Shingles is a painful, blistering rash that follows one nerve on one side of the body. It is caused by the chickenpox virus waking up years later. Antiviral tablets help most when they are started within three days of the rash appearing. A contagious varicella virus infection with successive crops of itchy blisters.
The same eight facts on every condition comparison.
Truncal shingles A band around one side of the chest or back.
Facial and ocular shingles Forehead, scalp or around the eye.
Disseminated shingles Widespread; in weakened immunity.
Chickenpox Red bumps, small blisters, and crusted spots appear together on the back.
Varicella-zoster virus remains dormant in sensory nerves after chickenpox. When it reactivates, it travels toward the skin and can cause pain and grouped blisters in a one-sided nerve distribution.
Initial infection with varicella-zoster virus produces the chickenpox rash. The virus then remains dormant in sensory nerves and may later reactivate as shingles.
Shingles. Risk rises with age, particularly after age 50, but younger people can be affected.
Chickenpox. Can occur at any age without immunity; adult illness may be more severe.
Shingles is caused by the chickenpox virus waking up years after it first infected you. The virus stays dormant in nerves and can reactivate later.
Varicella-zoster virus causes the primary infection and remains dormant afterwards.
Evidence labels come from each condition’s own treatment list.
The first step for shingles pain, and enough on their own for a milder episode. They work better taken regularly than only when the pain peaks. Shingles pain is nerve pain, so if these are not holding it, that is a reason to ring your doctor rather than to take more.
Dabbed on while the blisters are present, it cools the skin and takes the edge off the itching. A cool compress does much the same thing. Neither shortens the episode, and neither should be rubbed in, because breaking the blisters spreads virus and can leave scars.
An oatmeal soak can settle itching while the rash is blistering, in cool rather than hot water. It is comfort only. It does not change how long shingles lasts or whether nerve pain follows.
A thin layer of plain petroleum jelly on broken or crusting areas stops them drying and cracking, which lowers the risk of bacteria getting in. It has no effect on the virus itself. Use it under a loose, non-stick dressing rather than an adhesive one, which tears blisters when it comes off.
A numbing patch worn over the area for pain that carries on after the rash has healed. It goes only on intact skin, never on blisters or open areas. It helps some people a great deal and others hardly at all, so it is worth a proper trial before deciding.
A high-strength patch applied in a clinic for lasting nerve pain, with one treatment lasting up to three months. It burns while it is on, so the skin is numbed first. It is used after simpler options, and only once the skin has fully healed.
An antibiotic ointment used only if the crusts turn hot, swollen or start oozing pus, which means bacteria have moved in on top. It does nothing to the shingles virus. If the infection is spreading, antibiotic tablets are needed instead.
The usual first choice for shingles: three doses a day for seven days. Started within 72 hours of the rash it shortens the episode and lowers the chance of lasting nerve pain. It does not clear the virus from the body, and it does much less once everything has crusted over.
An equally effective alternative to valacyclovir, taken three times a day for seven days. It is used when valacyclovir does not suit. The same 72-hour clock applies, and it is usually the more expensive option.
The oldest of the three antiviral tablets and the cheapest. It works just as well, but it has to be taken five times a day for seven days, which is harder to keep up. The dose is lowered if your kidneys are not working well.
Nerve pain medicines rather than ordinary painkillers. They are the main treatment for pain that carries on after the rash heals, and they are often started during the episode when pain is severe. The dose is built up slowly, and they can make you drowsy or unsteady at first.
A low dose of an old antidepressant, taken at night for nerve pain. It suits people whose shingles pain is keeping them awake. It takes a few weeks before you can judge it, and it is used carefully in older adults because of dry mouth, dizziness and confusion.
A short course of steroid tablets is sometimes added to antivirals for severe pain or when the facial nerve is involved. It can speed up rash healing and early pain a little. Studies have not shown that it prevents lasting nerve pain, and it is never given on its own for shingles.
Selected higher-risk patients benefit from early prescription antiviral treatment; contact a clinician promptly.
Two injections a few months apart, more than 90 percent effective at preventing shingles in adults 50 and over. It prevents rather than treats, so it is not used during an episode. It is still recommended once an episode has cleared, because having had shingles does not protect you from having it again.
An episode runs two to four weeks, the pain sometimes longer. Most people get it once, though it can recur if the immune system is suppressed.
Most otherwise healthy children recover as the blisters crust over and heal. Some marks take longer to fade; pregnancy, immune suppression or significant illness changes the risk and needs medical advice.
Postherpetic neuralgia
Nerve pain that carries on after the skin has healed, because the virus damaged the nerve it traveled down. It is the most common complication of shingles, and the risk climbs steeply with age. Starting antiviral tablets within 72 hours and controlling the pain properly from day one both lower the chance of it. It is treatable, so it is worth going back rather than waiting for it to fade.
Shingles in the eye
When the affected nerve serves the forehead and eye, blisters appear on the forehead, the eyelid or the tip and side of the nose, and the eye itself can be involved. It can cause lasting damage to sight. Blisters anywhere in this area are a same-day problem, and often need an eye specialist as well as antiviral tablets.
Shingles in the ear
Blisters in or around one ear, together with weakness on that side of the face, and sometimes a change in hearing, ringing or dizziness. It is uncommon. It needs urgent treatment, because the facial nerve recovers better the sooner antiviral tablets and steroids are started.
Bacterial skin infection and other complications can occur; pregnancy and immune suppression increase concern.
Seek prompt care when shingles is suspected because antivirals work best early. Eye or ear involvement, widespread blisters or weakened immunity needs urgent assessment.
Contact a clinician promptly for pregnancy, immune suppression, adult infection or severe illness. Avoid ibuprofen unless advised.
Not with shingles - nobody catches shingles from you. But the blister fluid can give chickenpox to someone who has never had chickenpox and never been vaccinated. Keep the rash covered, wash your hands, and stay away from newborns, pregnant people who are not immune, and anyone immunosuppressed until it crusts.
Possibly not. The evidence is strongest inside 72 hours, but treatment is often still given if new blisters are forming, if you are older, if the rash involves the face or eye, or if you are immunosuppressed. Being late is a reason to be seen today.
Nerve pain that continues after the rash heals, from damage to the nerve the virus traveled down. Much more common in older adults, and it can last months. It is treatable with different drugs from ordinary painkillers, so go back rather than waiting it out.
Generally yes. One episode does not protect you from another, and vaccination is recommended once an episode has cleared. Ask your doctor about timing.
The virus travels down a single sensory nerve, and each nerve supplies a strip of skin on one side. That is also why the rash stops abruptly at the midline - one of the clearest clues.
Yes, though most people do not. Recurrence is more likely if your immune system is suppressed. If it has happened more than once, ask whether anything underlying should be looked into.
A contagious varicella virus infection with successive crops of itchy blisters.
Avoid scratching, keep nails short and avoid exposing high-risk contacts. Do not give aspirin to children.
Contact a clinician promptly for pregnancy, immune suppression, adult infection or severe illness. Avoid ibuprofen unless advised.
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