"Standard" shingles treatments often fail

Posted June, 2008

The standard treatments for Shingles, especially postherpetic neuralgia (PHN) are often ineffective. If we examine the usual process of treatment for PHN, it often goes like this: first the treating physician may prescribe Lidocaine patches, which numb the skin somewhat, but this technique may not be enough to make the pain subside.

The plan of attack might also include topical salves containing Capsaicin (basically a pepper extract that can cause a burning sensation), topical aspirin compounds (which are inflammable, a potential safety issue), and even skin coolants like Ethyl Chloride. There are serious drawbacks to all of these approaches, especially considering that none of them work well enough to make the patient's pain "go away," or at least descend to a minimal level.

If the previous list of products fails, the physician may prescribe a low-dose tricyclic antidepressant, often nortriptyline (Pamelor, Aventyl). This, too, often fails to provide sufficient relief from severe PHN pain.

Next may come a prescription for Gabapentin (an anti seizure agent such as Neurontin®). The patient will begin using this drug at a low dose and then the physician will increase it until there's some relief or until severe side effects occur. These types of drugs sometimes have unpleasant side effects that include sleepiness, inability to concentrate, and others. At the doses required to provide substantial relief for Shingles, when they're the only treatment employed, they sometimes make the patient feel worse rather than better.

Finally, the physician may try using opiods or similar potent painkillers. There are some drawbacks here, including dependency and gradual "immunity" from the opiod's painkilling effect. At the high doses that may be required to help with severe PHN, the patient may be chronically sleepy, feel disoriented and confused, and may suffer from other unintended effects.

All of these "standard" treatments often fail to significantly improve the patient's life. We strongly believe there's an alternative if you've tried such methods and have still not found relief.