How Shingles Is Treated

Treating shingles, also known as herpes zoster (HZ), requires a multi-pronged approach: speeding up healing of the rash, minimizing the pain associated with an outbreak, and lessening the risk of complications—in particular, stabbing or burning pain that can last for months or even years (post-herpetic neuralgia, or PHN). While home remedies such as cool compresses can help with symptoms, your healthcare provider also may recommend antihistamines, pain relievers, and other over-the-counter options, as well as antivirals or other prescription drugs.

The discomfort of shingles anywhere on the body likely will be enough to prompt you to see a healthcare provider right away, but it's imperative that shingles that affect the eye area, herpes zoster ophthalmicus, is treated as quickly as possible to avoid the possibility of permanent vision damage or even blindness. Oral antiviral medications are necessary. Your healthcare provider may prescribe a topical steroid as well depending on what part of the eye is involved.

Shingles symptoms


Early treatment is key to minimizing the severity of a shingles outbreak, and antivirals are the go-to choice.

Antiviral medications prevent the varicella virus from multiplying, speed healing of skin lesions, and reduce the severity and duration of pain. They're most effective when given within 72 hours of the first appearance of a rash, so if you suspect an outbreak of blisters might be shingles, see your healthcare provider right away.

Keep in mind that if you don't manage to begin treatment with an antiviral drug within 72 hours, it still may be helpful to take one.

Shingles Healthcare Provider Discussion Guide

Get our printable guide for your next healthcare provider's appointment to help you ask the right questions.

Doctor Discussion Guide Old Man

There are three antiviral drugs for treating shingles: Zovirax (acyclovir), Famvir (famciclovir), and Valtrex (valacyclovir). People with compromised immune systems (such as organ donors and those with advanced infection with human immunodeficiency virus, or HIV) may require intravenous acyclovir.

Acyclovir tends to be the least expensive drug, but it must be taken more frequently than other options.

Other drugs may also be prescribed to help minimize your symptoms:

  • Anticonvulsants: For pain relief, certain drugs used to control seizures sometimes help. Examples are Neurontin (gabapentin) and Lyrica (pregabalin), which may relieve PHN pain if used with an antiviral.
  • Tricyclic antidepressants: This class of antidepressants, which is different from the more well-known selective-serotonin reuptake inhibitors, or SSRIs, such as Prozac (fluoxetine), has been found to relieve nerve pain. Specific examples include amitriptyline (which is available only in generic form), Aventyl (nortriptyline), and Norpramin (desipramine).
  • Corticosteroids: Although they aren't commonly prescribed for shingles or PHN, anti-inflammatory corticosteroids such as prednisone are routinely used when the eye or other facial nerves are affected.  
  • Opioids: Certain transdermal opioid remedies, such as morphine sustained-release patches or fentanyl patches, and oral opioids (narcotic medications) have proven effective when shingles or PHN causes extreme pain. 

Over-the-Counter Therapies

Over-the-counter options may be recommended for use in conjunction with prescription medication, or perhaps instead of one, in some cases. 

  • OTC pain medications: A non-steroidal anti-inflammatory medication (NSAID) such as Tylenol (acetaminophen) or Motrin or Advil (ibuprofen) can be effective in alleviating mild to moderate pain. If you're giving an NSAID to a child with shingles, make sure the dose is appropriate for her age and weight (the label will tell you, but you also can check with her pediatrician).

Do not give children aspirin or any aspirin-containing medication. The use of aspirin-containing drugs in children has been associated with an increased risk of Reye's syndrome, a rare disease that causes brain and liver swelling.

  • Antihistamines: An oral antihistamine such as Benadryl (diphenhydramine) may ease itching (but also causes drowsiness, so don't take it when you need to be focused or drive). You also might try a topical antihistamine. For instance, Benadryl comes as a spray, cream, or stick for applying directly to the skin.
  • Calamine lotion: Like topical antihistamines, calamine lotion can soothe itching and pain. If you don't like the classic thick pink stuff, you also can find a clear version. 
  • Lidocaine: This local anesthetic helps relieve pain by temporarily numbing the area that hurts. It's found in a variety of OTC skin-numbing creams, as well as in a patch called Lidoderm that sticks to the skin and releases small amounts of lidocaine for up to 12 hours per day. Only use lidocaine (in any form) on the skin that's intact—that is, still sore or itchy after blisters have healed, as is the case when shingles are followed by postherpetic neuralgia (PHN).  
  • Capsaicin: The active ingredient in chili peppers that sets your mouth on fire also has a numbing effect on the skin. It works by depleting a neurochemical called substance P that transmits pain signals. A number of studies have found that capsaicin is effective at relieving nerve-damage pain such as PHN. Most research has looked at prescription-only patches (Qutenza) containing a high concentration (8 percent) of capsaicin. You can find creams containing lower doses of capsaicin in drugstores, health food stores, and online. One of these, Zostrix, contains 0.1 percent capsaicin. Talk to your healthcare provider about the right amount for you.

