Adult Shingles Treatment (Herpes Zoster)
Fast MD-only shingles evaluation and treatment by secure online video visit, $49 flat-fee, no insurance required.
Shingles (herpes zoster) is a painful, blistering rash caused by reactivation of the varicella zoster virus, the same virus that causes chickenpox. It typically appears on one side of the body in a band-like pattern and can cause burning pain, tingling, and sensitivity before the rash appears. Our MDs use guideline-based evaluation to confirm shingles, screen for eye or neurologic complications, and prescribe antiviral therapy when appropriate, especially when symptoms started within the last 72 hours.
- $49 flat-fee adult visit
- MD-only care (no mid-levels)
- No insurance required
- Secure video visits in 25+ states
Online MD-Only Shingles Care
- Adult 18+ evaluation for suspected shingles rash and pain
- Antiviral treatment when clinically appropriate, ideally early
- Pain control options and skin care guidance
- Clear triage for eye involvement, facial weakness, or severe illness
Adults 18+ only. No controlled substances are prescribed through TeleDirectMD. Eye pain, vision changes, rash near the eye, facial weakness, confusion, or severe spreading rash requires urgent in-person evaluation.
What Is Adult Shingles (Herpes Zoster)?
Shingles occurs when varicella zoster virus reactivates years after a chickenpox infection. The virus travels along a nerve and causes pain and a rash in the skin area supplied by that nerve. The rash is usually grouped fluid-filled blisters on a red base, often on the torso, back, or face, and it is typically limited to one side of the body.
Early antiviral treatment can shorten symptom duration and may reduce complications, especially when started within 72 hours of rash onset. TeleDirectMD can evaluate typical shingles patterns by video, review your medical history and medications, and prescribe antiviral therapy when appropriate. Certain situations require urgent in-person care, especially eye involvement, neurologic symptoms, pregnancy, or severe immunosuppression.
Symptoms and Red Flags in Adult Shingles
Many shingles cases are classic and can be managed through a virtual visit. Certain symptoms suggest complications such as herpes zoster ophthalmicus, bacterial superinfection, neurologic involvement, or disseminated disease that should not be managed by telehealth alone.
| Symptom or situation | What it suggests | Telehealth appropriate? | Red flag requiring urgent in-person care |
|---|---|---|---|
| One-sided burning pain followed by a blistering rash in a band pattern | Typical shingles in a single dermatome | Yes, often appropriate for evaluation and antivirals | Not a red flag if away from the eye and patient is otherwise well |
| Rash started within the last 72 hours | Best timing window for antiviral benefit | Yes | No |
| Rash near the eye, forehead, or nose, or eye pain or vision changes | Possible herpes zoster ophthalmicus | No as sole management | Urgent same-day in-person evaluation, often ophthalmology |
| Facial weakness, hearing changes, vertigo, or severe ear pain with rash | Possible cranial nerve involvement, including Ramsay Hunt syndrome | No as sole management | Urgent in-person evaluation |
| Fever, rapidly worsening redness, pus, or foul drainage from lesions | Possible bacterial superinfection | Telehealth may triage | Needs prompt in-person exam if severe or spreading |
| Widespread rash across multiple areas or on both sides of body | Possible disseminated zoster, higher risk in immunocompromised | No | Urgent in-person or ER evaluation |
| Severe headache, confusion, stiff neck, weakness, or trouble walking | Possible neurologic complication | No | Emergency care immediately |
| Shingles during pregnancy or severe immunosuppression | Higher risk, treatment decisions require careful supervision | Telehealth may help with triage | Urgent in-person evaluation recommended |
Differential Diagnosis: Shingles vs Other Rashes
During your TeleDirectMD visit, the MD will use the rash pattern, symptoms, timing, and your medical history to distinguish shingles from other skin conditions and infections that can look similar.
