Adult Shingles Treatment (Herpes Zoster) in California
MD-only shingles evaluation by secure video in California, $49 flat-fee, no insurance required.
Shingles is caused by reactivation of the varicella zoster virus. It often begins with burning or tingling pain on one side of the body, followed by a blistering rash in a stripe pattern. Antiviral treatment works best when started early, ideally within 72 hours of rash onset. Telehealth is appropriate for many adults when the rash is typical and there are no red flags.
- $49 flat-fee visit
- MD-only evaluation and prescribing
- Antiviral therapy when appropriate
- Pain control guidance and recovery plan
- Adults only, California-based care
Clinician note: TeleDirectMD care is MD-only and guideline-based. Your visit is reviewed by a physician (Parth Bhavsar, MD). We prescribe antivirals when appropriate and we clearly explain when you need urgent in-person care, especially for eye involvement or significant immune compromise.
Online Shingles Care by California-Licensed MDs
- Typical rash pattern assessment
- Timing check for antiviral benefit
- Eye risk screening for facial shingles
- Return precautions for worsening symptoms
Adults only (18+). You must be physically located in California at the time of your visit. Rash on the face or near the eye, eye pain or redness, vision changes, severe headache, confusion, or significant immune compromise require urgent in-person evaluation.
What Is Shingles?
Shingles, also called herpes zoster, happens when the varicella zoster virus reactivates later in life after a prior chickenpox infection. It commonly causes a painful rash limited to one side of the body in a bandlike distribution. Pain can start before the rash appears.
TeleDirectMD focuses on adult evaluation of typical shingles presentations. During your video visit, the MD reviews symptom timing, rash location, pain severity, and red flags to determine whether antiviral treatment is appropriate and whether urgent in-person evaluation is needed.
Symptoms and Red Flags
Many cases of shingles can be treated as outpatient care, but certain locations and symptoms require urgent evaluation.
| Finding | What it suggests | Telehealth appropriate? | Red flag requiring in-person care |
|---|---|---|---|
| One-sided burning pain with blistering rash | Typical shingles pattern | Often yes | Rapid spread across multiple areas or severe illness |
| Rash on face or near the eye | Possible herpes zoster ophthalmicus risk | No | Same-day eye evaluation recommended |
| Eye pain, redness, light sensitivity, vision changes | Eye involvement possible | No | Urgent ophthalmology or ER evaluation |
| Severe headache, confusion, stiff neck | Neurologic complications possible | No | ER evaluation recommended |
| Significant immune compromise | Higher risk of severe disease | Often no | Lower threshold for urgent in-person care |
What Else Can Look Like Shingles?
- Contact dermatitis: itchy rash after an exposure, often bilateral or widespread.
- Herpes simplex: can cluster, but often recurs in the same area and may not follow a nerve band.
- Cellulitis: redness and warmth without clustered blisters.
- Insect bites: itch more than pain and are often scattered.
When a Video Visit Is Appropriate vs. When to Go In-Person
When a Video Visit Is Appropriate
- Adult 18+ with a typical one-sided rash pattern
- Rash not on the face near the eye
- Symptoms started within the last 72 hours
- No severe headache, confusion, or neurologic symptoms
- No significant immune compromise
- Physically located in California at the time of the video visit
Red Flags Requiring In-Person or Urgent Care
- Rash on the face or near the eye
- Eye pain, redness, light sensitivity, or vision changes
- Severe headache, stiff neck, confusion, or weakness
- Widespread rash or rapidly worsening illness
- Significant immune compromise
- Uncertain diagnosis or severe uncontrolled pain
Treatment Options for Adult Shingles
Antivirals can reduce the duration of rash and pain when started early. Treatment decisions depend on symptom timing, rash location, and risk factors. Pain control is also important.
Supportive Care and Pain Control
- Keep the rash clean and dry. Avoid picking blisters.
- Cool compresses can reduce discomfort.
- Acetaminophen 650 mg by mouth every 6 hours as needed, maximum 3000 mg per day.
- Ibuprofen 400 mg by mouth every 6 to 8 hours as needed with food if safe for you.
- Topical calamine lotion may help itching.
Antiviral Medication Options
| Medication | Dose | Duration | When used |
|---|---|---|---|
| Valacyclovir | 1 g by mouth 3 times daily | 7 days | Most common outpatient regimen, start early when appropriate |
| Acyclovir | 800 mg by mouth 5 times daily | 7 days | Alternative regimen in selected adults |
| Famciclovir | 500 mg by mouth 3 times daily | 7 days | Alternative regimen in selected adults |
TeleDirectMD does not prescribe controlled substances. Shingles on the face near the eye, any eye symptoms, severe headache, confusion, weakness, or significant immune compromise require urgent in-person evaluation.
Home Care, Contagiousness, and Return to Work
Shingles is contagious to people who have never had chickenpox or the chickenpox vaccine through direct contact with fluid from blisters. It does not spread through casual airborne contact the way chickenpox can. Covering the rash helps reduce transmission risk.
- Keep the rash covered when possible, especially around others.
- Avoid contact with pregnant people without immunity, newborns, and immunocompromised individuals until lesions crust over.
- Most adults can work if they feel well and the rash can be covered.
- If pain is worsening or rash is spreading rapidly, seek in-person evaluation.
What to Expect From Your TeleDirectMD Visit
TeleDirectMD provides adult-only, MD-only virtual urgent care by secure video. Visits typically last about 10 to 15 minutes and cost $49 as a flat cash fee with no insurance involvement. During your shingles visit, the MD reviews symptom timing, rash location, pain, risk factors, and red flags.
If your presentation is appropriate for telehealth, we can send an electronic prescription to your preferred local pharmacy in California when appropriate. If urgent in-person evaluation is needed, we will explain why and guide you on the safest next step.
We do not prescribe controlled substances.
Shingles Treatment FAQ
Can I get shingles medication online today?
Often, yes. If your rash pattern is typical and there are no red flags, TeleDirectMD can prescribe an antiviral and send it electronically to your local California pharmacy. Antivirals work best when started early.
How soon do I need to start antivirals?
Ideally within 72 hours of rash onset. Treatment may still be considered later in some scenarios, but early treatment is most effective.
Is shingles contagious?
Shingles can spread varicella zoster virus to someone without immunity through direct contact with blister fluid. Covering the rash and good hygiene reduce risk.
What is shingles on the face or near the eye?
Shingles on the face, especially near the eye, can threaten vision. If you have a facial rash or any eye symptoms, urgent in-person evaluation is recommended.
How long does shingles last?
The rash often crusts over in about 7 to 10 days, with full healing over 2 to 4 weeks. Pain can last longer in some adults.
Can shingles cause long-term nerve pain?
Some adults develop postherpetic neuralgia, which is persistent nerve pain after the rash resolves. Risk increases with age. Early antiviral therapy may reduce severity in some cases.
Can I go to work with shingles?
Many adults can work if they feel well and the rash can be covered. Avoid contact with high-risk individuals until blisters crust over.
Is TeleDirectMD available throughout California for shingles care?
Yes. As long as you are physically located in California at the time of your visit, you can use TeleDirectMD for shingles evaluation and treatment guidance. Prescriptions are sent electronically to your local California pharmacy when appropriate.
Can TeleDirectMD provide a work note?
TeleDirectMD can provide a brief work note when medically appropriate as part of the $49 visit.
When should I seek urgent in-person care?
Seek urgent evaluation for facial rash near the eye, eye pain or vision changes, severe headache, confusion, weakness, widespread rash, high fever, or significant immune compromise.