Early Fix For Herpetic Zoster/Shingles – Inject the Spots With Local and Steroid

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
http://www.cqvip.com/Read/Read.aspx?id=43157204

• 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.