Wear disposable gloves when applying capsaicin. Take care not to touch your eyes or any areas with broken or sensitive skin.

Home Remedies and Lifestyle

In addition to triggering the uncomfortable rash, other common shingles symptoms are similar to other viral infections.

Shingles can make you feel feverish, tired, and generally unwell.

While prescription and over-the-counter drugs can help, one of the most important things you can do while dealing with it is to take good care of yourself. If you're caring for someone else who has shingles, lavish them with TLC. 

Home remedies for shingles.

Laura Porter / Verywell

Some specific strategies can help ease the pain:

  • Tend to your skin. Apply cool compresses as needed to help ease pain and dry out blisters. (Don't do this if you're using a topical cream or patch.)
  • Take a soothing soak. An oatmeal bath can provide relief from itching. You can buy packaged colloidal oatmeal bath products at the drugstore or supermarket, or make your own: Run regular oatmeal, the kind you eat for breakfast, in a food processor until it's a fine powder. Add a cupful per inch of water to a warm (not hot) tub.
  • Dress for comfort. Friction from clothing can exacerbate pain. If your rash is on a part of your body that needs to be covered when you're out, wear something that fits loosely and is made from a natural fiber. 
  • Get plenty of rest. In addition to clocking adequate nighttime sleep, which for most people is between seven and nine hours, take naps during the day if you feel you need them.
  • Eat well. This means getting a balanced variety of nutritious foods at and between meals, and keeping those that are high in saturated fat, salt, and empty calories to a minimum. 
  • Move your body when you feel able. Try simple exercises like stretching or walking.
  • Distract yourself. Find ways to take your mind off pain and discomfort. This could be as simple as having a friend over to chat or focusing on a hobby—picking up that knitting project again, for example. Engage a child with shingles in a card game, puzzle, or other fun activity. 
  • De-stress. Turn to activities or practices that help you to relax, such as meditation, reading, or listening to soothing music. Stress can make pain worse and lead to depression.

Complementary Medicine (CAM)

If you're open to trying a non-traditional approach to treating shingles pain, consider talking to your healthcare provider about transcutaneous electrical nerve stimulation (TEN). This therapy involves applying harmless levels of electricity to stimulate the skin, which can provide relief by interfering with the transmission of pain signals. 

Research has found TENS to be effective for relieving shingles pain and preventing PHN. 

Although other alternative treatments for shingles have been considered, none have been researched enough to be considered viable. Among these are proteolytic enzymes, which are produced naturally by the pancreas to help digest protein from the diet. They also are found in certain foods, such as papaya and pineapple.

Supplements derived from papaya (called papain), pineapple (called bromelain), and from the animal pancreas can be found online, in health food stores, and in some grocery and drugstores. They are often marketed as digestive enzyme supplements.

In a 1995 German study of 192 people with shingles, half took proteolytic enzymes for 14 days and the other half took acyclovir. Both groups experienced similar pain relief and skin improvement, with the exception of skin redness, which showed greater improvement with the acyclovir treatment. The group taking proteolytic enzymes had significantly fewer side effects.

Proteolytic enzymes can have some side effects, including digestive upset and allergic reactions. If you're allergic to pineapple or papaya, avoid supplements derived from those fruits.

Proteolytic enzymes, particularly bromelain and papain, should not be taken with blood-thinners such as aspirin or Coumadin (warfarin) as they may increase the effect of these drugs. The proteolytic enzyme pancreatin also may interfere with the absorption of the vitamin folate.

Given that there's so little evidence that proteolytic enzymes are truly helpful in relieving shingles symptoms and that they can have side effects, you should check with your healthcare provider before taking them to treat shingles.

Frequently Asked Questions

  • How long does shingles last?

    It depends on the individual case. Shingles symptoms typically last about three to five weeks. If antiviral treatment is started as soon as possible after symptoms begin, it can reduce the pain and shorten healing time. Antiviral medications can also halve the risk of PHN, which can cause chronic pain for months or years.

  • How long is shingles contagious?

    You can't catch shingles from another person, but the virus that causes shingles can cause chickenpox in people who haven't had chickenpox before or been vaccinated against it. The fluid from the blisters can spread the virus to others. Once the blisters from the rash crust or scab over, you're no longer considered contagious.

