Are there any tests for shingles?
Tests are not usually done for shingles. The rash can be recognised by its typical pattern and symptoms.
Should I see a doctor?
It is usually worth seeing a doctor to be certain about the diagnosis and to see if you need treatment or not. Ideally you should see a doctor as soon as possible after the rash appears. This is because the sooner anti-shingles treatment is started, the more effective it is. In particular, it is not usually given if the rash has already been present for more than three days.
The rash of shingles can be very painful. So even if the doctor doesn't think you need an anti-shingles medicine, they may be able to give you stronger painkillers than those you can buy over the counter from the chemist.
The doctor is likely to consider anti-shingles treatment if:
- You are over 50 years old.
- You have immunosuppression. That is, your immune system is not working as well as normal. This could be due to treatment (such as chemotherapy, steroids, or immunosuppressant medicines used after organ transplants or for severe arthritis) or illness (such as HIV/AIDS or certain cancers).
- The rash involves your eye or your ear.
- The rash covers a wide area or is very painful.
So if any of these apply to you, see a doctor as soon as possible after the rash appears.
What if I have shingles and a poor immune system?
If you have a poor immune system (immunosuppression) and develop shingles then see your doctor straightaway. You will normally be given antiviral medication whatever your age and will be monitored for complications. People with a poor immune system include:
- People taking high-dose steroids. (This means adults taking 40 mg prednisolone (steroid tablets) per day for more than one week in the previous three months. Or, children who have taken steroids within the previous three months, equivalent to prednisolone 2 mg/kg per day for at least one week, or 1 mg/kg per day for one month.)
- People on lower doses of steroids in combination with other immunosuppressant medicines.
- People taking anti-arthritis medications which can affect the bone marrow.
- People being treated with chemotherapy or generalised radiotherapy, or who have had these treatments within the previous six months.
- People who have had an organ transplant and are on immunosuppressive treatment.
- People who have had a bone marrow transplant and who are still immunosuppressed.
- People with an impaired immune system.
- People who are immunosuppressed with HIV infection.
Further reading and references
Immunisation against infectious disease - the Green Book (latest edition); Public Health England
Gagliardi AM, Andriolo BN, Torloni MR, et al; Vaccines for preventing herpes zoster in older adults. Cochrane Database Syst Rev. 2016 Mar 33:CD008858. doi: 10.1002/14651858.CD008858.pub3.
Who is eligible for the shingles vaccine beyond 2016; Public Health England
Cohen JI; Clinical practice: Herpes zoster. N Engl J Med. 2013 Jul 18369(3):255-63. doi: 10.1056/NEJMcp1302674.
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