Initial treatment of shingles pain includes over-the-counter pain medications such as ibuprofen or acetaminophen combined with antiviral drugs, including valacyclovir, famciclovir or acyclovir, and topical antibiotic creams applied to the affected area, according to WebMD. In severe cases, corticosteroids may be prescribed as part of the treatment plan.
For shingles pain that lasts longer than a month after the rash from shingles has healed, additional treatment may be necessary, notes WebMD. Postherpetic neuralgia, or PHN, is a common shingles complication that can last for months or even years, although it can be managed with the proper medications. Up to 15 percent of people with shingles develop PHN.
Treatment of PHN involves the administration of antidepressant medications such as amitriptyline, which is a tricyclic antidepressant, or anticonvulsant medication such as pregabalin or gabapentin, states WebMD. Topical anesthetics such as over-the-counter creams that contain benzocaine are sometimes prescribed, as are prescription-only lidocaine patches. In some instances, opioid medications, including codeine, are prescribed for pain.
Some pain relief may be obtained with topical creams that contain capsaicin. However, since it can burn or irritate the skin, it should be used with care, warns WebMD. A high-dose pain-relieving patch, Qutenza, is available via prescription only and may provide relief for some sufferers.