Behandlung: Virostatika & Symptomlinderung

Antiviral medication: the core of treatment

The standard of care for shingles is antiviral medication. The three main antivirals are:

• Aciclovir (Zovirax) — typically 800 mg, 5 times daily for 7 days
• Valaciclovir (Valtrex) — typically 1,000 mg, 3 times daily for 7 days
• Famciclovir (Famvir) — typically 500 mg, 3 times daily for 7 days

Valaciclovir and famciclovir are generally preferred due to simpler dosing schedules. All three reduce viral replication, speed healing, and lower the risk of complications when started within 72 hours.

Evidence-backed symptom relief

While antivirals target the virus, supportive care helps manage symptoms:

• Pain management: NSAIDs (ibuprofen, naproxen) or paracetamol for mild to moderate pain. Stronger prescription pain relief may be needed for severe pain.
• Wet dressings: Cool compresses with 5% aluminium acetate (Burow's solution) applied for 20–30 minutes, 3–4 times daily — supported by clinical evidence.
• Calamine lotion: May help soothe itching; apply gently to intact skin.
• Loose clothing: Reduces friction and irritation on the affected area.

What the evidence does NOT support

There is no reliable evidence from controlled trials that the following alter the course of shingles:

• Dietary supplements or "immune-boosting" products
• Homeopathic remedies
• Topical antibiotics (unless a secondary bacterial infection is diagnosed)

Complementary approaches and the evidence

The Cochrane Library has reviewed several complementary approaches. Most have insufficient evidence for firm recommendations. Some areas with limited or mixed evidence include acupuncture for PHN pain and transcutaneous electrical nerve stimulation (TENS). These may be discussed with a healthcare provider as adjunctive options, not replacements for antiviral treatment.