Can I use hydrocortisone cream on shingles rash?

Hydrocortisone cream is not recommended to put on a shingles rash and there is no evidence that hydrocortisone cream will help treat the pain of a shingles rash. The preferred treatment for shingles are antiviral medicines that you take by mouth, such as acyclovir, valacyclovir and famciclovir. These require a prescription from your doctor.

It is best to keep the rash clean and dry and not put anything on the rash if possible. Cover the rash with a nonstick dressing to prevent the virus that causes shingles being passed onto other people. The shingles rash is contagious until all the blisters have scabbed over and are dry. If the blisters are covered with a dressing, it is unlikely that the virus will pass on to others.

In general, it is best to avoid applying lotions or creams (eg, moisturizer) to the affected area, as this can further irritate the skin. If you do want to put something on your shingles rash, then the American Academy of Dermatology Association recommends using calamine lotion for shingles. Calamine lotion has a cooling effect and can help reduce itching. Other topical treatments for shingles include wet compresses and colloidal oatmeal baths.

But oral antiviral treatment remains the preferred treatment for shingles and this will help the rash heal faster, reduce shingles pain, and reduce the risk of postherpetic neuralgia (long-lasting nerve pain in an area of skin previously affected by shingles) developing. Oral antivirals are most effective when started within 72 hours after the shingles rash appears. The three antiviral drugs used to treat shingles are:

• Acyclovir
• Famciclovir
• Valacyclovir.

Other oral treatments include acetaminophen or ibuprofen for pain relief. Sometimes, oral corticosteroids may be prescribed alongside oral antivirals if inflammation is severe.

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