How to Soothe a Shingles Rash If the Pain Is Making You Miserable
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Thanks to its hallmark rash, which is characterized by red to brownish bumps that blister, leak fluid, and scab over, shingles, a.k.a. herpes zoster, is usually simple to diagnose.
In its earliest stages, however, shingles can be slightly more insidious. That’s because the infection begins with nerve discomfort: a deep burning, sharp tingling, or deep-seated itch in an area where a painful rash will ultimately emerge. “There’s nothing necessarily on the surface of the skin initially,” Susan Massick, MD, a clinical associate professor of dermatology at The Ohio State University Wexner Medical Center, tells SELF.
But being vigilant and seeking medical attention at the first sign of the illness—which is caused by a reactivation of the varicella-zoster virus, the same culprit behind chicken pox—can make a big difference in your recovery. Starting a course of antiviral medication within 72 hours of spotting a shingles rash can help you feel better faster. It also significantly reduces your risk of experiencing a type of pain known as postherpetic neuralgia long after the blisters have healed, says Jason Miller, MD, the medical director for Schweiger Dermatology Group’s New Jersey and Long Island region.
Shingles will improve without antivirals, but it will take longer and feel a lot worse, Dr. Massick says. If you can see a doctor ASAP, you should. The blisters generally scab over within 10 days, but it can take between two and four weeks for them to fade completely. Still, that doesn’t mean you have to grit your teeth and bear the pain. You can take steps to help ease the discomfort. Ask your doctor if some of these options may be helpful for you.
How to take care of a painful shingles rash
Early on, shingles can feel a lot like the flu. You might be hit with severe fatigue, a fever and chills, a pounding headache, or an upset stomach. To help, you’ll want to get plenty of rest and fluids, eat nutritious foods that are easy to digest, and avoid stress. Once the rash develops the symptoms can be a lot to handle, especially if you’re still feeling crummy and rundown. However, there are a few things experts recommend you do at home to ease your skin symptoms and prevent anyone around you from getting sick as the infection runs its course.
1. Clean the rash with a simple cleanser.
Your skin is already angry, so do your best to avoid products that might irritate it further, including harsh soaps. Use a fragrance-free wash with a creamy formula, which tends to be less drying—think a thicker, lotion-like consistency versus a thin and sudsy one. (Soothing and hydrating ingredients like hyaluronic acid, ceramides, and colloidal oatmeal are nice bonuses.) Steer clear of physical exfoliants or scrubs, chemical exfoliants (salicylic or glycolic acids, for example), acne fighters like sulfur or benzoyl peroxide, botanicals such as essential oils, and other active ingredients that might stress out sensitive skin. The simpler the better.
Dr. Miller says cleaning your rash once a day is plenty. If you choose to do so in the shower, use lukewarm water; high heat and humidity can aggravate the skin, Dr. Massick notes. Wash your hands well after touching the blisters to lessen the chance you’ll spread the virus to others, which brings us to our next point.
2. Cover the area to keep it (and others) protected.
Shingles itself isn’t contagious. However, the fluid from your blisters can spread the varicella-zoster virus, which can potentially cause a chicken pox infection in folks who’ve never had the illness nor the chance to be vaccinated against it. Exposure can be particularly risky for infants, who aren’t eligible for chicken pox vaccination until they’re a year old; pregnant people and their fetuses; and folks with compromised immune systems, per the Centers for Disease Control and Prevention (CDC).
One good thing to know: You can’t transmit the virus once the rash has fully crusted over and stopped producing fluid. But keeping your rash covered lowers your chances of spreading the virus when you’re contagious, whether you live with someone high-risk or need to venture out into your community. It also helps keep the skin clean as the blisters start to scab over and it limits friction against the rash, which promotes healing, reduces itchiness, and prevents additional irritation.
As a first layer use nonstick dressings or pads, which you can find at your local drugstore or pharmacy, and secure them with cotton gauze, Dr. Miller says. Gauze adheres to skin easily and can be uncomfortable to remove, so avoid putting it directly on the rash. Change the dressing once a day, ideally after cleaning the area.
