How Doctors Treat Shingles in Older Adults

Shingles affects older adults more frequently and severely than younger people. Understanding how do you treat shingles in the elderly is crucial for managing this painful condition effectively.

This comprehensive guide explores treatment options, medications, and care strategies specifically designed for seniors dealing with shingles.

Understanding Shingles in Older Adults

Shingles, also known as herpes zoster, occurs when the varicella-zoster virus reactivates in the body. This same virus causes chickenpox during childhood. After chickenpox heals, the virus remains dormant in nerve tissues. As people age, their immune systems weaken, allowing the virus to reactivate and cause shingles.

The condition typically appears as a painful, blistering rash on one side of the body. Common locations include the torso, face, and neck. Early symptoms often include tingling, burning, or shooting pain before the rash appears.

Older adults experience more severe symptoms than younger patients. The pain can be excruciating and may persist long after the rash heals. This condition, called postherpetic neuralgia, affects up to 20% of shingles patients over age 60.

Primary Treatment Approaches for Elderly Patients

The following are primary treatment approaches to treat shingles in elderly patients.

Antiviral Medications

Antiviral drugs form the cornerstone of shingles treatment in elderly patients. These medications work best when started within 72 hours of rash onset. The three main antivirals used include:

Acyclovir (Zovirax)

Acyclovir is the oldest antiviral medication for shingles treatment. Doctors typically prescribe 800 mg five times daily for seven to ten days. While effective, it requires frequent dosing throughout the day.

Valacyclovir (Valtrex)

Valacyclovir offers improved convenience with better absorption rates. The standard dose is 1000 mg three times daily for seven days. This medication converts to acyclovir in the body but requires fewer daily doses.

Famciclovir (Famvir)

Famciclovir provides another effective option with good bioavailability. The typical dose is 500 mg three times daily for seven days. This medication works similarly to other antivirals but may cause fewer side effects.

Pain Management Strategies

Effective pain control is essential for management of shingles in elderly patients. Multiple approaches work together to provide optimal relief:

Over-the-counter pain relievers

Acetaminophen and ibuprofen are used for mild to moderate pain. These medications reduce inflammation and provide general pain relief. However, elderly patients should use them cautiously due to potential kidney and stomach issues.

Prescription pain medications

For severe pain, options include tramadol (Ultram) for moderate pain and stronger opioids for severe cases. These are prescribed carefully in elderly patients due to increased fall risk and cognitive effects.

Topical treatments

Topical treatments provide localized pain relief without systemic side effects. Lidocaine patches (Lidoderm) can be applied directly to the affected area. Capsaicin cream (Zostrix) may help with nerve pain, but can initially increase burning sensations.

Specialized Treatments for Elderly Patients

Specialized treatment approaches to treat shingles in elderly patients are:

Corticosteroids

Corticosteroids like prednisone may be prescribed alongside antiviral medications for elderly patients with severe inflammation. These medications can reduce swelling and potentially prevent postherpetic neuralgia.

However, they carry risks in older adults, including blood sugar elevation and increased infection risk.

Doctors typically prescribe a tapering dose starting at 60-80 mg daily for the first week. The dose gradually decreases over two to three weeks. Close monitoring is essential due to potential complications in elderly patients.

Nerve Pain Medications

When standard pain relievers prove insufficient, specialized nerve pain medications become necessary. These drugs target the specific type of pain caused by nerve damage from shingles.

Gabapentin (Neurontin)

Gabapentin is commonly prescribed for nerve pain management. Starting doses are typically 300 mg three times daily, with gradual increases as needed.

This medication can cause dizziness and confusion in elderly patients.

Pregabalin (Lyrica)

Pregabalin offers another option for neuropathic pain. The usual starting dose is 75 mg twice daily, with potential increases based on response and tolerance. Side effects include dizziness, weight gain, and swelling.

Complications and Prevention in Elderly Patients

Doctors for elderly patients can also prevent shingles-related complications in elderly patients.

Postherpetic Neuralgia

Postherpetic neuralgia represents the most common complication of shingles in elderly patients. This condition involves persistent nerve pain lasting months or years after the rash heals. The risk increases significantly with age.

Treatment for postherpetic neuralgia requires a multimodal approach. Medications include tricyclic antidepressants, anticonvulsants, and topical agents. Physical therapy and nerve blocks may provide additional relief for severe cases.

Secondary Bacterial Infections

Elderly patients face an increased risk of bacterial infections in shingles lesions. Weakened immune systems and slower healing contribute to this complication. Signs include increased redness, warmth, pus, and red streaking from the rash.

Treatment involves topical or oral antibiotics, depending on severity. Common choices include mupirocin ointment (Bactroban) for localized infections or cephalexin (Keflex) for more extensive involvement.

Treating Shingles in the Elderly in Central and South Florida

Managing shingles in elderly patients requires prompt, comprehensive care from experienced healthcare professionals. At Palm Medical Centers, our dedicated team understands the unique challenges older adults face when dealing with shingles and other health conditions.

Our experienced physicians, who truly listen to you, provide personalized treatment plans that address both immediate symptoms and long-term complications. We offer convenient locations, extended hours, and same-day appointments to ensure you receive timely care when you need it most.

Contact Palm Medical Centers today at (833) 500-PALM to schedule your consultation or visit our patient portal. Our compassionate team is ready to help you feel better and return to the activities you enjoy.