Shingles: medication, causes, symptoms and ways to help relieve pain

This article is up to date as of July 24, 2025, and based on vaccine guidance provided by the U.S. Centers for Disease Control and Prevention (CDC). Individual states may adopt their own vaccine policies and recommendations based on local public health assessments and regulatory frameworks. For the most up-to-date information, consult a state or local health care provider.

If someone is suffering from shingles, here are some options to help support relief.

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Television commercials about shingles and its associated pain may make people wince, and with good reason: Shingles is serious stuff. The viral infection may cause a painful skin rash and nerve infection.

The shingles vaccination is the only way to protect against shingles and related complications from the disease. Anyone 19 or older with a weakened immune system or age 50 or older should get vaccinated, even if they’ve had shingles already.

If someone is suffering from a current case, they should contact their health care provider. Anyone who hasn’t had it yet will want to understand how the virus strikes and what they can do to prevent it.

What is shingles?

Herpes zoster, commonly known as shingles, is characterized by painful rashes caused by the varicella-zoster virus (VZV), which is the same virus that causes chickenpox. After people recover from a bout of chickenpox, the body doesn’t get rid of the virus. Instead, the virus remains dormant in the nerve cells for years, even decades. But for about one in three people, VZV may reactivate and cause shingles.

What causes shingles?

Precisely what unleashes the virus is still not known, but it often occurs when immunity to VZV is weakened by illness, certain medications, stress or age. “The strength of our immune system decreases with age, putting older patients at risk of varicella-zoster virus reactivation,” says Eric Ascher, DO, a family medicine physician affiliated with Lenox Hill Hospital in New York City.

The virus travels along various nerve pathways to the skin, producing shingles. The shingles rash tends to appear on one side of the body, such as the torso, neck or forehead, including the skin around the eye or jaw (although it can appear anywhere). The location of the shingles rash depends on which nerves the virus travels along.

What are shingles symptoms?

Early shingles symptoms typically begin with unusual itching, burning or tingling. “Someone may also develop a low fever and a headache, and feel down and out and generally flu-ish,” says Danilo Del Campo, MD, FAAD, a dermatologist at the Chicago Skin Clinic. Within days, a painful rash develops along with a cluster of fluid-filled blisters that scab over in 7 to 10 days.

How long does shingles last?

Most cases of shingles clear up in 2 to 4 weeks. But even after the rash is gone, 10 to 18 percent of people will experience deep burning, sometimes stabbing, nerve pain — a chronic condition called postherpetic neuralgia (PHN). It’s uncommon in people age 40 or younger, but the incidence increases dramatically with age.

Although not common, the pain from PHN can last for months or years. “The pain can become so intense that the slightest movement or touch can feel unbearable,” says Dr. Ascher.

Is shingles contagious?

People with shingles cannot spread the virus before their rash blisters appear. However, once the blisters are evident, contact with their fluid can spread VZV to people who haven’t received the chickenpox vaccine or haven’t previously had the condition. If infected, they will develop chickenpox and may develop shingles later in life.

The risk of spreading VZV to others is low if people cover their shingles rash or after the rash crusts over. They remain contagious until all blisters have formed a scab, approximately 7 to 10 days later.

Shingles treatment

If someone thinks they’re having a shingles outbreak, they should make every effort to see a health care provider immediately. While no medicine can eliminate the virus that causes shingles, early treatment is critical to help lessen the pain, to shorten the length and severity of the outbreak and to reduce the risk of developing PHN. “It’s important to see a health care provider within 72 hours after someone first feels pain or a burning sensation,” says Dr. Del Campo. “The sooner someone receives treatment, the sooner they’ll hopefully feel better.”

Ways to help relieve shingles pain

Treatment of shingles symptoms includes a combination of either over-the-counter (OTC) pain relievers or prescription antiviral and pain-relieving medications.

Minor discomfort

To help relieve minor discomfort, a health care provider might prescribe OTC pain relievers and nonsteroidal anti-inflammatories. It's best to start antiviral medication within 72 hours of developing a rash.

Experts also suggest taking an antiviral medication only available by prescription that a provider may recommend. The antiviral medication should be taken as soon as possible after the rash emerges to help shorten a shingles attack and ease the pain of the rash.

Itchy skin

To help soothe itchy skin, people with shingles may apply a clean, cool, moist washcloth to the rash and blisters, soak in a cool oatmeal bath, apply a thin layer of petroleum jelly or calm the skin with calamine lotion after the shingles blisters have scabbed over.

Lingering pain

For lingering pain due to PHN, a health care provider may prescribe a variety of other treatments. These include:

• Capsaicin (an extract of chili pepper), which works to desensitize receptors that cause people to experience pain. Available in creams, it is also frequently used for arthritis pain relief.
• Certain skin-surface numbing products such as prescription-strength lidocaine, available in numerous formulations like creams, patches, roll-ons and sprays. One 2020 study found that a 5 percent lidocaine patch was “well-tolerated and ensured rapid pain relief.”
• Oral prescription medications such as gabapentin and pregabalin that work as pain relievers by changing the way nerves send messages to the brain.
• Corticosteroids to reduce swelling and pain (though researchers caution about possible side effects).

Preventing shingles

To prevent shingles, “vaccination is the best line of protection,” says Dr. Ascher. It is recommended that adults age 50 or older — even if they’ve been previously vaccinated with the older, now-discontinued shingles vaccine or have had shingles before — get two doses typically separated by two to six months. People should also get vaccinated if they are age 19 or older and have a weakened immune system.

If someone has had shingles in the past, there’s no specific length of time they need to wait, according to the CDC.

Shingles vaccine side effects

As with all vaccines, there may be side effects. Side effects from current shingles vaccines might last two to three days and may include the following:

• Fever
• Headache
• Muscle pain
• Nausea
• Redness/swelling at the injection site
• Sore arm
• Tiredness

Guillain-Barré syndrome (GBS) is a nervous system disorder reported in rare cases after a shingles vaccine dose. Note, however, that there is also a very small increased risk of GBS after having shingles.

Vaccine availability varies by state based on law. Age restrictions apply. Available when a certified immunizer is on duty.

FOR SHINGLES VACCINE OPTIONS: This content is for informational purposes only and is not medical advice. Availability varies by state based on regulations. This is not an all-inclusive list of who should be vaccinated. Age restrictions apply. Consult with your health care provider or talk to your CVS pharmacist to see if a shingles vaccine is right for you. Visit CVS.com/Vaccines for details.

These statements have not been evaluated by the Food and Drug Administration. These products are not intended to diagnose, treat, cure or prevent any disease.

This content is for informational purposes only and is not medical advice. Consult your health care provider before taking any vitamins or supplements, and prior to beginning or changing any health care practices.