[Common Diseases] Varicella Zoster Virus (VZV)

A Complete Guide to Treating Shingles (Shingles) – A Practical Guide from Hong Kong

As someone who regularly compiles health news, I've noticed that many Hong Kong people have numerous myths about shingles (also known as herpes zoster), including whether immediate medical attention is necessary, medications, contagiousness, and the differences between traditional Chinese and Western medicine. This time, I've used reliable online medical resources to deconstruct treatment options, focusing on medical resources and common practices in Hong Kong .

1. What is shingles?

Shingles is caused by the varicella-zoster virus (VZV). After a childhood bout of chickenpox, the virus can remain dormant in nerve ganglia for years. When immunity weakens (due to stress, illness, or aging), it reactivates, causing a band-like rash and blisters along the nerves , accompanied by severe neuralgia.

In Hong Kong, shingles is quite common among people over 50 years old, but in recent years, due to stress and lifestyle habits, the number of young patients has also been increasing.

2. Why is early treatment necessary?

After consulting the Hong Kong Hospital Authority (HA) and private doctor clinics, I found that the timing of treatment is crucial :

  • Golden treatment period : Antiviral drugs are most effective within 72 hours after the onset of symptoms
  • Purpose : To reduce the severity of the rash, shorten the duration of the disease, and reduce the risk of developing **postherpetic neuralgia (PHN)**

If treatment is delayed, some patients may still experience neuralgia for months or even years even after the rash has healed, affecting their quality of life.

3. Common treatment methods (from a Hong Kong medical perspective)

The following content is mainly based on the commonly used schemes in Hong Kong and is for reference only:

(1) Antiviral drugs

  • Common drugs : Acyclovir, Valacyclovir, Famciclovir
  • Dosage : Oral or intravenous (for severe cases)
  • Treatment course : generally 7 days
  • Editor's Tip : Private clinics in Hong Kong generally prescribe oral antiviral drugs directly. The fees vary depending on the brand of the drug, ranging from several hundred to over a thousand Hong Kong dollars per course of treatment. Public hospitals will decide whether to prescribe based on the patient's condition.

(2) Analgesia and anti-inflammation

  • Mild pain : Paracetamol or ibuprofen can be used
  • Moderate to severe pain : Your doctor may add nerve pain medication, such as gabapentin or pregabalin
  • Editor's observation : Some Hong Kong patients refuse to take painkillers for fear of damaging the liver and kidneys. However, poor pain control can affect sleep and recovery speed.

(3) External ointments and care

  • Antiviral cream (rarely used because oral administration is more effective)
  • Moisturizing and skin care : Keep the affected area clean and dry, and avoid scratching the blisters
  • Cold compress : Temporarily relieves itching and stinging

(4) Prevent complications

  • Elderly people or those with weakened immune systems : The condition is more severe and may require short-term use of steroids to reduce neuroinflammation (requires doctor's evaluation)
  • Herpes zoster ophthalmicus : If the lesions are around the eyes, immediate referral to an ophthalmologist is necessary to avoid vision loss.

4. Application of Traditional Chinese Medicine and Naturopathy in Hong Kong

Many patients in Hong Kong will also consider Traditional Chinese Medicine treatment, for example:

  • Internal use of Chinese medicine : such as heat-clearing and detoxifying, wind-dispersing and pain-relieving prescriptions (requires diagnosis by a registered Chinese medicine practitioner)
  • Acupuncture : Some studies have shown that acupuncture can relieve neuralgia, but the effect varies from person to person. The editor reminds you: When combining Chinese and Western medicine, you should pay attention to the interaction between medications. It is best to let both doctors know about your medication situation.

5. Preventive measures

  • Vaccines : Hong Kong currently has the live attenuated vaccine (Zostavax) and the recombinant herpes zoster vaccine (Shingrix)
    • Shingrix has a higher protective effect and is suitable for people over 50 years old or those with low immunity
    • Vaccination is available at private clinics and some medical centers, with each dose costing approximately HK$1,500–2,000 (Shingrix requires two doses).
  • Lifestyle habits : balanced diet, adequate sleep, and stress reduction

6. Editor’s Summary

Shingles isn't something you can just ignore as "it will go away on its own." Especially in Hong Kong, where life is fast-paced and stressful, the chances of a weakened immune system are high. Here's what I've learned:

  • If you suspect you have a unilateral rash and tingling, seek medical attention immediately .
  • Antiviral drugs should be started within the golden 72 hours
  • Managing pain is just as important as taking care of your skin
  • If age or immune status is high risk, consider vaccination

Disclaimer : This article is for reference only and does not constitute any medical advice. The source is referenced from major medical articles.

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