Harvard Health Letter

Is that rash shingles?

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Cope with the blistering rash using antivirals and painkillers.

If your doctor diagnoses a painful rash as shingles, also known as herpes zoster, you're in for more pain. The virus inhabits nerves, and blisters arise near the affected nerves, making the skin especially sensitive. To combat pain, your doctor will prescribe a medicine to kill the virus—such as famciclovir (Famvir) or valacyclovir (Valtrex). That can help within three days of the start of the rash. Also helpful are nonsteroidal anti-inflammatory drugs like ibuprofen (Advil, Motrin) or naproxen (Aleve); acetaminophen (Tylenol); or a stronger prescription pain medicine if necessary. The blisters will last for a few weeks, and the pain may last for months. In 10% of cases, pain may last even longer.

The good news is that shingles will not return in 98% of people, although those with AIDS have a 20% chance of recurrence. So should you get the shingles vaccine if you've already had this painful rash? "The guidelines recommend that people with a history of shingles receive the vaccine. However, the only clinical trial done with the vaccine did not include people with a prior history of shingles, so we do not know definitively if the vaccine works in this patient population," says infectious disease specialist Dr. Paul Sax, who's a Harvard Medical School professor. Talk to your doctor to see if the shingles vaccine is right for you.

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