How long does gastroenteritis usually last?

Symptoms typically last 1-2 days for milder cases, though some infections, particularly bacterial ones, can last a week or more.

Is gastroenteritis contagious?

Yes, particularly viral causes like norovirus, which spreads easily through contact with an infected person, contaminated surfaces, or food. Staying home for 48 hours after symptoms clear helps prevent spreading it to others.

What should I eat when recovering from gastroenteritis?

Stick to small, bland meals that are easy to digest, such as toast, rice, or bananas, and avoid fatty, spicy, or acidic foods until you're feeling better.

Can children get dehydrated faster than adults with gastroenteritis?

Yes, babies and young children are at higher risk of dehydration and can become unwell more quickly, so it's important to seek medical advice sooner if you're concerned.

Shingles Symptoms, Treatment & Vaccine Advice

What is shingles?

Shingles is a painful viral infection and skin rash caused by the reactivation of the varicella-zoster virus.

Definition of shingles

Shingles, also known as herpes zoster, is a painful skin rash caused by the reactivation of the varicella-zoster virus, which is the exact same virus that causes chickenpox. After you recover from chickenpox, this virus remains dormant inside your nerve tissue and can reactivate decades later to cause an outbreak. Shingles is not the same as genital herpes, which is caused by a different virus called herpes simplex.

Connection to chickenpox

The varicella-zoster virus can wake up and reactivate years after your initial chickenpox infection. Our online GPs frequently speak to patients who are surprised to develop shingles decades after they last thought about chickenpox. Anyone who has had chickenpox is at risk of developing shingles later in life.

Triggers for an outbreak

The virus typically reactivates when something weakens your immune system. Key risk factors include being over 50, experiencing significant physical or emotional stress, or having an illness that compromises your immunity. Certain medications, such as steroid tablets or chemotherapy, can also lower your immune defences and trigger a shingles outbreak.

Symptoms of shingles

The symptoms of shingles begin with a painful burning or tingling sensation on one side of the body, followed a few days later by a blistering red or discoloured rash.

Early signs

Before any marks show on the skin, you will usually experience localised pain, burning, tingling or itching. According to the NHS, this initial discomfort almost always occurs on just one side of your body. You might also develop a headache, a high temperature, or simply feel generally unwell during this early stage.

Rash progression

Days 1 to 5

A red or discoloured rash appears in the painful area. It usually forms a single stripe or band on one side of your torso, although it can appear anywhere on your body.

Days 5 to 7

The rash develops into raised, fluid-filled blisters.

Days 7 to 10

These blisters begin to dry up, forming crusts or scabs.

Weeks 2 to 4

The scabs gradually fall off as the skin heals. You might notice some lingering skin discolouration after the scabs have gone.

Appearance on different skin tones

The appearance of the rash can vary significantly depending on your skin tone. On darker brown and black skin, the rash may not look red at all. Instead, it might appear purple, dark brown or slightly darker than your natural skin tone. Because the rash can be harder to see on darker skin, paying close attention to those initial tingling and burning sensations is very important.

Concerning locations

Where the rash appears matters. If shingles develops on your face, particularly near your eye, it is known as ophthalmic shingles. This requires urgent medical attention because it can cause inflammation and long-term vision damage if left untreated. Similarly, a rash around your ear can lead to a condition called Ramsay Hunt syndrome, which can cause facial weakness and hearing loss.

When to see a doctor

You must see a doctor within three days of a shingles rash appearing to start antiviral treatment while it is most effective.

Importance of early diagnosis

Antiviral medication is most effective when you start taking it within 72 hours of the rash first showing. According to RCGP guidance, starting treatment early helps to speed up your recovery, reduce the severity of the illness, and lower your risk of developing long-term complications like nerve pain. An online GP can assess your rash via a video consultation and prescribe the necessary medication quickly.

Red flag symptoms

Some symptoms mean you need to seek immediate medical advice rather than waiting for a routine appointment. Speak to a doctor urgently if:

You have a shingles rash on your face, especially near your eye.
You have a high temperature or feel severely unwell.
You are immunocompromised (for example, you are HIV positive, having chemotherapy, or taking immunosuppressant medicine).
The rash is widespread and crosses over to the other side of your body.

Treatment and management

Shingles is treated using prescription antiviral medication to stop the virus from multiplying, combined with painkillers and simple self-care steps at home.

Antiviral medications

Antiviral medicines, such as aciclovir, valaciclovir or famciclovir, are the primary medical treatment for shingles. They do not kill the virus, but they help to stop it from multiplying in your body. It is vital to start these tablets within three days of the rash appearing, as recommended by the NHS, to get the most benefit and speed up your healing time.

Managing shingles pain

Shingles pain can be severe, but there are several ways to manage it effectively.

Over-the-counter options

Standard analgesic tablets like paracetamol or anti-inflammatories like ibuprofen can help ease the discomfort. Always check with a pharmacist or doctor if you are unsure which is safe for you.

Topical treatments

Applying calamine lotion or a cool, damp compress to the rash can soothe the itching and cool the inflamed skin.

Prescription pain relief

If the nerve pain is intense, a GP might prescribe specific medicines designed to target nerve endings, such as amitriptyline or gabapentin.

