Shingles: what to watch for and what to do

About one in three people will get shingles in their lifetime. It’s caused by the varicella‑zoster virus—the same virus that gives you chickenpox. After chickenpox clears, the virus can hide in nerves for years and suddenly reactivate as a painful, blistering rash.

Typical signs start with burning, tingling, or sharp pain in one spot on one side of the body. Within a day or two a cluster of red blisters appears in that area, often wrapped around the torso or on the face. Fever, headache, and tiredness can show up too. The rash usually clears in two to four weeks, but pain can linger.

Shingles isn’t the same as genital herpes (that’s caused by a different virus), but both are part of the herpesvirus family. You can spread the varicella‑zoster virus to someone who never had chickenpox or the vaccine—usually by direct contact with the fluid in the blisters. That person would develop chickenpox, not shingles. People at higher risk for shingles or worse complications include older adults, anyone with a weakened immune system, and those under major stress.

Quick treatment guide

Start antivirals early—ideally within 72 hours of the rash appearing. Common choices are acyclovir, valacyclovir (Valtrex), and famciclovir. Early treatment shortens the outbreak and lowers the chance of severe nerve pain afterward. If pain is bad, options include acetaminophen or ibuprofen for mild pain, gabapentin or low‑dose antidepressants for nerve pain, and short courses of stronger pain meds when needed.

Eye involvement is an emergency. If shingles hits near an eye or forehead, see an eye doctor right away—damage to the cornea can cause lasting problems. Also seek urgent care if you’re immunocompromised, the rash is widespread, or you have high fever or confusion.

Postherpetic neuralgia (PHN) is the most common complication—ongoing nerve pain after the rash heals. Older age raises the risk. Treating the initial outbreak quickly and using nerve‑pain medicines if pain continues can help.

Preventing shingles and serious problems

The best prevention is vaccination. The Shingrix vaccine is given in two doses, 2–6 months apart, and is recommended for adults 50 and older. It cuts the risk of shingles and severe complications by a large margin—protection is strongest in the first years after vaccination. Common side effects are soreness at the shot site, fatigue, and fever for a day or two—these are normal immune responses.

At home, keep the rash clean and covered, use cool compresses, wear loose clothing, and avoid touching or scratching blisters. Stay away from people who haven’t had chickenpox or the vaccine, newborns, and pregnant women until lesions scab over. If you’re unsure about treatment or vaccination, talk to your doctor—especially if you’re older or have other health issues.

Want more on antiviral choices or how herpes affects kids? Check our related pieces on Valtrex alternatives and Understanding Herpes in Kids for practical, user‑friendly info from the same site.