Injecting shingles lesion in acute stage with local and steroid reduces pain, improves sleep and purportedly reduces post-herpetic neuralgia.
NOTE TO MY CHINESE VIEWERS – I only have access to the chinese abstract translation – if you could fill in gaps from articles it would be appreciated….
Effects of Subcutaneous triamcinolone acetonide and lidocaine in the early stage on patients with acute herpes zoster
He Z et al
Pain Clinic Journal June 2012, 8(3) 177-179
- 15 subjects in each group – one got Injections of lidocaine and triamcinolone
- Steroid treated group got improvement in pain, improvement in sleep, and higher cure rates withou post herpetic neuralgia p<0.05
- They felt it was safe and effective and “can reduce the incidence of post herpetic neuralgia”
Comment – it is well known that injecting post-herpetic neuralgia tender site with local and steroid repeatedly can reduce the pains; it actually makes more sense to inject them before hypersensitivity and scarring has set in. Triamcinilone is usually diluted at or below 10 mg/ml to avoid atrophy. I would be concerned re infection at sites, particularly in frail subjects and would probably put patients on cephalexin 500 qid for some days after. I am not sure I would inject anyone with metal implants of any form – or heart valve replacements. Might even swab for MRSA in worrisome cases.