Herpes Zoster

Key facts

• Herpes zoster (shingles) is caused by the varicella-zoster virus reactivating after lying dormant in nerve tissue, sometimes for decades after a chickenpox infection.
• It causes a painful, blistering rash in a band across one side of the chest, back, or face, usually preceded by several days of burning or shooting pain.
• Antivirals such as famciclovir and valaciclovir work best when started within 72 hours of the rash appearing; they shorten the episode and reduce pain severity.
• Seek urgent care for a rash near the eye, facial weakness, or shingles in someone with a weakened immune system.

The pain comes first

Before any rash appears, most people notice several days of burning, shooting, or prickling pain in a localised area, often with sensitivity to touch. The blisters follow, usually crusting over within two to four weeks. In some people, particularly older adults, nerve pain persists long after the skin heals, a complication called post-herpetic neuralgia.

Starting antivirals early matters

Antiviral medicines work best when taken within 72 hours of the rash appearing. Famciclovir and valaciclovir are both well-established options from the antivirals category; they shorten the episode and reduce the severity of pain. Prompt treatment also lowers the risk of post-herpetic neuralgia developing.

When to seek urgent care

Seek urgent medical attention if the rash appears near the eye, if you develop facial weakness, or if you have a condition that weakens your immune system, since shingles can be more severe and harder to control in these situations.

This page is educational and does not replace advice from a doctor or pharmacist who knows your health history.