Natural treatments for shingles

• PRINCIPAL PROPOSED NATURAL TREATMENTS: Capsaicin, proteolytic enzymes

• OTHER PROPOSED NATURAL TREATMENTS: Acupuncture, adenosine monophosphate, vitamin B₁₂, vitamin E

DEFINITION: Treatment of a painful and acute skin infection and continuing irritation of the nerves that develops years after a person has had chickenpox

Introduction

Shingles, or herpes zoster, is an acute, painful infection caused by the varicella-zoster virusthe organism that causes chickenpox. It develops many years after the original chickenpox infection, typically in older adults or those with compromised immune systems.

The first sign of shingles infection may be a tingling feeling, itchiness, or shooting pain on an area of the skin. A rash may then appear with raised dots or blisters. 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 resolve without complications within three to five weeks. However, in some people, especially older adults, the pain may persist for months or years. This condition is known as postherpetic 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 drugsacyclovir, famicyclovir, valacyclovir. When used properly, these lead to faster resolution of symptoms, which include lesions and acute neuralgia, and may reduce the incidence and severity of PHN. Steroids like prednisone and tricyclic antidepressants like amitriptyline are also prescribed to lessen shingles symptomsthe former might help prevent PHN. People who develop PHN may be treated, in severe cases, with nerve blocks.

Principal Proposed Natural Treatments

For the initial attack of shingles, proteolytic enzymes may be helpful. Capsaicin cream is a PHN treatment approved by the U.S. Food and Drug Administration (FDA).

Proteolytic enzymes. 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 the digestion of protein. Certain foods also contain these enzymes. Besides their use in digestion, these enzymes may have some effects on the body as a whole when taken orally.

Proteolytic enzymes are thought to benefit cases of shingles by decreasing the body’s inflammatory response and regulating the immune response to the virus. The most-studied proteolytic enzymes include papain from papaya, bromelain from pineapple, trypsin, and chymotrypsin, which is extracted from the pancreas of various animals.

A double-blind study of 190 people with shingles compared proteolytic enzymes to the standard antiviral drug acyclovir. Participants were treated for fourteen days, and their pain was assessed at intervals. Although both groups had similar pain relief, the enzyme-treated group experienced fewer side effects. Similar results were seen in another double-blind study in which ninety people were given either an injection of acyclovir or enzymes, followed by a course of oral medication for seven days.

Capsaicin. Capsaicin, the “hot” in hot peppers, has been found effective for treating 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.

Topical capsaicin cream like Zostrix HP is available in two strengths0.025 and 0.075 percent. 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 because 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.

A transdermal patch containing a relatively high concentration of capsaicin percenthas been developed. Compared to a low-concentration 0.04 percent version, the high-concentration patch was associated with significant improvements in pain in a trial involving 402 adults with PHN for a minimum of six months.

Other Proposed Natural Treatments

Adenosine monophosphate (AMP), a natural by-product of cell metabolism, has been studied as a possible treatment for initial shingles symptoms and for PHN prevention.

In a double-blind, placebo-controlled study of thirty-two people with shingles, AMP was injected three times per week for four weeks. At the end of the four-week treatment period, 88 percent of those treated with AMP were pain-free versus only 43 percent in the placebo group; all participants still in pain were then given AMP, and no recurrence of pain was reported in three to eighteen months of follow-up. However, this was a preliminary study, and more evidence is needed before AMP can be considered a proven treatment for shingles. Oral AMP has not been tried for this condition should not self-inject AMP products meant for oral consumption.

Vitamins E and B₁₂ have also been suggested as possible treatments for PHN, but the evidence that they work is extremely weak. Also, a single-blind, placebo-controlled study of sixty-two people with PHN failed to find any benefit with acupuncture treatment.

Topical licorice, Gentiana scabra oil, German chamomile oil, tea tree oil, eucalyptus oil, and topical versions of St. John's wort have also been proposed as shingles treatments, but these may have harsh reactions on the skin and have not been scientifically proven.

Care should be taken when consuming supplements and natural herbs, and a medical professional should be consulted before beginning a new regimen. Many substances marketed as all-natural may promise results that are questionable and may, in fact, be dangerous to combine with other medicines. Nonetheless, some natural treatments like green tea and melatonin may help alleviate symptoms and negative side effects, such as sleeplessness and anxiety.

Although there is no known cure for shingles, there are multiple options for natural ways to alleviate the symptoms. Lifestyle changes may also improve symptoms of shingles. These begin with improved dietary intake. A healthy diet to counter shingles includes an emphasis on fruits and vegetables, as well as proteins from meats. Fermented foods or foods that are red, orange, or dark green in color are likely to be beneficial. In addition, some foods should be avoided or at least decreased in frequency, like sugar-rich juices, excessive carbohydrates, high fructose syrups, and saturated fats. Exercise can be an important component of a strategy to alleviate shingles. This can result in multiple positive impacts beyond relief from shingles. This includes helping to maintain a healthy weight and getting enough sleep. Tobacco products should be eliminated, and alcohol should be limited when experiencing shingles.

Other natural treatments do not involve ingesting substances. For example, someone with shingles can immerse themselves in a tub of cool water. Adding one to two cups of oatmeal or cornstarch may also relieve symptoms. A paste made from cornstarch or baking soda mixed with water at a ratio of two parts dry material to one part water may also be applied to the skin. After fifteen to twenty minutes, the mixture should be washed off, but it can be reapplied several times each day. Using petroleum jelly, calamine lotion, or antihistamine creams on the skin may help keep blisters and lesions moisturized.

Bibliography

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Armour, Mike, et al. “Efficacy of a Topical Herbal and Mineral Formulation (Dynamiclear) for the Treatment of Herpes Simplex Labialis in the Community Setting: Study Protocol for a Randomised, Double-Blind Placebo-Controlled Trial.” BMJ Open, vol. 10, no. 1, 2020, doi:10.1136/bmjopen-2019-031876.

Backonja, M., et al. “NGX-4010, a High-Concentration Capsaicin Patch, for the Treatment of Postherpetic Neuralgia.” Lancet Neurology, vol. 7, 2008, pp. 1106-12.

Billigmann, P. “Enzyme Therapy: An Alternative in Treatment of Herpes Zoster.” Fortschritte der Medizin, vol. 113, 1995, pp. 43-48.

"Shingles (Herpes Zoster): Symptoms & Treatment." Cleveland Clinic, 2 Feb. 2022, Cleveland Clinic, my.clevelandclinic.org/health/diseases/11036-shingles. Accessed 30 Sept. 2024.

Weaver, Bethany A. “Herpes Zoster Overview: Natural History and Incidence.” Journal of the American Osteopathic Association, vol. 109, 2009, pp. S2-S6.

Weiss, Cynthia. "Mayo Clinic Q and A: Shingles - Not Just a Band of Blisters.” Mayo Clinic, 28 Nov. 2022, newsnetwork.mayoclinic.org/discussion/mayo-clinic-q-and-a-shingles-not-just-a-band-of-blisters. Accessed 30 Sept. 2024.

Wilson, Debra Rose. "Six Natural Treatments for Shingles.” Healthline, 3 Feb. 2023, www.healthline.com/health/shingles-natural-treatment. Accessed 30 Sept. 2024.