Loose-fitting clothes will also feel better than tight or compressive options. “You don’t want to wear anything rough or heavy like wool or denim,” Dr. Massick says. Choose airy fabrics like cotton or linen instead.
3. Soothe your skin with over-the-counter remedies.
If your rash is feeling really tender, sensitive, or itchy, try calming it down before covering it up. Here are a few remedies that are safe to try at home.
Cool compresses: Applying a clean, cool, and damp washcloth to the rash for 5 to 10 minutes can bring relief. Repeat several times a day if needed.
Oatmeal bath: Soaking in a cool bath that contains colloidal oatmeal, which has anti-inflammatory properties, can also feel nice, Dr. Miller says.
Gentle moisturizers: Your skin might feel dry, tight, and flaky, especially when the rash starts to scab. Using simple, fragrance-free moisturizers helps tame itchiness and support your skin’s healing. Look out for calming and protective ingredients like colloidal oatmeal, ceramides, and aloe. Once the blisters have completely dried up, you can use petroleum jelly to promote quicker wound healing and much-needed moisture.
Calamine lotion: This soothing salve can curb itchiness and dry out spots that are still oozing or weeping fluid.
4. Rely on pain relievers as needed.
Again, taking antiviral meds as soon as possible is the best way to minimize shingles-related nerve pain. But if you need reinforcements, over-the-counter pain medications, including ibuprofen (Advil) and acetaminophen (Tylenol), can temporarily quell the discomfort. Ask your doctor what dosage they recommend and how often you should take either drug based on your symptoms and medical history.
Dr. Miller also recommends trying OTC capsaicin creams like Zostrix after the blistering phase of the rash has resolved to help with any residual nerve pain. (Yep, these products are made with the same substance that gives chiles their heat.) The cream might sting when you first apply it, but that’s a sign that it’s working: It starts by rapidly firing up your nerve cells. Then the activity of these nerve cells swiftly drops so they “aren’t able to fire and create a sensation of pain,” resulting in several hours of relief, Dr. Miller explains. Just be sure to wash your hands with soap after using the cream—you don’t want this stuff near your eyes, nose, or mouth.
If your shingles rash is severe, meaning it’s widespread and the pain is tough to endure, your doctor might also prescribe a stronger medication, like an oral or injectable steroid, to tamp down inflammation quickly.
5. Call your doctor if your symptoms feel worse.
It’s possible to get a secondary bacterial infection with shingles, but it’s fairly rare. That’s why Dr. Miller and Dr. Massick don’t recommend slathering the area with antibiotic ointment; it isn’t useful against the virus and can cause irritation and allergic reactions for some people.
However, scratching or picking at shingles blisters or scabs can up your risk of introducing harmful germs, so try to keep your fingers off the rash (another reason why covering it is helpful). Reach out to your doctor if your skin seems to improve only for you to develop any of the following symptoms, which may signal a secondary infection and warrant a check-in:
Increased pain and swelling
Increased redness or other skin discoloration
The affected area feels warm to the touch
Yellowish fluid oozing from the blisters
Yellowish crusting of the skin
An unpleasant odor emitting from the blisters
6. Baby your skin once it’s healed too.
Shingles rarely leaves behind major scars, but it depends on the severity of your rash, Dr. Miller says. If you have a lot of blisters and pick or pull off the scabs, you’re more likely to deal with marks, he explains. But if you have a mild, localized rash and quickly start an antiviral treatment, your skin will probably heal just fine. It’s worth noting that people with medium-to-deep skin tones have a higher risk of hyperpigmentation, or dark spots, per the American Academy of Dermatology.
Don’t stop caring for your rash after making it through the worst stages—freshly healed skin still needs tending. One of the best things you can do is minimize direct sun exposure and reapply sunscreen as needed. “[Sun exposure] will prolong the discoloration from any type of injury or inflammation to the skin,” Dr. Massick says.
And remember, anyone with shingles can wind up with complications, but they’re most common in older adults. If you’re still feeling unusual pain or other out-of-the-ordinary sensations after the rash is gone, or if you’re noticing problems with your vision, hearing, or balance, get back in touch with your doctor. The symptoms may be unrelated to your bout with herpes zoster, but you’ll rest more easily knowing you’re in the clear.
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Originally Appeared on Self
