Zoster vaccine is the most effective strategy to prevent shingles and toameliorate complications such as postherpetic neuralgia. Antiviral treatment is effective in treating shingles attacks if used early.
- Shingles, or herpes zoster, is common, with a lifetime risk of up to 50% in people who live to the age of 85 years.
- Complications, especially postherpetic neuralgia (PHN), increase significantly in older age groups.
- Immunisation with zoster vaccine is the most effective strategy to boost immunity and prevent shingles and ameliorate its complications including PHN.
- Antiviral treatment with famciclovir, valaciclovir or aciclovir has proven efficacy for shingles and is most effective if commenced within 72 hours of rash onset.
- Analgesia for acute pain should be titrated against the severity of the pain; referral of patients to a pain clinic is recommended if pain is evolving into PHN.