Herpes Zoster Treatment in NYC

Herpes zoster, commonly known as shingles, is a painful, blistering skin condition caused by the reactivation of the varicella-zoster virus—the same virus that causes chickenpox. At Aglow Dermatology in New York City, we have a shingles specialist who offers expert, compassionate care for herpes zoster to reduce discomfort, speed healing, and prevent complications.

What Is Herpes Zoster or Shingles?

Herpes zoster is a reactivation of the varicella-zoster virus (VZV) that lives dormant in your nerves after a chickenpox infection. When your immune system weakens due to age, stress, or illness, the virus can “wake up” and travel along nerve pathways, causing a painful, burning rash typically on one side of the body or face. The rash tends to follow.

How Do You Get Herpes Zoster?

You cannot catch shingles from another person. However, someone with active shingles can spread chickenpox to people who’ve never had it or been vaccinated. That’s why if you have shingles, you should avoid contact with:

• Pregnant women
• Infants
• People with weakened immune systems
• Anyone unvaccinated for varicella

Herpes Zoster and Chickenpox: The Connection

The varicella-zoster virus causes both chickenpox and shingles. After recovery from chickenpox, the virus remains dormant in your spinal nerves. Years later, it can reactivate as shingles—especially when your immune defenses are low.

Who Is at Risk for Shingles?

Shingles risk increases with:

• Age over 50
• Immune suppression (HIV, cancer, biologics, chemo)
• Chronic illnesses
• High stress or recent illness
• History of chickenpox

How Long Does Zoster Last?

Most outbreaks last 2–4 weeks. Without treatment, symptoms may linger longer, and complications such as postherpetic neuralgia (PHN) may persist for months or even years.

Herpes Zoster Treatment Guidelines

Start Antivirals ASAP (within 72 hours of rash):

• Acyclovir: 800 mg 5x/day for 7–10 days
• Valacyclovir (Valtrex): 1000 mg 3x/day for 7 days
• Famciclovir (Famvir): 500 mg 3x/day for 7 days

👉 Valtrex and Famvir are preferred due to simpler dosing and higher absorption.

Pain Relief for Active Shingles:

• NSAIDs (e.g., ibuprofen, naproxen)
• Cool compresses
• Topical lidocaine patches or gels
• Oral prednisone may help reduce nerve inflammation if started early

Shingles Treatment – Topical Options

Topical treatments help manage discomfort:

• Lidocaine for numbing
• Capsaicin for nerve pain (PHN)
• Aloe vera or calamine for soothing blisters (supportive only)

Managing Postherpetic Neuralgia (PHN)

If pain persists after the rash resolves, you may have PHN. Treatment includes:

• Gabapentin or pregabalin
• Tricyclic antidepressants (e.g., amitriptyline)
• Referral to a neurologist for pain control
• Prevention: Early antivirals, Shingrix vaccine

Shingles Vaccine: Should I Get It?

Yes! The Shingrix vaccine is over 90% effective at preventing shingles and PHN.

• Recommended for adults 50+
• Also for immunosuppressed adults 19+
• Given as 2 doses, 2–6 months apart
• You can and should get it even if you’ve had shingles or chickenpox

Can You Get the Vaccine on Immunosuppressants?

Yes. Unlike the older Zostavax, Shingrix is a non-live recombinant vaccine, making it safe for people on biologics or chemotherapy. Discuss with your dermatologist or primary provider.

Can You Get Shingles Without a Rash?

Yes. Zoster sine herpete is a rare form of shingles that presents with nerve pain but no rash. It’s more difficult to diagnose and may require imaging or antibody testing.

Shingles Complications to Know

Untreated or severe shingles can lead to:

• Postherpetic neuralgia (chronic nerve pain)
• Scarring and hyperpigmentation (especially in skin of color)
• Hair loss if it affects the scalp
• Vision loss or blindness if it affects the eye (herpes zoster ophthalmicus)
• Hearing loss, facial paralysis, or encephalitis (rare)

Treatment for Herpes Zoster Ophthalmicus

Shingles near the eye is a medical emergency. It requires:

• Immediate antiviral treatment
• Referral to an ophthalmologist
• Pain control and possible long-term follow-up

Will Shingles Heal on Its Own?

Sometimes—but without antiviral treatment, shingles lasts longer and is more likely to cause complications like scarring or nerve pain. That’s why seeing a dermatologist early is critical. It’s best to start treatment within 72 hours of symptoms.

Shingles Scar Treatment

If shingles leaves behind scarring or discoloration, we offer advanced treatments to restore your skin:

• RF Microneedling
• Laser resurfacing
• Chemical peels
• Topical pigment correctors

Why You Should See a Doctor for Shingles

Still wondering, “Do I need a doctor for shingles?” The answer is yes—especially if:

• The rash is on your face, scalp, or near the eyes
• You’re under 50 with an unexplained rash
• You have severe pain
• You have a weakened immune system
• You want to prevent long-term complications

Dermatologists are shingles specialists trained to diagnose, treat, and manage all stages of herpes zoster—including the pain, pigment changes, and scarring.

When Is Shingles an Emergency?

Get medical attention if you experience:

• Eye involvement
• Severe headache, neck stiffness
• Confusion, dizziness
• Facial weakness or trouble speaking

How Often Should You Get the Shingles Vaccine?

Shingrix is a 2-dose series. No booster is currently needed, though future guidelines may evolve. If you received the old Zostavax, it’s still recommended to get Shingrix.

Schedule Your Shingles Evaluation Today

If you’re experiencing symptoms or concerned about shingles, don’t wait. Early care can make all the difference.
📞 Call/Text: 212-627-1004
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