Shingles: When to See a Dermatologist for Treatment

Q: Shingles: When to See a Dermatologist for Treatment

Hello： Herpes is often misdiagnosed as other conditions; for example, lesions on the back may be mistaken for lower back pain, and those on the chest may be confused with heart disease. <br>Therefore, patients often first consult internal medicine physicians, orthopedic specialis

Herpes Zoster - 2

Hello Doctor, thank you for your quick response.
I still have some questions I would like to ask you: Initially, I thought it was an abdominal issue, so I consulted the gastroenterology department.
Fortunately, I was not misdiagnosed.
However, the doctor mentioned that I should have seen a dermatologist.
He prescribed me Acetaminophen 500mg/tablet, Panadol 500mg/tablet, and Neomycin ointment, which are general anti-inflammatory medications.
There were no oral antiviral medications mentioned in your article, such as Acyclovir (which has a price difference of nearly half between the original and local brands, with a normal dosage of 4000mg/day divided into five doses, and Valacyclovir 3000mg/day divided into three doses, currently only available as the original brand).
Should I see a dermatologist again? If the out-of-pocket medications are effective, I am willing to pay the price to reduce the pain.
Thank you for taking the time to respond.
Nancy

Nanxi, 40~49 year old female. Ask Date: 2009/06/07

Dr. Zhang Zhibo reply Dermatology

Hello: Herpes is often misdiagnosed as other conditions; for example, lesions on the back may be mistaken for lower back pain, and those on the chest may be confused with heart disease.
Therefore, patients often first consult internal medicine physicians, orthopedic specialists, or neurologists.
Panadol and Neomycin are symptomatic treatments.
Generally, physicians will refer patients to a dermatologist because antiviral medications (such as Valtrex or Zovirax) need to be taken within 3-4 days of the outbreak to be effective.
It is not recommended to take these medications for rashes that have persisted for more than a week.
For pain relief, non-steroidal anti-inflammatory drugs (NSAIDs) or controlled substances containing opium may be more effective than Panadol.

Reply Date: 2009/06/07

More Info

Shingles, also known as herpes zoster, is a viral infection caused by the reactivation of the varicella-zoster virus, which is the same virus that causes chickenpox. It typically presents as a painful rash that develops on one side of the body, often accompanied by other symptoms such as fever, fatigue, and sensitivity to light. Understanding when to see a dermatologist for shingles treatment is crucial for effective management and pain relief.

If you suspect you have shingles, it is advisable to see a dermatologist or a healthcare provider as soon as possible, ideally within 72 hours of the rash appearing. Early intervention is key because antiviral medications, such as Acyclovir or Valacyclovir, are most effective when started early. These medications can help reduce the severity and duration of the symptoms, as well as lower the risk of complications, such as postherpetic neuralgia, which is a condition characterized by persistent pain in the area where the shingles rash occurred.

In your case, it seems that you initially consulted a gastroenterologist due to abdominal symptoms, which is understandable given the location of the rash. However, the recommendation to see a dermatologist is appropriate, as they specialize in skin conditions and can provide targeted treatment for shingles. The medications prescribed to you, such as Acetaminophen and Neomycin ointment, may help alleviate some discomfort, but they do not address the underlying viral infection. Antiviral medications are essential for managing shingles effectively.

If you are considering self-paying for antiviral medications, it is a worthwhile investment in your health, especially if it can significantly reduce your pain and expedite recovery. The cost of these medications can vary, and while the branded versions may be more expensive, they are often more effective than generic alternatives. Discussing your options with a dermatologist can help you make an informed decision about the best course of treatment.

In addition to antiviral medications, dermatologists may recommend other supportive treatments, such as topical analgesics to relieve pain and itching, and corticosteroids to reduce inflammation. It is important to follow the dermatologist's advice regarding the use of these medications, as they can provide a comprehensive approach to managing shingles.

To summarize, if you suspect you have shingles, it is crucial to see a dermatologist promptly for an accurate diagnosis and appropriate treatment. Early intervention with antiviral medications can significantly improve your symptoms and reduce the risk of complications. If you have already been prescribed medications that do not address the viral infection, seeking a second opinion from a dermatologist is advisable. They can provide you with the necessary treatment to alleviate your symptoms and help you recover more effectively.

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