Shingles, a viral infection caused by the varicella-zoster virus, manifests as a painful rash with fluid-filled blisters. While the rash typically heals within two to four weeks, it can sometimes leave noticeable marks or changes in skin texture. These lasting skin alterations can be a source of concern for individuals, prompting a desire to understand and address them.
Understanding Shingles Scars
Shingles can lead to scarring due to deep inflammation and tissue damage caused by the varicella-zoster virus during an outbreak. The severity of scarring depends on factors such as the outbreak’s intensity, the individual’s skin type, and the care provided to the wound. About 10% of shingles cases may result in scarring.
Various types of scars can form following a shingles infection. Hyperpigmented scars appear as darkened patches or spots, resulting from an excess production of melanin. These can range in color from pink, red, or brown to black, and are more common in individuals with medium to dark skin tones. Conversely, hypopigmented scars are areas of skin that have lost their natural color, appearing lighter than the surrounding skin.
Atrophic scars are characterized by depressions or indentations in the skin’s surface, forming when the skin fails to regenerate tissue due to a loss of underlying structures like collagen. These sunken or pitted scars can vary in depth and shape, from narrow icepick scars to wider boxcar scars or wavy rolling scars. Less commonly, shingles can also lead to hypertrophic scars or keloids, which are raised scars resulting from an overproduction of collagen during healing.
Preventing Scarring from Shingles
Preventing shingles scars begins with prompt action during the active infection. Seeking early medical help and initiating antiviral medications are important steps. Antiviral drugs such as acyclovir, valacyclovir, and famciclovir can accelerate the healing of the rash and blisters, reduce their spread, and decrease pain, minimizing the risk of scarring. These medications are most effective when started within 72 hours of the rash appearing.
Avoiding scratching or picking at the blisters and scabs is important, as this can worsen skin damage and increase the likelihood of scarring or secondary infections. Keeping the affected area clean and dry promotes proper healing. Applying cool compresses provides relief from itching and discomfort, further deterring scratching.
Protecting the affected skin from sun exposure during the healing phase is another preventative measure. New or healing skin is susceptible to sun damage, which can lead to increased pigmentation and make scars more noticeable. Following these care guidelines and a healthcare provider’s recommendations can significantly reduce lasting skin marks from shingles.
At-Home and Over-the-Counter Scar Treatments
Several accessible methods can help manage existing shingles scars. Topical treatments, such as silicone sheets or gels, are widely used. Silicone products work by hydrating the scar tissue and applying gentle pressure, which can soften and flatten raised scars and reduce discoloration. Consistent application over several months is recommended for optimal results.
Other over-the-counter scar creams may contain ingredients like onion extract or vitamin E. While some anecdotal reports suggest vitamin E might help, research indicates it has no notable effect on improving scar appearance and can cause contact dermatitis. Topical retinoids, such as tretinoin, can be beneficial for atrophic scars by stimulating collagen production and promoting skin cell turnover, which may gradually improve their appearance.
Sun protection remains crucial for all types of scars, particularly those with discoloration. Ultraviolet (UV) rays can darken hyperpigmented scars and impede healing, making them more visible. Applying a broad-spectrum sunscreen with an SPF of at least 30 to scarred areas, even on cloudy days, and reapplying regularly, helps prevent further discoloration and supports scar fading.
Professional Medical Treatments for Shingles Scars
For persistent or severe shingles scars, dermatologists offer professional medical treatments. Laser therapy is a common approach, with different types targeting specific scar characteristics. Fractional lasers, such as fractional CO2 lasers, create microscopic zones of injury to stimulate collagen production and improve atrophic scar texture. Pulsed dye lasers are effective for reducing redness and hyperpigmentation by targeting blood vessels in the scar tissue.
Chemical peels involve applying a chemical solution to the skin to remove outer layers, encouraging cell turnover and revealing smoother, more evenly toned skin. They can improve skin texture and reduce discoloration, depending on the peel’s depth. Microneedling uses fine needles to create controlled micro-injuries, promoting the skin’s natural healing and stimulating collagen induction to improve scar appearance.
Corticosteroid injections are often used for raised scars like hypertrophic scars or keloids. These injections deliver a steroid solution directly into the scar, which helps suppress inflammation, reduce collagen synthesis, and flatten the scar. Multiple injections, typically spaced weeks apart, may be necessary. Consulting a healthcare professional ensures a personalized treatment plan tailored to the specific type and severity of shingles scars.