Shingles is a reactivation of the virus that causes chickenpox, called varicella-zoster. After recovering from chickenpox, this virus can lie dormant or inactive in your body for decades before reactivating.
Its hallmark symptom is a rash on one side of your body. the
Shingles has no cure. But doctors often prescribe antiviral drugs to shorten its duration and reduce its severity.
Topical treatments like creams, ointments, and lotions can help manage irritation and itching. They can also help manage persistent nerve pain called postherpetic neuralgia (PHN). Some topical treatments are available over the counter. For others, you will need a prescription from a healthcare professional.
Here is an overview of creams and other topical treatments available for shingles.
What is the difference between cream, lotion and ointment?
Ointments, lotions, and creams are three types of substances you can apply to your skin to help manage shingles.
These topicals are similar, but there are slight differences in their composition. The main difference is the amount of water and oil they contain.
According to this 2016 primer, creams are roughly equal parts oil and water and often have moisturizing properties. They are thicker than lotions but thinner than ointments.
Lotions are similar to creams, but they are made up mostly of water. They have less oil and have a thinner consistency. Because they are thinner, your skin absorbs them faster. Some lotions are oil-free.
Ointments are the thickest of the three. They are made to stay on your skin instead of being absorbed immediately. Ointments are at least 80% oil.
The following creams can help you manage the symptoms of shingles.
Lidocaine cream and patches
Lidocaine 5% is a prescription drug. This
PHN is a complication of shingles characterized by long-term nerve pain after your rash goes away. The CDC says that approximately
Lidocaine is often given in patches. The study linked above notes that up to 3 patches can be applied in a 12 hour window.
Capsaicin is the chemical found in hot peppers that makes them spicy. Capsaicin cream can desensitize nerve fibers and potentially help with PHN. You can get it over the counter (OTC) or with a prescription.
According to this
Cream of Eutectic Mixture of Local Anesthetics (EMLA)
EMLA cream is a prescription medication that is made up of a 1:1 ratio of 2.5% lidocaine and 2.5% prilocaine.
A 2018 one-person case study found that EMLA cream may be an effective alternative to lidocaine cream for the treatment of PHN in people with special conditions such as kidney failure. However, there is not much research available on its effectiveness. Most of the existing research dates from the 80s and 90s.
A doctor can give you specific instructions on how to use EMLA cream.
Topical antibiotic creams
Topical antibiotic creams like mupirocin or soframycin can help prevent bacterial infection around a shingles rash. These antibiotics are only available by prescription. A doctor or pharmacist can recommend the frequency of application.
Other topical solutions that can help manage your shingles symptoms include:
Calamine lotion is an over-the-counter medication that the
Liquid dimethyl sulfoxide (DMSO) and idoxuridine
Idoxuridine is an antiviral drug approved in Europe for the treatment of shingles.
A 2015 publication suggested that frequent application of 5-40% idoxuridine dissolved in DMSO could speed up the healing time of shingles. However, in the United States, idoxuridine is only FDA-approved to treat keratitis, a herpes simplex virus infection of the cornea of your eye.
Burow’s solution, or aluminum acetate, is an over-the-counter astringent. Astringents have a protective effect against inflamed and irritated skin.
There is a limited amount of evidence that Burow’s solution can help heal shingles, but it’s possible that it can help soothe the blisters.
You can try applying a 5% aluminum acetate solution for about 30 to 60 minutes at a time.
Bathing your blisters in saline solution several times a day can help reduce inflammation. You can cover your blisters with a non-stick bandage afterwards to prevent other people from coming into contact with the blisters.
Aloe and other topical botanical therapies
Aloe vera has antiviral effects. A
It’s unclear if aloe vera gel is effective for treating shingles, but some people anecdotally report that it helps with redness and inflammation.
In a 2021 case report, a person showed substantial improvement after applying a topical botanical formulation that included:
When using a topical cream, it’s important to follow your doctor’s instructions or the directions on the package. This should help you avoid unwanted side effects.
Applying topicals too long or too often can lead to skin irritation or even more serious side effects.
Topical lidocaine can cause side effects such as:
- severe burning, stinging, irritation
- swelling or redness
- unusual temperature sensation
- skin color changes
- bruising or purple
Some topical solutions for shingles are only available by prescription. You can find other OTCs.
Over-the-counter medications do not require a pharmacist’s approval. You can buy them online, at pharmacies, and other places that sell drugs.
If you suspect you have shingles, it’s important to see a healthcare professional as soon as possible. According to the American Academy of Dermatology (AAD), treating shingles within the first 72 hours gives you the best chance of minimizing complications such as nerve pain.
Antiviral drugs or other medications available only by prescription can shorten the duration of your shingles or lessen its severity.
If a cream or other topical doesn’t reduce your pain, it’s a good idea to see your doctor again. They may recommend trying another treatment like capsaicin cream instead of lidocaine.
If a product makes your symptoms worse, it is important to stop taking it immediately.
You may be able to reduce your symptoms by using home remedies while you wait to see a healthcare professional. These include applying a damp cold compress or taking a cool bath.
Learn more about home remedies for shingles here.
The AAD suggests that treating shingles within the first 72 hours gives you the best chance of minimizing complications such as nerve pain. A doctor may prescribe medications such as:
- antiviral medicines, such as acyclovir or valacyclovir, to help your body fight the virus faster
- anti-inflammatory drugs, such as ibuprofen, to relieve swelling and pain
- opioid medications, such as hydrocodone and tramadol (and less commonly morphine), to reduce pain
- other medications, such as anticonvulsants and tricyclic antidepressants
- antihistamines, such as diphenhydramine, to treat itching
- numbing agents like lidocaine
Learn more about shingles treatment here.
Certain creams or other topical medications can help you manage shingles symptoms. But they are not a substitute for proper medical treatment.
It is essential to see a medical professional for a proper evaluation if you think you have shingles. They may prescribe antiviral drugs or other medications that can lower your risk of developing long-term complications.