Do corticosteroids improve healing time and prevent postherpetic neuralgia in patients with acute Herpes Zoster infection?

Abstract

The role of corticosteroids in acute herpes zoster infection remains unclear. Previous studies have suggested the use of prednisone and acyclovir leads to a decreased reduction in acute pain and development of postherpetic neuralgia. A recent review of the literature was performed using PubMed limiting the results to randomized control trials conducted in healthy adult patients. After reviewing three studies it was concluded that prednisone when combined with acyclovir does not reliably decrease the risk of developing postherpetic neuralgia but may decrease the time to cessation of pain and analgesic therapy. Additionally, the use of systemic corticosteroids may lead to unintended patient harm by increasing the likelihood of opportunistic infections. Based on these findings, there is insufficient evidence to support or reject the use of corticosteroids in acute herpes zoster infection