Shingles (Dad): Symptoms, Treatment and Prevention

A burning, tingling or sharp pain on one side of the body, followed a few days later by a band of painful blisters. Shingles, known in Urdu as dad or herpes zoster, affects about one in three people at some point in life, mostly after the age of 50. It is not usually dangerous, but the pain can be severe and sometimes lingers for months, so early treatment makes a real difference.

What causes shingles?

Shingles is caused by the varicella-zoster virus, the same virus that causes chickenpox. After chickenpox, the virus hides quietly in nerve roots for life. Years later, particularly when immunity is lower because of age, stress, illness or certain medicines, it can reactivate and travel along a nerve to the skin.

Who is at higher risk?

• Adults over 50, and the risk rises with age
• People with weak immunity, including those with diabetes, cancer, HIV or on steroids and immune-suppressing medicines
• People under major physical or emotional stress, or recovering from illness

Symptoms

It usually unfolds in stages:

• Days 1 to 5: burning, tingling, itching or deep pain in one area on one side of the body, sometimes with fever, headache and tiredness.
• Then: a red rash appears in a band or strip, usually on one side of the chest, back or abdomen. It can also appear on the face or around the eye.
• Next: clusters of fluid-filled blisters, which break open, ooze and crust over in about 7 to 10 days.
• The rash heals in 2 to 4 weeks, sometimes leaving scars or marks.

Is shingles contagious?

You cannot catch shingles from someone. But the fluid in the blisters can spread the chickenpox virus to a person who has never had chickenpox or the vaccine, causing chickenpox rather than shingles. Until the blisters have crusted over, cover the rash, wash your hands, and avoid newborns, pregnant women who have not had chickenpox, and anyone with weak immunity.

Treatment: start early

• Antiviral medicines such as acyclovir or famciclovir work best when started within 72 hours of the rash appearing. They shorten the illness and lower the risk of long-lasting nerve pain. Please see a doctor as soon as you notice the rash.
• Pain relief: paracetamol or other painkillers as advised. For severe nerve pain, doctors may prescribe gabapentin or pregabalin.
• Skin care: keep the rash clean and dry, apply cool, damp compresses, and wear loose cotton clothes. Calamine lotion can soothe itching. Do not burst blisters. Your doctor may prescribe an antibiotic cream if it gets infected.
• Do not put ghee, turmeric paste, toothpaste or herbal powders on the blisters, which can cause infection.
• Rest, eat well, and drink fluids.

Complications

• Post-herpetic neuralgia: nerve pain lasting weeks to months after the rash has healed. It is more common in older adults. Early antiviral treatment helps prevent it, and doctors have nerve-pain medicines to control it.
• Shingles near the eye can damage vision and needs urgent attention by an eye specialist.
• Shingles on the ear or face can cause hearing loss or facial weakness.
• Bacterial skin infection, scarring, and widespread rash in people with weak immunity.

Prevention

A shingles vaccine is available in some countries and recommended for adults aged 50 and over. It greatly reduces the chance of shingles and the nerve pain that follows. Ask your doctor whether it is available and suitable for you. The chickenpox vaccine in childhood also lowers the risk.

When to see a doctor straight away

• A painful one-sided rash, especially in the first three days
• Any rash on the face, near the eye, nose tip or ear
• You are over 60, pregnant, or have diabetes or weak immunity
• Fever, spreading redness, pus or increasing pain
• Pain that persists after the rash has healed

Key takeaways

• Shingles is a reactivation of the chickenpox virus, causing a painful one-sided blistering rash.
• See a doctor within 72 hours, as antivirals work best when started early.
• Rash near the eye is an emergency. Nerve pain can linger after the rash heals.
• Cover the rash, and avoid newborns, pregnant women and people with weak immunity until the blisters crust.

Related medicines on Medimart

• Acyclovir and famciclovir: antiviral medicines prescribed for shingles
• Gabapentin and pregabalin: used for nerve pain after shingles

Browse nerve pain products and skin infection products on Medimart, delivered across Pakistan. Prescription medicines are supplied only against a valid prescription and should be taken only as advised by your doctor.

This guide is for general information and does not replace advice from a doctor.