Herpes Zoster

Management:

• 1. Acyclovir 600-800 mg 5 times a day for 7 days is indicated in all the clinical varieties of zosters mentioned above. To be effective the drug should be started within 48 hr of the onset of vesicles. Famciclovir 250mg, needs to be given 3 times a day only, and therefore has better compliance. Valacyclovir 1000mg TDS is also a superior alternative because of convenience of dosage.

  2. Analgesics.

  3. Local treatment with potassium permanganate soaks and some antibiotic cream. Local acyclovir ointment has no value. Wet compresses are preferred to drying lotions like calamine.

  4. Steroids 40-60 mg of prednisolone daily may prevent postherpetic neuralgia.

  5. Take opinion of ophthalmologist in case of ophtalmic zoster and an ENT specialist in case of Ramsay-Hunt syndrome.