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Currently submitted to: JMIR Dermatology

Date Submitted: Oct 12, 2020
Open Peer Review Period: Oct 15, 2020 - Dec 15, 2020
(currently open for review)

Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.

Analysis of Non-prescription Products for the Prevention and Management of Herpes Zoster and Postherpetic Neuralgia

  • Pengyi Zhu; 
  • Benjamin KP Woo



Herpes zoster affects a million people annually in the United States, while postherpetic neuralgia is the most common complication. Opioids is most prescribed as the first line medication for herpes zoster or postherpetic neuralgia, however it contributes to the increasing healthcare cost of treating herpes zoster and postherpetic neuralgia. With the advent of internet retailers providing alternative products for prevention and management these conditions, there are limited studies on the availability of products, the ingredients in the products, and consumer preference for the products.


This study seeks to determine the availability of products for management of herpes zoster and postherpetic neuralgia and consumer preference based off ingredients.


Internet retailer Amazon was used in September 2020 to conduct a search for products related to “shingles.” Top products sorted by reviews and ratings were determined to be either shingle specific (including “shingles” in either product title or description) or shingle non-specific. Analysis of price, rating, type of vehicle, and ingredients was performed. The types of vehicles, ingredients, and percentage of positive and negative reviews related to “shingles” of the product groups was analyzed with two-tailed two-sample proportions Z-test to assess a difference between shingles specific and shingles non-specific products. P<.05 showed statistical significance.


The top 131 products out of over 3,000 products was determined by having a rating of 4 or more after searching “shingles” on Amazon. 46 out of 131 products (35.1%) were shingles specific. Shingles non-specific products were more likely to have positive reviews mentioning “shingles” (P=0.005). As vehicles, balms (P=0.02) and salves (P=0.04) were more likely to be shingles specific and tablets or capsules (P=0.002) more likely to be shingles non-specific. Of ingredients analyzed, aloe vera was the top ranked ingredient, comprising 29 out of 131 total products (22.1%). Aloe vera (P=0.01), lemon balm (P=0.0009), vitamin E (P=0.03), and peppermint oil (P=0.008) were more likely included in shingles specific products, while magnesium (P=0.0096) was more likely included in shingles non-specific products.


There is an abundant amount of products and ingredients being used for management and treatment of shingles with certain ingredients preferred by customers. There is a discrepancy between approved ingredients and the ingredients preferred by customers. Furthermore, there are not enough studies on ingredients used by consumers on internet retailers, such as Amazon, and future studies can focus on the effectiveness of popular ingredients to decrease misinformation on the internet.


Please cite as:

Zhu P, Woo BK

Analysis of Non-prescription Products for the Prevention and Management of Herpes Zoster and Postherpetic Neuralgia

JMIR Preprints. 12/10/2020:24971

DOI: 10.2196/preprints.24971


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