Can I use hydrocortisone cream on shingles rash blog image

Prevalence rates of shingles in the US, is relatively high with about one third of all adults expected to develop the condition once during lifetime. Shingles is a viral infection attributed to the varicella-zoster virus, that is also responsible for chickenpox. The virus is typically known to get reactivated in the body, in individuals who have previously had chickenpox, and this is known to cause the painful rashes of shingles. As a result of the high prevalence rates, many are known to try out certain unapproved treatments in an attempt to find relief. One such common question is – can I use hydrocortisone cream on shingles rash? Following sub sections offer detailed information about the condition, including answers to the question.

Overview of shingles

The rash typically appears as a single band or stripe of fluid-filled blisters generally located on one side of the body – usually the torso or face. The rash typically begins as red or itchy, and then gradually progresses to become clusters of blisters that eventually scab over. These blisters are known to heal over the course of many weeks. Symptoms linked to shingles include fever, headache, fatigue, and sensitivity to light. The rash, in addition to being painful, can persist long after healing. This condition is medically known as postherpetic neuralgia.

Overview of hydrocortisone cream and its uses

Belonging to the category of topical steroid medications, Hydrocortisone is used to reduce inflammation, itching, and redness on the skin, common among certain skin conditions. For instance, it is used to treat Eczema, Psoriasis, Contact dermatitis, Insect bites and stings and Skin rashes. The cream is generally not used on broken or infected skin.

Mechanism of action of hydrocortisone cream  

The cream works by binding to cytoplasmic glucocorticoid receptors, and this translocates into the nucleus binding to specific DNA sequences. Known as glucocorticoid response elements, this occurs in the promoter region of target genes. As a result of this, gene transcription is either activated or repressed, causing a wide range of anti-inflammatory and immunosuppressive effects.

Hydrocortisone cream is also known to decrease the production of inflammatory cytokines and chemokines, and inhibit the release of arachidonic acid, resulting in a reduction in inflammation, itching, and redness in the affected skin area. Other properties of the cream include vasoconstrictive actions, that reduce swelling and inflammation by constricting blood vessels in the affected area.

Ideal treatment for shingles rash

Ideally, treatment for shingles depends on the severity and the stage of the rash. The purpose of treatment is to reduce pain and discomfort, quicken healing, and prevent further complications. Treatment regimens typically include antiviral medications such as acyclovir, valacyclovir, and famciclovir to reduce the severity and duration of the rash and to prevent postherpetic neuralgia. The mechanism of action of these medications includes stopping the replication of the virus that is responsible for shingles.

Apart from the above antivirals, other treatments also include the following:

Mechanism of action of any one of the antivirals

To highlight the difference between hydrocortisone cream and antivirals used for treating shingles, here is a look at the mechanism of action of one of the antivirals. Acyclovir works by selectively inhibiting the DNA polymerase of the herpes simplex virus and varicella-zoster virus, responsible for herpes and shingles, respectively. As a synthetic analogue of guanine, acyclovir  is phosphorylated to its active form, acyclovir triphosphate, which competes with deoxyguanosine triphosphate for integration into the growing viral DNA chain during viral replication. As a result of this, chain termination and inhibition of viral DNA synthesis occurs. This reduces the replication of the virus, its spread, and ultimately controls symptoms of the infection. Acyclovir is not a cure for shingles and does not eliminate the virus from the body, but controls the symptoms of the infection and reduces the duration and severity of the rashes outbreak.

Side effects of hydrocortisone cream

Hydrocortisone cream is generally considered as safe, but the possibility of side effects exists in certain instances – such as prolonged use or excessive application. Commonly reported side effects of hydrocortisone cream are as listed below:

Can I use hydrocortisone cream on shingles rash?

It is generally not recommended to use hydrocortisone cream on shingles rash, as this is known to worsen the condition and delay healing. Shingles is a viral infection and needs to be treated with antivirals. The application of hydrocortisone cream on rashes can reduce inflammation and itching on a short term basis, but this could suppress the immune response and worsen the infection. As a result, the condition may take longer to be resolved as it becomes harder for the body to fight the virus. Additionally, as listed above, side effects of hydrocortisone cream may cause thinning of the skin and prone to bruising and discoloration. This exposes the individual to increased risk of developing postherpetic neuralgia, that results in chronic pain and discomfort. The best treatment for shingles includes antiviral medications to combined with topical treatments such as lidocaine or capsaicin to relieve pain and itching.

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