this topical ointment on blistering skin is "like putting red peppers on active shingles," says Dr. Altman. "The idea behind Zostrix is its counterirritant effect. It is for healed skin that has a pain sensation, not for an open, oozing infection."
POST-BLISTER CARE
You may have some discomfort even when the blisters are gone. Here's what to do.
Chill out with ice. If you still have pain after the blisters have healed, put ice in a plastic bag and stroke the skin vigorously, says Dr. Robb. "What we're trying to do here is confuse the nerves. This has been found to be beneficial."
Do some detective work. Sometimes, for some sufferers, long-lasting shingles pain may point to some underlying emotional need that's not being met, says Dr. Altman. Is the pain diverting your attention away from some other problem? Or is the pain diverting much-needed attention to you? It's an issue to consider, says Dr. Altman, and one which you may want to discuss with your doctor.
PANEL OF ADVISERS
Jules Altman, M.D., is a private practitioner in Warren, Michigan, and a clinical professor of dermatology at Wayne State University in Detroit.
John G. McConahy, M.D., is a dermatologist with a private practice in New Castle, Pennsylvania.
James J. Nordlund, M.D., is a professor and chairman of the Department of Dermatology at the University of Cincinnati College of Medicine in Ohio.
Leon Robb, M.D., is director of the Robb Pain Management Group in Los Angeles, California, where he treats patients with shingles and conducts research. An anesthesiologist for 25 years, he is former chief of anesthesia at Hollywood Presbyterian Medical Center.
