Treating Scarring After Shingles: Options for Recovery and Prevention

Atrophic scars from shingles?

In June of this year, I had an outbreak of shingles on the bridge of my nose and above my lips, which is my first recurrence since having chickenpox as a child.
I took medication for a week, and the scabs took about a month to fall off.
I saw a shingles vaccine at the clinic; can I still get that? Additionally, after the shingles healed, I was left with hyperpigmentation and smooth indentations.
What treatments can improve this? Both blisters had burst initially...
I'm wondering if fractional laser treatment could help?

Ya Ya, 40~49 year old female. Ask Date: 2018/08/08

Dr. Wu Yuxin reply Dermatology

1.
Vaccination is not currently necessary.
2.
Pigmented scars and atrophic scars should be evaluated by a dermatologist; fractional laser treatment can improve some atrophic scars.

Reply Date: 2018/08/08

More Info

After experiencing shingles, also known as herpes zoster, it is common for individuals to be concerned about the scarring and pigmentation changes that may occur post-infection. Shingles is caused by the reactivation of the varicella-zoster virus, which also causes chickenpox. The rash associated with shingles can lead to various skin changes, including scarring and hyperpigmentation, especially if the blisters have ruptured.

Vaccination After Shingles
Regarding your question about receiving the shingles vaccine after having had shingles, it is indeed possible to get vaccinated. The Centers for Disease Control and Prevention (CDC) recommends that individuals who have had shingles wait at least 8 weeks after the rash has resolved before receiving the shingles vaccine. The vaccine can help prevent future outbreaks and reduce the risk of postherpetic neuralgia, a painful condition that can occur after shingles. It is advisable to consult with your healthcare provider to determine the best timing for your vaccination.

Treatment Options for Scarring and Hyperpigmentation
1. Topical Treatments: Over-the-counter creams containing ingredients like hydroquinone, kojic acid, or vitamin C can help lighten hyperpigmented areas. Additionally, retinoids can promote skin cell turnover and improve the appearance of scars.

2. Chemical Peels: These treatments involve applying a chemical solution to the skin, which exfoliates the top layers and can help reduce pigmentation and improve skin texture. They can be effective for both hyperpigmentation and superficial scarring.

3. Laser Therapy: Laser treatments, such as fractional laser or pulsed dye laser, can target pigmented areas and stimulate collagen production, which may improve the appearance of scars. Laser therapy is often effective for both discoloration and textural changes.

4. Microneedling: This procedure involves using fine needles to create micro-injuries in the skin, promoting collagen production and improving skin texture. It can be beneficial for atrophic scars (depressed scars) and may also help with pigmentation issues.

5. Dermal Fillers: For deeper scars, dermal fillers can be injected to raise the depressed areas, providing a smoother appearance. This is a temporary solution, as fillers typically last several months to a year.

6. Sunscreen: Protecting your skin from sun exposure is crucial, especially after experiencing shingles. UV exposure can worsen hyperpigmentation, so using a broad-spectrum sunscreen with an SPF of 30 or higher is essential.

Considerations for Treatment
Before starting any treatment, it is important to consult with a dermatologist. They can assess your specific skin type and condition, recommend appropriate treatments, and monitor your progress. Additionally, some treatments may not be suitable for all skin types, and a professional can help tailor a plan that minimizes risks and maximizes results.

Conclusion
In summary, while shingles can leave behind scarring and pigmentation changes, there are several effective treatment options available. Vaccination against shingles is also a viable option to prevent future outbreaks. Always consult with a healthcare professional to determine the best course of action for your individual needs. Taking proactive steps in skin care and treatment can significantly improve the appearance of scars and pigmentation, leading to better skin health and confidence.

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