Shingles: early signs, why fast treatment matters, and when to get care

Shingles often starts with pain, itching or tingling in one area. A few days later, a rash appears there. Some people also have a fever before the rash.

• A painful, often itchy rash on one side of the body or face
• Most often, a stripe of rash around the left or right side of the chest or belly
• Blisters that scab over in 7 to 10 days

The rash usually clears up in 2 to 4 weeks.

Antiviral medicines, like acyclovir, valacyclovir and famciclovir, can make shingles shorter and less severe. They work best when you start them as soon as the rash appears, ideally within about 3 days.

Pain medicine can ease the pain. Wet compresses, calamine lotion and warm oatmeal baths can ease itching.

You cannot give someone shingles. But fluid from the blisters can give chickenpox to a person who never had chickenpox or the chickenpox vaccine.

Keep the rash covered until it crusts over, try not to touch or scratch it, and wash your hands often. Until then, stay away from pregnant people who never had chickenpox or the vaccine, from babies born early or very small, and from people with a weak immune system.

A shingles vaccine can prevent shingles. CDC recommends 2 doses for adults 50 and older, and for adults 19 and older with a weak immune system.

Get emergency care right away for a rash near or around the eye, on the forehead near the eye, or on the tip of the nose. Shingles there can hurt your eye and your vision. Also go to the emergency room for confusion, a stiff neck or a very bad headache. These can be signs that the virus has spread to the brain.

See a doctor in person, the same day, for:

• New weakness or drooping of the face, ear pain, or a change in hearing or balance
• A rash that spreads over many areas of the body, or crosses to the other side
• A fever
• Shingles with a weak immune system
• Pain that over-the-counter medicine does not control

If you are in Virginia or West Virginia, you can start a visit online at any time. It is for adults and children 4 and older (with a parent or legal guardian) with a painful rash on one side of the body or face that started within the last 72 hours. You send a clear photo of the rash.

A board-certified physician reviews your answers and photo. If an antiviral is right for you, the doctor can send it to your pharmacy. If you need to be seen in person, the doctor will tell you.

It is not the right fit if you have:

• A rash near or around the eye, on the forehead near the eye, or on the tip of the nose
• New weakness or drooping of the face, ear pain, or a change in hearing or balance
• A rash in many areas of the body or crossing to the other side, or you feel very sick
• A weak immune system, like from HIV, an organ transplant, chemotherapy, or medicines like prednisone, methotrexate or biologics
• Fever, confusion, a bad headache or a stiff neck
• A rash that started more than 72 hours ago with no new blisters
• Pain that over-the-counter medicine does not control

It is also not for anyone who is pregnant.

Visits start at $59. You see the price before you pay, and you do not need insurance.