Adult Health

Shingles: Symptoms & Treatment Guide

Shingles occurs when the dormant chickenpox virus reactivates, causing a painful, blistering rash. Early treatment within 72 hours significantly reduces complications.

Cause
Reactivated varicella-zoster virus
Lifetime risk
1 in 3 people
Treatment window
Within 72 hours of rash onset
Vaccine available
Yes (Shingrix, age 50+/65+)

Symptoms

Antiviral Treatment

TimingAction
Within 72 hours of rash onsetAntivirals (aciclovir, valaciclovir) significantly reduce severity and duration
After 72 hoursStill may be given, especially if new blisters still forming or high risk of complications
Pain reliefParacetamol, NSAIDs; gabapentin/amitriptyline if nerve pain severe

Postherpetic Neuralgia (PHN)

PHN is persistent nerve pain lasting more than 90 days after the rash has healed. It affects 10–18% of people with shingles, and risk increases significantly with age (up to 50% in those over 70). Early antiviral treatment reduces PHN risk.
Shingles Near the Eye — EmergencyShingles affecting the tip of the nose, forehead, or around the eye (ophthalmic shingles) can threaten vision and requires urgent same-day ophthalmology assessment. Do not delay treatment.
Contagious RiskShingles cannot be 'caught' as shingles, but the fluid in blisters can transmit chickenpox to anyone who hasn't had it or been vaccinated. Cover the rash and avoid contact with pregnant women, newborns, and immunocompromised people until blisters crust.
Can I get shingles more than once?
Yes, though it's uncommon — most people get it only once. Recurrence is more likely in people who are immunocompromised.
Should I get the shingles vaccine?
The Shingrix vaccine is recommended for adults 50+ in the US and being rolled out in the UK for those 65+ (and immunocompromised from 50). It's over 90% effective at preventing shingles and PHN.
What triggers shingles reactivation?
Stress, illness, ageing immune system, immunosuppressive medications, and other illnesses that weaken immunity. Often there's no identifiable trigger.
Medical Disclaimer: This page is for general education only and does not replace professional medical advice. Always consult a qualified healthcare provider.