• Post-herpetic Neuralgia

Shingles is a painful infection of the nerves and skin. It is caused by the same virus that causes chickenpox. Shingles most often occurs in people who have had chickenpox. The virus does not fully leave the body. Some of it settles in nerve roots. Shingles happens when the virus becomes active again.

There is no cure. It can be managed with medicine until the virus passes. Some natural therapies have also been used with standard treatment.

Natural Therapies

Likely Effective

Capsaicin is the compound in chili peppers that make them hot. It is likely to ease pain. A1-A5

May Be Effective

These therapies may ease pain:

  • Acupuncture is the use of thin needles in specific body parts. B2-B4
  • Acupuncture plus moxibustion is the use of heat at specific pressure points. It may also speed healing. B1
  • Clinacanthus nutans is a perennial herb. G1
  • Cupping therapy uses special cups on the skin to create suction. F1, F2
  • Gentiana is a flowering plant. C1
  • Vitamin B12 is found in some foods, added to others, and can also be taken as a supplement. D1

Not Enough Data to Assess

  • Moxibustion alone H1
  • Multifaceted integrated complementary alternative therapy E1

Editorial process and description of evidence categories can be found at EBSCO NAT Editorial Process.

Editorial process and description of evidence categories can be found at EBSCO NAT Editorial Process.

Herbs and Supplements to Be Used With Caution

Talk to your doctor about all herbs or supplements you are taking. Some may interact with your treatment plan or health conditions. Some supplements discussed here have certain concerns such as:

  • TCHM—Toxicities and side effects of TCHM vary depending on the herb and amount used.



REFA1 Backonja M, Wallace MS, Blonsky ER, et al. NGX-4010, a high-concentration capsaicin patch, for the treatment of postherpetic neuralgia: a randomised, double-blind study. Lancet Neurol. 2008 Dec;7(12):1106-1112.

REFA2 Webster LR, Malan TP, Tuchman MM, Mollen MD, Tobias JK, Vanhove GF. A multicenter, randomized, double-blind, controlled dose finding study of NGX-4010, a high-concentration capsaicin patch, for the treatment of postherpetic neuralgia. J Pain. 2010;11(10):972-982.

REFA3 Irving G, Backonja M, Rauck R, Webster LR, Tobias JK, Vanhove GF. NGX-4010, a capsaicin 8% dermal patch, administered alone or in combination with systemic neuropathic pain medications, reduces pain in patients with postherpetic neuralgia. Clin J Pain. 2012;28(2):101-107.

REFA4 Yong YL, Tan LT, et al. The Effectiveness and Safety of Topical Capsaicin in Postherpetic Neuralgia: A Systematic Review and Meta-analysis. Front Pharmacol. 2017 Jan 10;7:538.

REFA5 Hempenstall K, Nurmikko TJ, et al. Analgesic therapy in postherpetic neuralgia: a quantitative systematic review. PLoS Med. 2005 Jul;2(7):e164. Epub 2005 Jul 26.


REFB1 Coyle ME, Liang H, Wang K, et al. Acupuncture plus moxibustion for herpes zoster: A systematic review and meta-analysis of randomized controlled trials. Dermatol Ther. 2017;30(4).

REFB2 Pei W, Zeng J, et al. Is acupuncture an effective postherpetic neuralgia treatment? A systematic review and meta-analysis. J Pain Res. 2019 Jul 16;12:2155-2165.

REFB3 Wang Y, Li W, et al. Acupuncture for postherpetic neuralgia: Systematic review and meta-analysis. Medicine (Baltimore). 2018 Aug;97(34):e11986.

REFB4 Ursini T, Tontodonati M, et al. Acupuncture for the treatment of severe acute pain in herpes zoster: results of a nested, open-label, randomized trial in the VZV Pain Study. BMC Complement Altern Med. 2011 Jun 5;11:46.

Gentiana/Traditional Chinese Herbal Medicine

REFC1 Wang K, Coyle ME, Mansu S, Zhang AL, Xue CC. Gentiana scabra bunge. Formula for herpes zoster: biological actions of key herbs and systematic review of efficacy and safety. Phytother Res. 2017;31(3):375-386.

Vitamin B12

REFD1 Wang JY, Wu YH, Liu SJ, Lin YS, Lu PH. Vitamin B12 for herpetic neuralgia: A meta-analysis of randomised controlled trials. Complement Ther Med. 2018;41:277-282.

Multifaceted Integrated Complementary-Alternative Therapy

REFE1 Hui F, Boyle E, et al. A randomized controlled trial of a multifaceted integrated complementary-alternative therapy for chronic herpes zoster-related pain. Altern Med Rev. 2012 Mar;17(1):57-68.

Cupping Therapy

REFF1 Cao H, Li X, et al. An updated review of the efficacy of cupping therapy. PLoS One. 2012;7(2):e31793.

REFF2 Cao H, Zhu C, et al. Wet cupping therapy for treatment of herpes zoster: a systematic review of randomized controlled trials. Altern Ther Health Med. 2010 Nov-Dec;16(6):48-54.

Clinacanthus Nutans

REFG1 Kongkaew C, Chaiyakunapruk N. Efficacy of Clinacanthus nutans extracts in patients with herpes infection: systematic review and meta-analysis of randomised clinical trials. Complement Ther Med. 2011 Feb;19(1):47-53.


REFH1 Lee MS, Choi TY, et al. Moxibustion for treating pain: a systematic review. Am J Chin Med. 2010;38(5):829-838.

Revision Information

  • Reviewer: EBSCO NAT Review Board Eric Hurwitz, DC
  • Review Date: 12/2019
  • Update Date: 06/18/2020