The painful skin rash known as shingles strikes about one-third of American adults at some point in their lives, most commonly after age 60. 

If you had chicken pox as a child, you still have the varicella zoster virus in your nerve tissue, which can lead to shingles years later. People whose immunity is weakened by cancer or a chronic health problem, such as diabetes, are more likely to get shingles. The itchy, painful rash and fluid-filled blisters can last for up to six weeks.

Medical doctors (MDs) often prescribe an antiviral, such as acyclovir (Zovirax) or valacyclovir (Valtrex), as soon as symptoms begin, to shorten the course of the illness and lessen associated nerve pain. Other commonly prescribed medications include over-the-counter (OTC) painkillers, such as ibuprofen (Motrin)…numbing topical agents, including lidocaine…powerful prescription antidepressants, such as nortriptyline (Pamelor)…nerve pain medication, including the antiseizure drug gabapentin (Neurontin)…and opioid pain medications

However: Prescription antivirals do not affect the frequency of shingles recurrence, and drugs used to treat shingles-related pain can have side effects, ranging from liver and kidney damage to opioid-related addiction.

Simple self-care steps I recommend…

• Wear loose, comfortable clothing until the pain eases. If the pain is too intense to leave the house, wear a lightweight cotton robe until you get relief. 

• Soak in a lukewarm bath for 15 minutes. Add to bathwater a cup or two of colloidal oatmeal or baking soda, which can ease pain and itchy blisters. Important: Avoid bathing or showering in hot water during an outbreak of shingles—heat increases blood flow to the skin, which can worsen pain. 

• Try a cool washcloth. Soak a washcloth in cool water, wring it out and hold it on the rash for several minutes to ease pain. 

• Use a soothing topical. Mix two tablespoons of baking soda or cornstarch and one tablespoon of water. Gently apply it to the rash, and rinse off with cool water after 15 minutes. Also helpful: Freshly squeezed aloe gel, as needed, or capsicum, also known as capsaicin, a popular topical nerve-pain blocker derived from hot peppers.

Beyond self-care: As a naturopathic doctor (ND), I often prescribe natural therapies instead of prescription medications to help ease symptoms and restore the body’s self-healing capacities following shingles. Important: These therapies should not be self-administered. An ND* or other health-care practitioner who is knowledgeable in the use of botanical medicines should be consulted for proper dosing and monitoring. 

What I often prescribe for shingles…

• Chinese liniment (Zheng Gu Shui) or efficascent oil, a Filipino remedy, can be helpful for pain. (I advise my patients to avoid using either product near the eyes, nose or mouth.) Most NDs can boost the effectiveness of efficascent oil by using an ultrasonic device to help the active components penetrate affected areas more deeply.

• Lomatium is a potent herbal anti-viral that reduces the risk for recurrence of shingles. An oral supplement of an isolate of lomatium can be taken…or a few drops of lomatium tincture can be added to an eight-ounce glass of water. Caution: Lomatium can cause a rash in some people, so a small dose usually is prescribed initially and stopped if there are any signs of a new rash. 

Best practice: An MD and ND should collaborate on the most effective therapies for you, based on your age, medical history, chronic conditions and use of any medications. To reduce risk for lingering shingles pain (postherpetic neuralgia), prescription antiviral medication is advisable (within 48 to 72 hours of the onset of shingles symptoms).

*To find a naturopathic doctor (ND) near you, consult the American Association of Naturopathic Physicians at Naturopathic.org.