Findings Consistent With Shingles
- One-sided rash that does not cross the midline
- Grouped blisters on a red base in a stripe or band pattern
- Burning pain, tingling, or sensitivity before the rash appears
- Localized area that matches a nerve distribution
Other Conditions Considered
- Herpes simplex: Recurrent clustered blisters, often on lips or genitals, typically smaller area.
- Contact dermatitis: Itchy rash after exposure, often bilateral or widespread.
- Cellulitis: Diffuse redness and warmth without grouped blisters.
- Impetigo: Honey-colored crusting, often bacterial.
If the rash pattern is not typical for shingles or there are signs of eye involvement, neurologic symptoms, or severe illness, our MDs will direct you to in-person evaluation.
When Is a Video Visit Appropriate for Adult Shingles?
When a Video Visit Is Appropriate
- Adult 18+ with a classic one-sided painful blistering rash
- Rash is on the trunk, back, or extremity and not near the eye
- Symptoms started within the last 72 hours or rash is still evolving
- No severe immunosuppression and no pregnancy
- No confusion, severe headache, weakness, or other neurologic symptoms
- Able to send clear photos during the visit if requested
Red Flags Requiring In-Person or ER Care
- Rash near the eye, forehead, or nose, or any eye pain or vision change
- Facial weakness, severe ear pain with rash, hearing change, or vertigo
- Widespread rash across multiple body areas or on both sides
- High fever, rapidly spreading redness, pus, or severe skin pain out of proportion
- Severe headache, stiff neck, confusion, weakness, or trouble walking
- Pregnancy or severe immunosuppression
If any red-flag symptoms are present, seek urgent in-person or emergency care. TeleDirectMD is not an emergency service and is best used for stable adults with likely shingles away from the eye and without neurologic symptoms.
Treatment Options for Adult Shingles
Shingles treatment focuses on antiviral therapy when appropriate, symptom control, and preventing complications. Antivirals are most effective when started early, ideally within 72 hours of rash onset, but may still be considered later in selected cases based on severity and risk factors.
Supportive Measures and Skin Care
- Keep the rash clean and dry and avoid picking blisters.
- Use cool compresses or calamine lotion if soothing.
- Wear loose clothing to reduce friction and irritation.
- Avoid contact with pregnant people who have never had chickenpox, premature infants, and severely immunocompromised individuals until lesions are fully crusted.
Medication Options (When Appropriate)
- Antiviral therapy such as valacyclovir, acyclovir, or famciclovir when clinically appropriate.
- Non-opioid pain control options, including acetaminophen, NSAIDs, and selected neuropathic pain options based on individual risk.
- Topical strategies for comfort, while avoiding irritating products on open blisters.
TeleDirectMD does not prescribe controlled substances for shingles pain. If pain is severe, rash is widespread, or there are red flags such as eye involvement or neurologic symptoms, in-person evaluation is required.
Common Medications Used for Adult Shingles
The specific medication and dose depend on timing, kidney function, age, and other medications. The table below shows typical examples an MD may consider for adults appropriate for telehealth.
| Medication | Dose | Duration | When it is used |
|---|---|---|---|
| Valacyclovir 1000 mg tablet | 1000 mg by mouth 3 times daily as directed | 7 days | Common first-line antiviral when started early and renal function allows |
| Famciclovir 500 mg tablet | 500 mg by mouth 3 times daily as directed | 7 days | Alternative antiviral option when clinically appropriate |
| Acyclovir 800 mg tablet | 800 mg by mouth 5 times daily as directed | 7 days to 10 days | Alternative antiviral, more frequent dosing |
| Acetaminophen 500 mg tablet | 500 mg to 1000 mg by mouth every 6 hours as directed | As needed, short course | Non-opioid pain control for many adults |
| Ibuprofen 400 mg tablet | 400 mg by mouth every 6 hours to 8 hours with food as directed | As needed, short course | Anti-inflammatory pain option when no contraindications |
These are example regimens only. Actual medications, strengths, and durations are determined by the MD after reviewing your history, kidney function, contraindications, and other medications.
