Overview
Shingles, also known as herpes zoster, is a painful skin condition caused by the varicella-zoster virus, the same virus that causes chickenpox. After you recover from chickenpox, usually in childhood, the virus does not leave your body. Instead, it lies dormant in the nerve tissue near your spinal cord and brain. Years or even decades later, the virus can reactivate and travel along the nerve fibres to the skin, causing the characteristic shingles rash. According to the NHS, shingles affects around one in four people at some point in their lifetime and is most common in adults over the age of 50. You cannot catch shingles from someone who has it, but if you have never had chickenpox, you could catch chickenpox from contact with the shingles rash. The condition can occur at any age but becomes more likely as the immune system naturally weakens with age or due to illness or medication.
Shingles usually begins with a tingling, burning, or painful sensation on one side of the body, often on the torso, chest, abdomen, or face. This pain can be intense and is sometimes mistaken for a muscle strain, heart problem, or other condition. Within a few days, a red, blotchy rash appears in the same area, which quickly develops into fluid-filled blisters similar in appearance to chickenpox. The blisters typically crust over within seven to ten days and fully heal within two to four weeks. Other symptoms may include a high temperature, headache, fatigue, and a general feeling of being unwell. The rash almost always appears in a band or strip on one side of the body, following the path of a single nerve. In some cases, shingles can affect the eye, known as ophthalmic shingles, which requires urgent medical attention to prevent damage to your vision. If you develop a rash near your eye, or if you are unsure whether your symptoms could be shingles, seek advice from your pharmacist or GP as soon as possible. Early treatment within 72 hours of the rash appearing is most effective.
Treatment for shingles focuses on reducing the severity and duration of symptoms and preventing complications. If you are diagnosed within 72 hours of the rash appearing, your doctor or pharmacist may prescribe antiviral medication such as aciclovir or valaciclovir, which can help the rash heal faster and reduce the risk of long-term nerve pain. Antiviral treatment is particularly important for people over 50, those with weakened immune systems, and anyone with shingles affecting the eye or ear. Pain relief is also an important part of treatment. Over-the-counter painkillers such as paracetamol and ibuprofen can help with mild to moderate pain, while stronger pain relief may be prescribed for more severe cases. Calamine lotion can soothe itching, and keeping the rash clean and covered with a non-adhesive dressing helps prevent bacterial infection. Cool compresses may also provide relief. Under the NHS Pharmacy First service, pharmacists at Allied Pharmacies can now assess and treat shingles directly, including supplying antiviral medication where clinically appropriate, without the need for a GP appointment.
The most common complication of shingles is postherpetic neuralgia, a condition in which pain persists in the affected area long after the rash has healed. This nerve pain can last for months or even years and is described by sufferers as a burning, stabbing, or throbbing sensation that can be severe enough to interfere with daily activities, sleep, and quality of life. Postherpetic neuralgia is more likely to occur in older adults and in people who experienced severe pain or a widespread rash during the initial shingles episode. Treatment may include prescription painkillers, nerve pain medications such as amitriptyline, gabapentin, or pregabalin, topical treatments such as capsaicin cream or lidocaine patches, and in some cases, referral to a specialist pain clinic. Starting antiviral treatment early, ideally within 72 hours of the shingles rash appearing, is one of the most effective ways to reduce the risk of developing postherpetic neuralgia. The NHS postherpetic neuralgia guide provides further information on managing this condition.
The most effective way to prevent shingles and its complications is through vaccination. The NHS offers a free shingles vaccine to eligible adults as part of the national immunisation programme. The current vaccine used in the UK is Shingrix, a non-live recombinant vaccine given in two doses, two to six months apart. Since September 2023, the NHS shingles vaccination programme has been expanding and is now available to adults turning 65 and those aged 70 to 79 who have not yet been vaccinated. People with severely weakened immune systems may be eligible from the age of 50. The vaccine is highly effective, reducing the risk of developing shingles by over 90 per cent and significantly lowering the risk of postherpetic neuralgia. Even if you have had shingles before, you can still benefit from the vaccine, as the condition can recur. You can receive the shingles vaccine at your GP surgery or at participating pharmacies. The NHS shingles vaccination page provides full details on eligibility and how to book your appointment.
While anyone who has had chickenpox can develop shingles, certain groups are at significantly higher risk. Adults over the age of 50 are more susceptible as the immune system naturally weakens with age. People with conditions that suppress the immune system, such as HIV, leukaemia, lymphoma, or those undergoing chemotherapy, radiotherapy, or taking immunosuppressant medications after an organ transplant, face an increased risk. Prolonged periods of stress, physical illness, or extreme fatigue can also trigger reactivation of the virus. It is estimated that around one in four people will develop shingles at some point in their life, with the risk increasing significantly after the age of 70. If you fall into a higher-risk category, it is particularly important to be aware of the early symptoms so that you can seek treatment promptly. Speaking with your pharmacist or GP about whether you are eligible for the shingles vaccine is one of the most effective preventive steps you can take.
Shingles itself is not contagious, meaning you cannot catch shingles from someone who has it. However, the varicella-zoster virus that causes shingles can be passed to someone who has never had chickenpox or the chickenpox vaccine, giving them chickenpox rather than shingles. The virus spreads through direct contact with the fluid from the shingles blisters, not through coughing, sneezing, or casual contact. Once the blisters have crusted over, the person is no longer infectious. To reduce the risk of spreading the virus, you should keep the rash covered with a loose, non-adhesive dressing, avoid touching or scratching the blisters, wash your hands frequently, and avoid close contact with pregnant women who have not had chickenpox, newborn babies, and anyone with a weakened immune system until all blisters have fully crusted over. If you are unsure whether your rash is still infectious, your pharmacist can advise you.
Shingles is one of the conditions that can be assessed and treated directly by pharmacists under the NHS Pharmacy First service. This means you can visit your nearest Allied Pharmacies branch without a GP appointment and receive a clinical assessment, advice on managing your symptoms, and where appropriate, a supply of antiviral medication to start treatment as quickly as possible. Early treatment is crucial for reducing the severity of shingles and lowering the risk of complications such as postherpetic neuralgia, so being able to access care at your pharmacy without waiting for a GP appointment can make a real difference to your recovery. Our pharmacists can also recommend suitable over-the-counter pain relief and soothing treatments, advise on caring for the rash at home, and refer you to your GP or hospital if your symptoms are severe or affecting your eye. If you are already taking medication for shingles or postherpetic neuralgia, our New Medicine Service provides structured follow-up consultations to check how your treatment is working, and our Prescription Dispensing service ensures your prescriptions are managed accurately.
If you experience a tingling, burning, or painful sensation on one side of your body followed by a rash or blisters, do not wait to seek help. The sooner shingles is diagnosed and treated, the better your outcome is likely to be. Visit your nearest Allied Pharmacies branch for a Pharmacy First assessment, or contact your GP if you are unable to visit a pharmacy. If the rash is near your eye, seek urgent medical attention. For more information about shingles, visit the NHS shingles guide. To check whether you are eligible for the free NHS shingles vaccine, visit the NHS shingles vaccination page. To find your nearest Allied Pharmacies branch, visit www.alliedpharmacies.com. Acting quickly can prevent weeks of unnecessary pain and help you recover faster.