Persistent Blisters After Three Days of Antiviral Treatment for Shingles

After three days of using antiviral medication for shingles, there are still blisters present?

Hello, I have shingles and had not developed blisters when I visited the dermatologist.
The doctor prescribed antiviral medication for three days.
The day after my appointment, I developed large blisters.
Even after finishing the medication, I still have some blisters, some of which are quite large.
Should I see a doctor again and continue taking antiviral medication? Thank you!

Ms. Li, 50~59 year old female. Ask Date: 2024/07/29

Dr. Wu Yuxin reply Dermatology

Three days is not enough; you still need to continue monitoring.

Reply Date: 2024/07/29

More Info

When dealing with shingles (herpes zoster), it's important to understand that the condition is caused by the reactivation of the varicella-zoster virus, which also causes chickenpox. Antiviral medications, such as acyclovir, valacyclovir, or famciclovir, are typically prescribed to help reduce the severity and duration of the outbreak, especially when initiated within 72 hours of the rash appearing.
In your case, you mentioned that you have been on antiviral treatment for three days, but you are still experiencing persistent blisters. It's not uncommon for blisters to continue to form even after starting antiviral therapy, as the medication works to suppress the virus and reduce the severity of the symptoms, but it may not eliminate all symptoms immediately.
Here are some key points to consider regarding your situation:
1. Blister Formation: The presence of blisters after starting antiviral treatment can occur. The antiviral medications help to reduce the viral load and promote healing, but the blisters may still appear as the body responds to the virus. It is essential to monitor the blisters for signs of infection, such as increased redness, warmth, swelling, or pus.

2. Follow-Up with Your Doctor: If the blisters are persistent and you are experiencing significant discomfort, it is advisable to follow up with your healthcare provider. They can assess the situation more thoroughly and determine if additional treatment is necessary. This may include a longer course of antiviral medication or other supportive treatments to manage pain and discomfort.

3. Pain Management: Shingles can be quite painful, and managing that pain is crucial. Over-the-counter pain relievers such as acetaminophen or ibuprofen can help alleviate discomfort. In some cases, your doctor may prescribe stronger pain medications or topical treatments to help with the pain associated with shingles.

4. Preventing Complications: One of the potential complications of shingles is postherpetic neuralgia, which is characterized by persistent pain in the area where the shingles rash occurred, even after the rash has healed. Early intervention and treatment can help reduce the risk of developing this condition.

5. Skin Care: Keep the affected area clean and dry. Avoid scratching the blisters, as this can lead to secondary infections. You may also consider using cool compresses to soothe the area and reduce itching.

6. Vaccination: If you have had shingles, it is also worth discussing with your healthcare provider about the shingles vaccine (Shingrix) for future prevention. This vaccine is recommended for adults over the age of 50, even if you have had shingles before, as it can help reduce the risk of recurrence.

In summary, while it is not unusual to have persistent blisters after starting antiviral treatment for shingles, it is essential to keep an eye on the symptoms and consult your healthcare provider if you have concerns or if the blisters do not improve. They can provide tailored advice and treatment options based on your specific situation.

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