What to know about shingles in older adults

Shingles, also called herpes zoster, occurs when the chickenpox virus becomes active again in a nerve. Burning, tingling, sensitivity, or pain may begin before clusters of blisters appear. The rash often follows a narrow band on one side of the chest, back, face, or another body area. Blisters eventually crust. Pain can continue after the skin clears because the affected nerve remains irritated.

Contact a clinician as soon as a painful, blistering, one-sided rash appears, particularly when it involves the face. Antiviral medicine may be considered early, and a clinician can recommend suitable pain relief alongside it. Keep the rash clean and covered when possible, avoid scratching, and wash hands after touching it. Until blisters have crusted, avoid direct contact between the rash and people who are pregnant, immunocompromised, or have never had chickenpox or vaccination. Shingles itself is not passed as shingles, but fluid from blisters can transmit chickenpox virus.

Seek urgent medical attention for a rash near the eye or on the nose, vision changes, facial weakness, severe headache, confusion, widespread blisters, or fever with marked illness. Prompt review is also needed when pain is severe, the person has a weakened immune system, or the rash spreads beyond one area. These situations can require focused treatment and monitoring.

Ask whether the rash fits shingles, whether antiviral treatment is appropriate, how to manage nerve pain, and which contacts should be protected. Ask about vaccination after recovery and what symptoms would require reassessment.