Patient Education – Shingles

What It Is

Shingles is a painful skin rash caused by the same virus that causes chickenpox. After you recover from chickenpox, the virus stays asleep in your nerves and can wake up years later as shingles.

Causes and Risk Factors

• The varicella-zoster virus causes shingles.
  
  

• It happens when the virus becomes active again, often when your immune system is weak.
  
  

• Risk factors include:
  
  

  • Being over 50 years old
    
    

  • Having a weak immune system (from illness, medicines, or stress)
    
    

  • Having had chickenpox before
    
    

  • Stress or trauma to the body
    
    

Signs and Symptoms

Early warning signs:

• Burning, tingling, or pain in one area of the body or face
  
  

• Sensitivity or itching on the skin
  
  

Then, a rash appears:

• Red patches with blisters that may break open and crust over
  
  

• Usually appears on one side of the body or face in a stripe pattern
  
  

• Pain can be severe and last after the rash heals (called postherpetic neuralgia)
  
  

Other symptoms:

• Fever, headache, or feeling tired
  
  

• Sensitivity to touch
  
  

Complications If Untreated or Noncompliance

• Long-lasting nerve pain (postherpetic neuralgia)
  
  

• Skin infections from scratching blisters
  
  

• Vision loss if shingles affect the eye (ophthalmic shingles)
  
  

• Hearing loss or facial paralysis (rare)
  
  

Treatment and Self-Care Measures

• Start antiviral medicines as soon as possible (within 72 hours) to lessen symptoms and healing time
  
  

• Pain relievers or nerve pain medicines to ease discomfort
  
  

• Keep rash clean and dry
  
  

• Avoid scratching to prevent infection
  
  

• Use cool compresses to soothe skin
  
  

• Rest and reduce stress
  
  

Common Types of Medications

• Antiviral drugs: acyclovir, valacyclovir, famciclovir (side effects: nausea, headache)
  
  

• Pain medicines: acetaminophen, ibuprofen, or stronger prescription meds (side effects vary)
  
  

• Nerve pain medicines: gabapentin or pregabalin (side effects: dizziness, tiredness)
  
  

• Topical creams: for itching or pain relief
  
  

Dietary Needs

• No special diet required
  
  

• Eat a balanced diet with plenty of fruits, vegetables, and fluids to support healing
  
  

• Avoid alcohol while taking medications
  
  

Lifestyle Changes

• Manage stress through relaxation techniques
  
  

• Avoid contact with pregnant women, newborns, or people with weak immune systems while rash is active
  
  

• Get plenty of rest
  
  

• Practice good hygiene
  
  

Safety Considerations

• Cover the rash to prevent spreading the virus to others who haven’t had chickenpox or the vaccine
  
  

• Wash hands often
  
  

• Dispose of bandages safely
  
  

• Avoid scratching or touching the rash
  
  

Prevention and Maintenance Tips

• Get the shingles vaccine if you are 50 or older
  
  

• Keep your immune system strong by eating well, exercising, and managing stress
  
  

• Seek care early if you notice symptoms
  
  

When to Call for Help

Call your Home Health Agency or Doctor if you have:

• New or worsening pain
  
  

• Signs of skin infection (redness, swelling, pus)
  
  

• Fever higher than 101°F (38.3°C)
  
  

• Rash spreading to eyes or face
  
  

• Blisters that do not heal or worsen after 7 days
  
  

Go to the Emergency Room or Call 911 if you have:

• Vision changes or eye pain
  
  

• Difficulty breathing or swallowing
  
  

• Severe headache or stiff neck
  
  

• Weakness or numbness in the face or body
  
  

• Confusion or difficulty staying awake
  
  

© 2025 Judith Regan / K.N.O.W. – Knowledge for Nurturing Optimal Well-Being. All rights reserved. | Educational use only | Not a substitute for medical advice | In emergencies call 911

Patient Homework / Assessment

Instructions: Choose True or False for each statement. Correct any false statements.

1. True or False: Shingles is caused by the same virus as chickenpox.
   
   

2. True or False: Only children can get shingles.
   
   

3. True or False: The rash usually appears on one side of the body.
   
   

4. True or False: Pain and tingling can start before the rash appears.
   
   

5. True or False: Scratching the blisters is safe and helps healing.
   
   

6. True or False: Antiviral medicines work best if started early.
   
   

7. True or False: Shingles can cause long-lasting nerve pain after the rash heals.
   
   

8. True or False: The shingles vaccine can help prevent shingles.
   
   

9. True or False: You should avoid contact with certain people while the rash is active.
   
   

10. True or False: Alcohol is safe to drink while taking shingles medicines.
    
    

11. True or False: Good hygiene helps prevent spreading the virus.
    
    

12. True or False: Shingles only causes a rash and no other symptoms.
    
    

13. True or False: You can get shingles more than once.
    
    

14. True or False: The rash from shingles always appears on both sides of the body.
    
    

15. True or False: If shingles affect your eye, it can cause vision loss.
    
    

16. True or False: You don’t need to tell your doctor if your rash gets infected.
    
    

17. True or False: Stress can trigger shingles to come back.
    
    

18. True or False: It is okay to share towels or clothing with others while you have shingles.
    
    

19. True or False: Pain medicines can help control shingles pain.
    
    

20. True or False: Rest and good nutrition support healing from shingles.
    
    

Individualized Questions for Patients

• When did your rash first appear?
  
  

• Have you started antiviral medicines?
  
  

• Are you experiencing pain or itching? How severe is it?
  
  

• Do you have any vision problems or eye pain?
  
  

• Have you had the shingles vaccine?
  
  

• Are you able to keep the rash clean and dry?
  
  

• Do you have any side effects from medications?
  
  

• Have you noticed any new symptoms?
  
  

• Are you avoiding contact with people at risk?
  
  

• How is your stress level, and are you using any relaxation methods?