Bad case of shingles

In May 2015 I started having a bad case of shingles which lasted for four months and I still suffer the effects of skin itching and irritation on a small area of my back and tummy. My GP has prescribed treatments including Diprobase, Amitriptyline, Clobavate; none of which have cleared the problem. So, my first question is can you suggest anything else that may help. My second question is that I am now eligible for a shingles vaccination. I am getting mixed messages from my surgery about whether a vaccination is necessary or desirable, with regard to my present immunity or whether it could trigger another bout of shingles. What is your expert view please?

22 August 2016

Hi Mary,

Thank for your question,

Shingles (herpes varicella-zoster) is likely to manifest itself in the form of a blistery rash affecting the torso (front / back). At times it can affect the body and face.

Clobavate should be applied as directly daily for duration of four weeks. If the condition worsens or does not improve within four weeks, treatment and diagnosis should be re-evaluated.

Diprobase Cream is an emollient, moisturising and protective cream that is to be applied to the dry skin areas as often as is required and rubbed well into the skin.

Amitriptyline is commonly prescribed to treat the long term issues associated with shingles; it works by blocking the pain.
Postherpetic neuralgia (PHN), which is long-term nerve pain associated with Shingles that can last for months, even years after the rash heals. Common symptoms can be felt as itching, irritation, burning, tingling, super sensitivity, pain, numbness and soreness

There are alternative treatments that your doctor could prescribe; these can take up to 4 weeks to take full effect. Examples are as follows: 

Gabapentin- an antiepileptic medicine that is also used to treat nerve pain
Pregabalin - am antiepileptic, also used to treat nerve pain and sleep problems.
Axsain cream (capsaicin)- applied topically to help relieve nerve pain associated with shingles.
Versatis plasters (patches) – can wear for 12 hours (day or night as preferred) on or near the painful area.  The skin is   uncovered the other 12 hours so that it can breathe.

If symptoms persist, stronger painkillers may be prescribed by your doctor for a short time, examples include:

Tramadol- an opioid for pain relief

An alternative would be to try TENS machines. They transmit very low voltage electrical impulses to a small area.  This is felt as a buzzing sensation and it can prevent the nerves from sending pain messages to the brain. You may be able to try this at a Pain Clinic.

Self-care tips include:

•    Wear loose-fitting clothing - this may help you to feel more comfortable
•    Do not use scented soaps or bath oils.

It's okay to have the shingles vaccine if you've already had shingles. The shingles vaccine has been known to work well in people who have had shingle as it has been known to boost immunity against further shingles attacks.

In the NHS, the shingles vaccine is routinely available to people aged 70 and 78 (from September 2016). This remains so, until the last day of August 2017. Additionally, any eligible person in the previous three years who has missed out remains eligible until their 80th birthday. This includes:

Aged 71, 72, 73 on 1 September 2016.

Aged 79 on 1 September 2016.

Until 31 August 2016, the shingles vaccine is still available to all those who were aged 70 or 78 on 1 September 2015.

I hope this is of some help to you

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