Shingles (Herpes Zoster)
• Post-herpetic Neuralgia
Herpes zoster (shingles) is an acute, painful infection caused by the varicella-zoster virus, the organism that causes chicken pox. It develops many years after the original chicken pox infection, typically in the elderly or those with compromised immune systems. The first sign may be a tingling feeling, itchiness, or shooting pain on an area of skin. A rash may then appear, with raised dots or blisters forming. When the rash is at its peak, rash symptoms can range from mild itching to extreme pain. People with shingles on the upper half of the face should seek medical attention, as the virus may cause damage to the eyes.
Shingles usually resolves without complications within 3 to 5 weeks. However, in some people, especially seniors, the pain may persist for months or years. This condition is known as post-herpetic neuralgia (PHN). It is thought to be caused by a continuing irritation of the nerves after the infection is over.
Conventional medical treatment for shingles includes antiviral drugs (acyclovir, famicyclovir, valacyclovir). When used properly, these lead to faster resolution of symptoms including lesions and acute neuralgia, and may reduce the incidence and severity of PHN.
Individuals who do develop PHN may be treated with steroids, antidepressants, and topical creams (
Principal Proposed Natural Treatments
For the initial attack of shingles, proteolytic enzymes may be helpful.Capsaicin cream is an FDA-approved treatment for PHN.
There is some evidence that proteolytic enzymes may be helpful for the initial attack of shingles.
Proteolytic enzymes are produced by the pancreas to aid in digestion of protein, and certain foods also contain these enzymes. Besides their use in digestion, these enzymes may have some effects in the body as a whole when taken orally. The most-studied proteolytic enzymes include papain (from papaya),
(from pineapple), and
Similar results were seen in another double-blind study in which 90 people were given either an injection of acyclovir or enzymes, followed by a course of oral medication for 7 days.
Proteolytic enzymes are thought to benefit cases of shingles by decreasing the body's inflammatory response and regulating immune response to the virus.
For more information, including dosage and safety issues, see the full
Capsaicin: Useful for Post-herpetic Neuralgia
Capsaicin, the "hot" in hot peppers, has been found effective for treating the pain related to PHN, and has been approved by the FDA for that purpose. Capsaicin is thought to work by inhibiting chemicals in nerve cells that transmit pain (for further detail on how this works, see the cayenne
Topical capsaicin cream is available in 2 strengths, 0.025 and 0.075%. Both preparations are indicated for use in neuralgia. The cream should be applied sparingly to the affected area three to four times daily. Treatment should continue for several weeks as the benefit may take a while to develop. Capsaicin creams are approved over-the-counter drugs and should be used as directed.
Over-the-counter creams containing concentrated capsaicin are recognized as safe, but caution should be used near the eyes and mucous membranes. Mild to moderate burning may occur at first, but it decreases over time.
Other Proposed Natural Treatments
In a double-blind,
Oral AMP has not been tried for this condition. Note: Do not self-inject AMP products meant for oral consumption.
2. Kleine MW, Stauder GM, Beese EW. The intestinal absorption of orally administered hydrolytic enzymes and their effects in the treatment of acute herpes zoster as compared with those of oral acyclovir therapy. Phytomedicine. 1995;2:7–15.
Last reviewed April 2009 by EBSCO CAM Medical Review Board
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