Do	Don't
Keep the rash clean and dry to prevent bacterial infection.	Use sticky plasters or tight dressings that can irritate the blisters.
Wear loose-fitting cotton clothing.	Share towels or flannels with other people
Get plenty of rest and take time off work if needed.	Go swimming or play contact sports.

Is shingles contagious?

Shingles itself is not contagious, but the virus that causes it can spread through direct contact with the blisters to cause chickenpox in people who are not immune.

Catching shingles

You cannot catch shingles from someone with shingles. It is biologically impossible. However, because shingles is caused by the varicella-zoster virus, you can catch chickenpox from someone with an active shingles rash if you have never had chickenpox before or have not been vaccinated against it.

Spreading the virus

The varicella-zoster virus is spread through direct physical contact with the fluid inside the shingles blisters. If a person touches your open blisters and they are not immune to chickenpox, they could become infected. Once your blisters have fully dried up and crusted over, you are no longer contagious.

Protecting vulnerable people

While your rash is blistering and weeping fluid, you must be careful to avoid spreading the virus to people who could become seriously ill from chickenpox. You should stay away from:

Pregnant people who have not had chickenpox
Newborn babies
People with a weakened immune system, such as those having cancer treatment

Complications of shingles

Shingles complications can include persistent nerve pain called post-herpetic neuralgia, vision problems if the rash is near the eye, and temporary facial paralysis or hearing loss.

Post-herpetic neuralgia (PHN)

Post-herpetic neuralgia is persistent nerve pain in the exact area where your shingles rash was. According to the NHS, this burning, throbbing or stabbing neuralgia continues for more than three months after the skin has fully healed. It is the most common complication of shingles, affecting around one in five people over the age of 50 who develop the condition.

Ophthalmic shingles

As highlighted earlier, shingles that develops near your eye is a medical emergency. The RCGP advises that ophthalmic shingles requires urgent assessment because the virus can cause severe inflammation in the eye. Without prompt treatment, this can lead to glaucoma, corneal damage, and even permanent vision loss.

Ramsay Hunt syndrome

Ramsay Hunt syndrome happens when the shingles virus affects the facial nerve near one of your ears. This can cause severe ear pain, temporary facial paralysis on one side, and hearing loss. Other very rare complications of an acute shingles infection include pneumonia, encephalitis (inflammation of the brain), or secondary bacterial infections if dirt gets into the open blisters.

The shingles vaccine

The shingles vaccine is a safe and highly effective way to prevent the reactivation of the varicella-zoster virus and protect against painful long-term complications.

How Shingrix works

Shingrix is a non-live recombinant vaccine. This means it does not contain a live virus, making it safe for people who are immunocompromised. The vaccine helps your body build a strong immune response against the varicella-zoster virus. It is given as an injection into the upper arm in two doses, usually a few months apart.

UK eligibility

The NHS offers the shingles vaccine based on specific age and immune status criteria. The UK Health Security Agency (UKHSA) outlines a phased rollout for the Shingrix vaccine, targeting older adults and individuals over 50 with severely weakened immune systems. Because the eligibility rules can change, it is always best to check the latest NHS or GOV.UK guidance to see if you qualify. If you are not eligible for a free vaccine on the NHS, you may be able to access private vaccination services.

Effectiveness and side effects

The UKHSA Green Book confirms that the Shingrix vaccine is highly effective at preventing shingles. Crucially, even if you do get shingles after being vaccinated, the immunisation greatly reduces your risk of developing severe post-herpetic neuralgia. Common side effects include a sore arm, redness at the injection site, tiredness or a headache. These reactions are usually mild and only last for a few days.

The difference between shingles and hives is found in their underlying causes, symptoms, and physical appearance. Shingles is a viral infection that causes a painful, blistering rash, almost always restricted to one side of the body. Hives are an allergic skin reaction causing raised, itchy welts that can appear anywhere.

Stress can cause shingles to reactivate by acting as a trigger rather than the direct cause. While the varicella-zoster virus is the direct cause, significant physical or emotional stress can weaken your immune system. This makes it harder for your body to keep the dormant virus in check, giving it the opportunity to reactivate.

You should stay off work with shingles until your blisters have completely dried up and crusted over. The NHS advises that this is the point when you are no longer contagious. If your rash is on a part of your body fully covered by clothing and you feel well enough, you might be able to work, but always avoid contact with vulnerable people.

You can get shingles more than once, although it is highly uncommon. Most people who develop shingles will only ever experience the condition one time. Getting the shingles vaccine is the most effective way to help reduce your risk of a recurrence and protect against future painful outbreaks.

Shingles is a reactivation of the chickenpox virus that typically starts with localised pain before a blistering rash appears. Seeking medical advice within 72 hours of the rash developing is vital, as early antiviral treatment can speed up your recovery and help prevent complications like long-term nerve pain. While the symptoms can be distressing, they can be effectively managed with the right medication and simple self-care steps at home. For those in eligible groups, vaccination remains the most effective way to prevent shingles altogether.

If you are experiencing symptoms of shingles or have concerns about a painful rash, do not wait to get help. Book an appointment with a GP today to get a diagnosis, discuss your pain relief options, and start treatment promptly.

Shingles: symptoms, treatment and vaccine advice