Shingles is a viral infection that affects your nerves. It causes a painful rash on one side of your body within the first week of symptoms, developing into itchy blisters. Pain usually peaks in a matter of days after you first notice symptoms.
According to the Centers for Disease Control and Prevention (CDC), the blisters typically scab over and clear up within a month. For most people, shingles pain typically disappears as the scabs heal.
However, for some people, the pain does not disappear. This is postherpetic neuralgia (PHN), and the older you are at the time of infection, the greater your risk of developing it. According to the CDC, up to 85% of people who develop PHN are over the age of 80.
Timeline of shingles
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Typically, the shingles rash goes through two to three different stages before disappearing. How severe shingles rash pain is varies between individuals.
Pre-eruptive phase
The pre-eruptive shingles phase happens within the first 1–5 days of the infection. No rash is visible at this stage, but you will experience symptoms that tell you something is wrong. Pain is typically not the most severe symptom of the prodromal phase, and you might experience:
During the eruptive phase, those patches of skin that were previously tingling or numb begin to form a rash. This is most likely the stage of shingles that causes the most pain, as the rash will begin to blister and form fluid-filled bumps.
These blisters eventually dry out, crusting over approximately 7–10 days after the rash first appears.
This rash occurs on one side of your body, typically around your waist, shoulders, and neck. In some rare cases, shingles rashes can form around your eye.
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Not everyone with a shingles infection experiences the chronic stage. This is when you have PHN, or nerve pain, that continues even after your rash disappears. Around 1 in 5 people with shingles go on to develop this type of chronic pain, but it’s rare in people under the age of 40.
Most people recover from PHN within 1 year of their first shingles symptoms, but it may last years or even become lifelong.
This stage of shingles can be severely painful, even to the point where a breeze can hurt the affected area. If you experience PHN, this may be the peak of your shingles pain.
Treatments
Typically, a doctor will recommend medications such as antivirals to help treat the infection early on. However, natural remedies you can use at home can provide relief while these medications start to work.
Medications
If you notice any symptoms of shingles, it is important to speak with a doctor as soon as possible. Many of the following medications are only effective if you take them in the early stages of a shingles infection.
Pregabalin can reduce the severity of PHN. According to a study from 2020, taking pregabalin reduces itching, pain episodes, and burning sensations in people with PHN.
These types of antidepressants help reduce pain from shingles infections and PHN.
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According to the National Institute of Aging (NIA), even if you’ve previously had a chickenpox infection, the shingles vaccine (Shingrix) is over 90% effective as protection from shingles and complications such as PHN.
The CDC recommends that anybody over the age of 50 should get the shingles vaccine. Also, any adults over the age of 18 who have a compromised immune system due to medications or existing health conditions should try to get the vaccine.
If you previously had the Zostavax vaccine, which is no longer in use, you still need the Shingrix vaccine.
Shingrix is given in two doses, and you can get it at your local doctor’s office or pharmacy.
Summary
Shingles is common, but it can be uncomfortable, with pain that may linger for months after the initial infection. For most people, the most severe pain from a shingles infection peaks during the first weeks of the infection, during the erupting phase.
To avoid lingering pain from PHN, speak with a doctor about getting the Shringrix vaccine if you are over the age of 50, have a health condition, or take medication that weakens your immune system.
As soon as you notice shingles symptoms, it is important to speak with a doctor to receive antiviral medications. These can help prevent pain and long-term complications.
