Talk:Herpes zoster

Treatment

There is, I believe, a good deal more dispute here than these studies alone suggest. I base this not so much on RCT's, but on published clinical guidance and a substantial amount of discussion with clinicians. Having been one of the relatively rare people to have had two attacks so far, but without postherpetic neuralgia, it's a subject I track closely.

Coincidentally, I had this discussion with my primary physician recently, not for myself but in one of the end-of-the-day impromptu seminars in his office. While there's no question about the use of antivirals, he's adamantly opposed to corticosteroids; I disagree. I think there's also increasing community use of capsaicin early in the acute phase, on the argument that if it works, it's a low-risk, neurochemically reasonable approach based on Substance P depletion. It's also worth knowing if the patient cannot tolerate it, although studies are needed to determine if such individuals can tolerate it if started on a much lower concentration.

Howard C. Berkowitz 14:13, 30 October 2009 (UTC)