In order to discuss possible treatments, we first must look at the disease and its symptoms more closely. Shingles is most common in adults. Children who get Shingles will typically have a very mild case. Often, the disease is a sign of an immune system weakened by another condition. Shingles occurs when the varicella-zoster virus reactivates and travels through the nerves. Thus, the first symptoms are often burning or tingling sensation along the affected nerves. Forty eight to seventy two hours later, when the virus reaches the skin, red bumps or blisters develop along the skin above the affected nerve (1). This usually happens on one side of the torso, face, arm, or leg, and can be accompanied by flu-like symptoms, chills, or headache (5). Depending on where the disease manifests, there can be serious complications. Herpes Zoster Ophthalmicus occurs when Shingles involves the eye and is very dangerous as it can affect vision and even cause blindness. Otic Zoster occurs when shingles affects the ears. Like Herpes Zoster Ophthalmicus, it is dangerous as it can result in the loss of hearing. Bell's Palsy is yet another possible complication of Shingles. Bell's Palsy causes the facial nerve to be paralyzed. All three of these complications, being quite obviously serious, necessitate immediate professional attention and intensive treatment often including potent anti-viral drugs (1).
However, the most common complication of Shingles is perhaps the hardest to treat. Even worse, it often does not manifest until the virus has had time to "entrench" itself in the body, making anti-viral drugs somewhat less effective. This is Post-Herpetic Neuralgia (PHN), the severe pain that can remain with shingles sufferers months and occasionally even years after the blisters have healed. Of those shingles sufferers over sixty, as many as half will develop Post-Herpetic Neuralgia. Many liken the excruciating pain to the feeling of skin being ripped off or burned. Others say that the pain is worse than that of childbirth, a heart attack, or a war injury. Often the pain of PHN does not respond to medication and thus leaves patients depressed undernourished, dehydrated, and even suicidal (5).
Treatment for Post-Herpetic Neuralgia as well as Shingles blisters can come from a variety of different medicines from narcotics to epilepsy drugs to St. John's Wort to Chinese herbs. Dr. Fred Hui M.D., a Toronto physician, has developed a unique method of treatment for Shingles which combines elements of both eastern and western medicine. The basic principals behind his method, those of bringing together a wide array of treatments in a short time span, could be useful for anyone, patient or doctor, in helping to relieve Shingles symptoms (3).
Typical western medicine, of course, is still a part of this combined east/west Shingles treatment. Antiviral drugs, most effective within the first few days of the disease, are often given to patients. Such drugs include acyclovir and valacyclovir, and are used to help shorten the outbreak of the virus, thus diminishing the possibility of developing Post-Herpetic Neuralgia (5). The anti-viral drug Valtrex, a brand of valacylovir, has recently been developed, tested, and approved by the FDA for the treatment of Shingles (7). Vitamin C and bioflavonoids are also helpful as they are thought to have anti-viral activity (6).
If the patient does develop PHN, narcotics such as codeine, anti-depressants such as amitriptylie, and epilepsy drugs such as garbapertin are sometimes used. All three are thought to help blunt the nerve's perception of pain (5). Dr. Hui mentions "German Neurotherapy" in his list of methods for treating Shingles (3). This is a therapy which involves nerve blocks, a tactic in which a local anesthetic is injected directly into the affected nerve. However, the relief from nerve blocks is only temporary, lasting approximately a week and a half. And, unfortunately, all of the above mentioned methods only work about half of the time (5).
One typically eastern method of treatment which has been widely accepted by western doctors is a Capsaicin cream or ointment. Capsaicin is the chemical in red pepper responsible for heat (2). Ointments made with Capsaicin and rubbed into the affected area (usually after the blisters heal) are frequently used and have proven effective in relieving the lingering Shingles pain of some patients (6). Zostrix, an over the counter medication made with the red pepper extract, has been developed for this purpose (2).
Cayenne or red pepper is not the only "herbal" remedy which appears to be somewhat effective. The homeopathic remedies developed for Shingles are numerous. For example, Arsenicum album can be taken if the pain of the blisters seems to be relieved by heat and if the pain is worse at night. Iris versicolor is often helpful with shingles infection that is accompanied by gastro-intestinal problems and bumps which appear on the abdomen. If the patient is restless and the rash is itchy rather than burns, Rhus Toxicodendron can be taken in a low potency. All three of these remedies, though many claim to have found them helpful, have never been clinically tested. These remedies are probably best used in conjunction with other types of treatment (4).
Dr. Hui also mentions Chinese herbs as one of the methods in his "breakthrough" Shingles therapy. Though he does not specifically state which herbs he uses, there are a few which have been used in the past by other Chinese herbalists. Genitian ( Gentiana macrophylla ) and Oriental Wormwood have been used in treating Shingles blisters. In addition, a tea called San Sheng Yin, made of ginseng, ginger, acomite, costus root, and Tian Nin Xing (Arisalana erubescens), has been used for its pain killing effect (11). Saint Johns Wort, an herb that has been recognized more and more in western medicine, is also thought to be effective for milder cases of neuralgia. A tea or hot compress can be made from Saint Johns Wort and Lavender, both of which are thought to be good restoratives for the nervous system (10). The reason that Saint Johns Wort is thought to help is that it contains compounds that act as manomire-oxidase enzyme inhibitors. A warm lotion made from the flowers and leaves may also relieve the burning of the Shingles blisters (9).
In addition to herbs from Chinese and other cultures, Dr. Hui employs a number of hands-on methods in the treatment of Shingles. These include, spinal manipulation, energy techniques such as Reiki, Meditations, and acupuncture (2). Ms. Linda B. Hayes, a Shingles sufferer, uses acupuncture as part of a combined east/west Shingles therapy for the disease. She comments that acupuncture in points along the affected nerve area is helpful in relieving the pain; however, the relief is only temporary, lasting five to six hours. Also, the acupuncture must be done on both the back and front of the torso, or the method will be ineffectual. Interestingly, the acupuncture, in conjunction with Darvaset (a narcotic pain reliever) and a red pepper extract cream, relieves Shingles pain best during times of high barometric pressure. Pain is worst, Hayes claims, on days when the barometric pressure is low (8).
Ms. Hayes, like many other shingles sufferers has not come across a treatment that provides 100 percent alleviation of her symptoms. Unfortunately, as shown by the seeming affect of barometric pressure in Ms. Hayes, Shingles pain varies greatly from patient to patient. Perhaps this is the reason that methods which combine a variety of elements from the eastern and western medical traditions come closer to a "cure." Though such methods cannot be guaranteed, they show signs of offering some important relief. Perhaps more research conducted on this more rounded and wholistic style of treatment will yield even better theories for new Shingle pain therapy.
2)"Herbal Remedies Cayenne: The Hottest Healer", updated July, 2000
3)"Herpes Zoster, Shingles - A Dramatic Breakthrough", Herpes Zoster Treatment
4)"Homeopathic Remedies for Herpes Zoster", Herbal remedies
5)"Hope for Pain After Shingles", updated February 4, 1999
6)"Shingles", Marks, Thomas
7)"New Shingles Therapy Approved by FDA", October 12, 1995
Other Sources
8) Hayes, Linda. Personal Interview. November 7, 2000. ,
9) Lipp, Frank J. Herbalism. Duncan Baird Publishers, London. 1996. ,
10) Ody, Penelope. Home Herbal. Darling Kindserley, London. 1995. ,
11) Tang, Stephen, & Richard Craze. Chinese Herbal Medicine. Berkley Books, New York. 1995. ,