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Shingles Treatment: Acyclovir, Pain Management, and Prevention of Postherpetic Neuralgia

Middle-aged Hispanic patient in a medical consultation, listening to a Hispanic doctor explaining shingles treatment options. The doctor holds a tablet displaying a diagram of the varicella-zoster virus. On the desk, there are brochures about acyclovir, analgesia, and shingles vaccine to prevent complications. Professional and collaborative environment.

Shingles, commonly known as culebrilla, is a disease caused by the reactivation of the varicella-zoster virus, the same virus that causes chickenpox. This condition affects a significant percentage of the population, especially as we age, and can lead to severe complications such as postherpetic neuralgia (PHN). Timely and appropriate treatment is crucial to minimize the impact of this disease and its complications.

Diving into Shingles Treatment

The treatment of shingles focuses on three fundamental pillars: the use of antivirals, pain management, and prevention of complications. Antivirals such as acyclovir, valacyclovir, and famciclovir are effective in reducing the severity and duration of the outbreak if initiated within the first 72 hours of the rash's appearance. These medications not only help control viral replication but can also decrease the incidence of ocular and cutaneous complications [1].

Pain management is another critical component of treatment. Analgesia may include the use of topical analgesics such as lidocaine or capsaicin, as well as oral medications like gabapentinoids, tricyclic antidepressants, and opioids in more severe cases. The combination of these treatments can provide significant relief, although it is often partial and requires an individualized approach [2].

Postherpetic neuralgia is a debilitating complication that can persist long after the rash has resolved. Preventing this condition is a key objective, and vaccination with the shingles vaccine has proven to be an effective strategy to reduce both the incidence of shingles and PHN. Vaccination is recommended for adults over 60 years old and for certain at-risk groups starting at age 50 [3].

Conclusions

Managing shingles requires a multidisciplinary approach that combines the use of antivirals, pain control strategies, and preventive measures such as vaccination. Early implementation of these treatments is essential to minimize complications and improve the quality of life for affected patients. As the population ages, the burden of this disease on healthcare systems will increase, making the adoption of effective preventive strategies even more crucial [4].

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Created 6/1/2025