Home Care, Expectations, and Return to Work
Shingles often evolves over several days, with blisters crusting over about 7 days to 10 days and gradual improvement in pain over weeks. Some adults can develop prolonged nerve pain called postherpetic neuralgia, especially with older age or severe initial pain.
- Start antiviral medication as soon as prescribed and take it exactly as directed.
- Keep lesions covered when possible and wash hands frequently.
- Avoid close contact with high-risk individuals until lesions are fully crusted.
- Return to work is often reasonable if you feel well, lesions are covered, and your job does not involve close contact with high-risk populations.
- Seek urgent care for eye symptoms, facial weakness, widespread rash, or signs of bacterial infection.
After recovery, many adults benefit from shingles vaccination discussion with their primary care clinician to reduce future risk, especially for adults 50+ or those with higher risk.
TeleDirectMD Telehealth Disclaimer
TeleDirectMD provides MD-only virtual urgent care for adults using secure video visits to evaluate conditions such as shingles. Visits are $49 flat-fee with no insurance required and are available in 25+ states. Our physicians follow evidence-based guidance, clarify what can be safely managed via telehealth, and explain when in-person primary care, urgent care, specialist, or emergency evaluation is more appropriate. TeleDirectMD is not an emergency service or a replacement for comprehensive in-person care.
Adult Shingles Treatment FAQs
What is shingles?
Shingles is a painful blistering rash caused by reactivation of varicella zoster virus, the virus that causes chickenpox. It usually affects one side of the body in a band-like pattern and can cause burning pain, tingling, and sensitivity.
Can TeleDirectMD treat shingles through an online visit for adults?
For many adults 18+ with a typical shingles pattern and no red flags, yes. Our MDs can evaluate your symptoms and rash by video, review your medications and risk factors, and prescribe antiviral treatment when appropriate.
Why does timing matter for shingles antivirals?
Antiviral medicines work best when started early, ideally within 72 hours of rash onset. Early treatment can shorten symptom duration and may reduce complications. In some cases, antivirals may still be considered later depending on severity and risk.
What does the shingles rash look like?
Shingles often begins with burning pain or tingling in one area, followed by a red rash with grouped blisters. It typically stays on one side of the body and follows a stripe or band pattern.
When is shingles an emergency?
Shingles is urgent when there is rash near the eye, eye pain, or vision changes, facial weakness, confusion, severe headache, widespread rash, or severe illness. Those situations require same-day in-person or emergency evaluation.
Is shingles contagious?
Shingles can spread varicella zoster virus to someone who has never had chickenpox or vaccination, causing chickenpox, not shingles. Risk is highest with direct contact with fluid from blisters. Cover lesions and avoid high-risk contacts until lesions are fully crusted.
How should I care for the rash at home?
Keep the rash clean and dry, avoid picking blisters, use cool compresses if soothing, and wear loose clothing. Wash hands often and keep lesions covered when possible to reduce spread risk.
Will TeleDirectMD prescribe opioids for shingles pain?
No. TeleDirectMD does not prescribe opioids or other controlled substances. We focus on antiviral therapy when appropriate, non-opioid pain options, and clear triage when in-person pain management is needed.
What is postherpetic neuralgia?
Postherpetic neuralgia is nerve pain that persists after the shingles rash resolves. Risk increases with age and more severe initial pain. Early evaluation and treatment may help, and persistent pain should be followed with your primary care clinician.
What makes TeleDirectMD different for adult shingles care?
TeleDirectMD offers MD-only, guideline-based shingles evaluation through secure video visits with a simple $49 flat-fee model and no insurance required in 25+ states. We emphasize early antiviral treatment when appropriate and clear triage for eye and neurologic red flags.
Concerned this could be shingles?
$49 flat fee. Adult-only video visits. MD-only care. Fast evaluation and antivirals when appropriate, with clear red flag triage.