Was this page helpful?
Article Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. [Internet]. Cologne, Germany: Institute for Quality and Efficiency in Health Care (IQWiG); 2006-. Shingles: Overview. 2014 Nov 19 [Updated 2019 Nov 21].Available from:

  2. Opstelten W, Zaal MJ. Managing ophthalmic herpes zoster in primary careBMJ. 2005;331(7509):147‐151. doi:10.1136/bmj.331.7509.147

  3. Wu JJ, Brentjens MH, Torres G, Yeung-Yue K, Lee P, Tyring SK. Valacyclovir in the treatment of herpes simplex, herpes zoster, and other viral infectionsJ Cutan Med Surg. 2003;7(5):372‐381. doi:10.1007/s10227-002-0140-3

  4. Stankus SJ, Dlugopolski M, Packer D. Management of herpes zoster (shingles) and postherpetic neuralgiaAm Fam Physician. 2000;61(8):2437‐2448.

  5. Sansone RA, Sansone LA. Pain, pain, go away: antidepressants and pain managementPsychiatry (Edgmont). 2008;5(12):16‐19.

  6. Santee JA. Corticosteroids for herpes zoster: what do they accomplish?Am J Clin Dermatol. 2002;3(8):517‐524. doi:10.2165/00128071-200203080-00001

  7. Pavan-Langston D. Herpes zoster antivirals and pain managementOphthalmology. 2008;115(2 Suppl):S13‐S20. doi:10.1016/j.ophtha.2007.10.012

  8. Cohen KR, Salbu RL, Frank J, Israel I. Presentation and management of herpes zoster (shingles) in the geriatric populationP T. 2013;38(4):217‐227.

  9. MedlinePlus. Diphenhydramine Topical. U.S. National Library of Medicine. Updated February 15, 2018.

  10. Ayoade F, Kumar S. Varicella Zoster (Chickenpox) [Updated 2019 Dec 16]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan-. Available from:

  11. Lin PL, Fan SZ, Huang CH, et al. Analgesic effect of lidocaine patch 5% in the treatment of acute herpes zoster: a double-blind and vehicle-controlled studyReg Anesth Pain Med. 2008;33(4):320‐325. doi:10.1016/j.rapm.2007.02.015

  12. Derry S, Rice AS, Cole P, Tan T, Moore RA. Topical capsaicin (high concentration) for chronic neuropathic pain in adults. Cochrane Database Syst Rev. 2017;1:CD007393. doi:10.1002/14651858.CD007393.pub4

  13. Sanjay S, Huang P, Lavanya R. Herpes zoster ophthalmicusCurr Treat Options Neurol. 2011;13(1):79‐91. doi:10.1007/s11940-010-0098-1

  14. Reynertson KA, Garay M, Nebus J, et al. Anti-inflammatory activities of colloidal oatmeal (Avena sativa) contribute to the effectiveness of oats in treatment of itch associated with dry, irritated skinJ Drugs Dermatol. 2015;14(1):43‐48.

  15. [Internet]. Cologne, Germany: Institute for Quality and Efficiency in Health Care (IQWiG); 2006-. Chickenpox: Overview. 2014 Jun 30 [Updated 2019 Nov 21].Available from:

  16. Hirshkowitz M, Whiton K, Albert SM, et al. National Sleep Foundation's sleep time duration recommendations: methodology and results summary. Sleep Health. 2015;1(1):40-43.

  17. Irwin M, Pike J, Oxman M. Shingles Immunity and Health Functioning in the Elderly: Tai Chi Chih as a Behavioral TreatmentEvid Based Complement Alternat Med. 2004;1(3):223‐232. doi:10.1093/ecam/neh048

  18. Harpaz R, Leung JW, Brown CJ, Zhou FJ. Psychological stress as a trigger for herpes zoster: might the conventional wisdom be wrong?Clin Infect Dis. 2015;60(5):781‐785. doi:10.1093/cid/ciu889

  19. Kolšek M. TENS - an alternative to antiviral drugs for acute herpes zoster treatment and postherpetic neuralgia prevention. Swiss Med Wkly. 2012;141:w13229. doi:10.4414/smw.2012.13229

  20. [Internet]. Cologne, Germany: Institute for Quality and Efficiency in Health Care (IQWiG); 2006-. Lasting pain after shingles. 2014 Nov 19 [Updated 2019 Nov 21]. Available from:

  21. Desser L, Holomanova D, Zavadova E, Pavelka K, Mohr T, Herbacek I. Oral therapy with proteolytic enzymes decreases excessive TGF-beta levels in human bloodCancer Chemother Pharmacol. 2001;47 Suppl:S10‐S15. doi:10.1007/s002800170003

  22. Billigmann P. [Enzyme therapy--an alternative in treatment of herpes zoster. A controlled study of 192 patients]. Fortschr Med. 1995;113(4):43-8.

  23. National Institute of Neurological Disorders and Stroke. Shingles: Hope through research.

Additional Reading