Shingles: the most effective dietary supplements

Shingles is a viral disease caused by the reactivation of the varicella-zoster virus (VZV), the same virus responsible for chickenpox. After a primary infection, often during childhood, the virus remains latent in the nerve ganglia and can reactivate years later, causing shingles. Shingles presents as a painful skin rash and vesicles localized along one or more dermatomes​, which are areas of skin supplied by the affected nerve.

Pathogenesis

The virus remains latent in the sensory nerve ganglia after the initial varicella infection. Its reactivation is often associated with: • Advanced age (> 50 years). • Immunosuppression (due to diseases such as cancer or HIV, or to immunosuppressive treatments). • Chronic stress or acute infections (including COVID-19 and its vaccination). This reactivation of the virus leads to inflammation of the affected nerves and to the spread of viral particles along the sensory nerve fibers. The skin lesions correspond to the dermatomes innervated by the infected ganglia​. The pain is a central element of the pathogenesis of shingles. It is caused by inflammation of the affected nerves as well as by structural damage to the nerve fibers​.

Symptoms

Shingles often begins with pain, itching, or a burning sensation localized to a specific skin area, usually on one side of the body. A few days later, a vesicular rash appears in that area, accompanied by redness and sharp pain​. The rash develops into crusts within one to two weeks, and healing takes about three to four weeks​. In some cases, neuropathic pain can persist for several months or even years after the rash has healed, a condition called postherpetic neuralgia (PHN).

Complications

The most common and disabling complication of shingles is postherpetic neuralgia (PHN), which occurs in about 10 to 15% of patients, particularly in older adults. This condition is characterized by chronic, severe pain in the affected area, which can last for months after the skin lesions have resolved​. Other complications include infection of the skin lesions, ocular involvement (herpes zoster ophthalmicus) that can lead to blindness, and neurological complications such as facial paralysis or encephalitis​.

Epidemiology

Shingles affects about 3 to 5 individuals per 1000 per year, with an incidence that increases after age 60, reaching up to 11 cases per 1000 among the oldest. Women are slightly more affected than men. The emergence of reactivations associated with COVID-19 or its vaccination is a recently observed phenomenon. mRNA vaccines have been associated with an increased risk of reactivation.

Treatment

Treatment of shingles aims to speed healing of skin lesions, reduce pain, and prevent complications. Antiviral drugs, such as acyclovir, valacyclovir and famciclovir, are effective at reducing the duration and severity of symptoms if administered within the first 72 hours after lesion onset​. Adjunctive treatments, such as analgesics (including opioids for severe pain) and topical agents like lidocaine or capsaicin patches, are often necessary to manage acute pain. In cases of postherpetic neuralgia, tricyclic antidepressants, anticonvulsants (gabapentin or pregabalin) and local anesthetics may be used​.

Prevention

Prevention of shingles relies mainly on vaccination and maintaining good varicella-zoster virus–specific immunity. The live attenuated shingles vaccine has shown notable effectiveness, with a 51% reduction in shingles incidence and a 67% decrease in postherpetic pain among vaccinated individuals.

Natural approaches

Complementary approaches useful for soothing symptoms and supporting immunity: • Essential oil of peppermint (Mentha piperita): known for its analgesic effect, it can help relieve localized pain. • Immunostimulant essential oils: Ravintsara (Cinnamomum camphora CT cineole), niaouli (Melaleuca quinquenervia CT cineole) and linalool thyme (Thymus vulgaris CT linalool): they help strengthen the body’s natural defenses against the virus. • Anti-inflammatory essential oils: lemon eucalyptus (Eucalyptus citriodora), spike lavender (Lavandula spica) and Roman chamomile (Chamaemelum nobile): these oils soothe skin inflammation and promote tissue regeneration. • Echinacea (Echinacea purpurea): this plant is traditionally used to stimulate the immune system, improving resistance to viral infections such as shingles. • Trace elements: the Copper-Gold-Silver (Cu-Au-Ag) complex acts as an immune stimulant and supports tissue regeneration.