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:
- Over-the-counter pain relievers including acetaminophen, ibuprofen, or naproxen to relieve pain and reduce inflammation.
- Antihistamines to reduce itching and irritation caused by the rash.
- Topical creams and gels containing lidocaine or capsaicin to numb the affected area and reduce pain.
- Calamine lotion to soothe the skin and reduce itching.
- Application of cool compresses to the affected area to reduce inflammation and provide relief.
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:
- Prolonged or excessive use of the cream can make the skin thinner, and the skin also becomes more prone to bruising and discoloration.
- Topical steroids can reduce the immune response in the skin, making it more vulnerable to infections (bacterial or fungal).
- Individuals are known to experience mild irritation, burning, or stinging at the site of application.
- The possibility of allergic reaction exists, though rare in occurrence. This includes itching, swelling, and difficulty breathing.
- Extended use of high-potency hydrocortisone cream may result in suppression of the adrenal glands. This could trigger symptoms such as fatigue, weakness, and weight loss.
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.
Education: Doctor of Pharmacy (PharmD) from the University of Florida. Experience: 5 years as a pharmacist and medical writer, creating content on medication management and pharmaceutical news for healthcare blogs and patient education sites.
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