Shingles – how to treat it

Why it’s important to get medical help for shingles as soon as symptoms appear. Plus, what causes this painful condition in the first place.

What are the symptoms?

Who is at risk of shingles? 

When to see a doctor and getting diagnosed

How is it treated?

Self-care tips 

How to prevent it

Once you’ve had chickenpox you are at risk of getting shingles, which is caused by the same virus, particularly as you get older or if you’re run down. Symptoms of shingles include a painful skin rash and other symptoms such as headache and fever. It is treatable but you need to see a doctor. 

Shingles – also known as herpes zoster –  is caused by the same virus as [chickenpox](https://www.livehealthily.com/health-library/conditions/chickenpox) (varicella-zoster). Once you have had chickenpox the virus stays in your system, doing no harm.

However, having a weakened immune system, which could be due to stress, aging, or certain conditions, can cause the varicella-zoster virus to be reactivated, in the form of shingles. 

The condition causes an unpleasant and painful skin rash, which can take weeks to get better. 

That’s why it’s important to get medical help as soon as possible. Managing your symptoms with self-care can help with your recovery.


## What are the symptoms?

The early stages of shingles may make your skin feel sensitive, itchy, or tingly. You may also feel unwell, headachy, and feverish. 

After a few days, a rash will break out, typically on your chest and belly but it can appear anywhere – even in your eye. The rash is usually:

- on one side of your body or face 
- in a single stripe 
- patchy and red at first, turning into clusters of blisters after a few days which ooze fluid (before they dry out and scab over)
- a sore and red eye (if it appears here), and may affect your sight and hearing, plus movement on 1 side of your face. 

Sometimes with shingles there will be no rash, only pain, but this is rare. 

__Seek urgent medical help__ if you have symptoms of shingles as you may need treatment that works best when you take it within 3 days of the rash starting. The sooner you get treatment, the faster you can recover, helping to lower your risk of developing other health issues. 

This is especially important if:
- the rash and pain are in your eye area – it can lead to permanent damage
- you are over the age of 50 because of your risk of complications
- you or a family member have a weakened immune system, for example, due to a cancer or chronic illness 
- your rash is widespread and you are in a lot of pain.


Get help with this

## Who is at risk of shingles? 

Anyone who has had chickenpox could get shingles.

If you have already had shingles you can get it more than once. You cannot catch shingles from someone else with it. However, you can catch chickenpox from someone with shingles (if you have not already had it). 

Things that may increase your risk of shingles include getting older, or a weakened immune system, which can be caused by:

- stress
- some conditions
- some medications 
- cancer treatment.

There is a [vaccine](https://www.livehealthily.com/health-library/conditions/shingles#prevention) to reduce your risk of getting shingles. It is safe, easy, and effective – check with your healthcare provider about whether you are eligible and whether you can get it for free or need to pay for it privately. 

## When to see a doctor and getting diagnosed

If you suspect you may have shingles, call your doctor as soon as possible.

Getting the right treatment will also reduce your risk of developing serious complications of shingles, such as:

- [postherpetic neuralgia](https://www.livehealthily.com/health-library/conditions/postherpetic-neuralgia) (ongoing nerve pain)
- skin infection
- scarring or skin changes after the rash has healed
- eye problems which can affect vision 
- muscle weakness
- problems with hearing or balance, facial paralysis, or brain inflammation. 

Your doctor can diagnose shingles based on your symptoms and medical history, and visual examination of the rash. 


## How is it treated?

Depending on how severe your shingles symptoms are (mild symptoms may not need treatment), your age, and your medical history, your doctor may want to start you on antiviral medication (such as acyclovir, valacyclovir, or famciclovir) as soon as possible. Treatment works best when you take it within 3 days of the rash starting. 

Other treatments can also include:

- __painkillers__ –  acetaminophen (paracetamol) and/or ibuprofen (check this is safe for you to take) may be strong enough to manage pain, or a weak opioid painkiller, such as codeine 
- __medication to help with nerve pain __
- __steroids__. 

## Self-care tips 

While you recover from shingles these self-care steps can help:

- soothe irritated or itchy skin with cool compresses
- take acetaminophen (paracetamol) to help relieve pain
- wear comfortable, loose clothing
- keep your rash clean and dry
- avoid touching or scratching your skin 
- try to relax and minimize stress
- get plenty of rest
- eat well
- see your pharmacist, who can recommend treatments. 

Stay off work until your shingles rash has crusted over (usually within 10 days).


## How to prevent it

Having the chickenpox vaccine greatly reduces your chances of getting shingles.

Remember that even though you can’t catch shingles from someone else with shingles or chickenpox, you can pass chickenpox on to someone else. 

To prevent spreading chickenpox from your shingles, make sure you:

- stay at home if your rash is still oozing (weeping) and can’t be covered 
- avoid contact with anyone who has not had chickenpox or the chickenpox vaccine, or are vulnerable, for example, people with a weakened immune system, those who are pregnant, elderly people, and babies less than 1 month old
- cover the rash if possible (with loose clothing or non-sticky dressing)
- wash your hands with soap and water regularly to prevent spreading infection.


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References

Juliet Blank

Fiona Bugler

Dr Maria Reza

Article information

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