Shingles: how to recognise it and why you should not put off seeing a doctor
A burning pain on one side of the body followed by a band of blisters may be shingles. Antiviral treatment works best in the first few days: a doctor can assess the rash in an online consultation too.
Shingles usually announces itself with burning pain, itching or tingling on one side of the body; a few days later a band of painful blisters appears in the same place. It is caused by the chickenpox virus waking up again. In an online consultation, the doctor looks at the rash over video or in a photo, assesses whether it is shingles and when the symptoms started, and therefore whether there is still time for antiviral treatment. Czech medical literature states ideally within 24 hours of the first signs, and no later than 72 hours. The doctor then decides with you on treatment and pain relief and plans the next steps.
The chickenpox virus
Why shingles appears
Shingles (herpes zoster) develops when the virus that once caused chickenpox becomes active again in the body.
After chickenpox, the varicella-zoster virus stays permanently in the nerve ganglia. When immunity drops, it can reactivate and show up as shingles. The Czech National Institute of Public Health lists possible triggers such as physical exertion, stress, or illnesses linked to impaired immunity, such as HIV or lymphoma.
It becomes more common with age. VZP states that the illness occurs most often in people aged 50 and over, and in people whose immune system is weakened, for example after a transplant, with HIV infection or with cancer. According to SZÚ, shingles can also come back during a person's lifetime.
Sources: SZÚ, Herpes zoster, pásový opar (2019); VZP ČR (December 2025).
Pain before the rash
How to recognise shingles
Typically, pain or burning in a particular strip of skin comes first, and only after a few days does a rash appear in the same place.
- Before the rash: pain, itching, tingling or numbness in one area of skin.
- Rash: small fluid-filled blisters, usually on one side of the body only, often on the trunk or face.
- General symptoms: sometimes fever, headache, chills or an upset stomach.
- Course: new blisters keep appearing for roughly 7 to 10 days and usually clear within 2 to 4 weeks.
The pain is often described as an intense burning. According to VZP, pain, itching or tingling can come days or even weeks before the rash. As soon as blisters appear in the same strip of skin, do not put off a consultation: the doctor can assess the rash over video, so no time for treatment is lost.
Sources: SZÚ (2019); NZIP — Pásový opar; VZP ČR.
Starting treatment early
Why you should see a doctor in the first few days
Antiviral treatment (antivirals) works best when it is started early. Whether you need treatment, and which one, is for the doctor to assess in the consultation.
A Czech expert review states that systemic antiviral treatment should be given promptly, ideally within 24 hours of the first signs and no later than 72 hours. However, if new lesions keep forming for longer, the medicine can still be started depending on how severe the illness is.
According to the same review, treatment reduces the multiplication of the virus and the risk of complications, including long-lasting pain. So do not wait for the rash to 'go away on its own'. The doctor decides on the medicine, its dose and how long to take it; if treatment is appropriate and can be safely prescribed remotely, they can issue an ePrescription. In the consultation they will also discuss with you how to relieve the pain.
Source: L. Růžičková Jarešová, Neurologie pro praxi 2015; 16(5): 290–292.
The eye and other risks
When shingles is urgent
According to VZP, a rash near the eye is an urgent medical condition. Do not leave it for the next few days.
If the virus affects the nerve supplying the eye, signs can also appear on the cornea or conjunctiva; according to the Czech expert review, the risk of permanent eye damage without treatment is high. SZÚ lists complications including inflammation of the cornea, iris and retina, bacterial skin infection, and inflammation of the brain or its membranes. In people with weakened immunity, shingles can spread across the whole body.
Not sure whether the rash reaches the eye? Have a doctor assess it in a video consultation straight away. If your condition needs an in-person or urgent examination, the doctor will explain why and recommend the right care.
Sources: VZP ČR; Neurologie pro praxi (2015); SZÚ (2019); NZIP — Zdravotnická záchranná služba.
While blisters last
Is shingles contagious, and what is postherpetic neuralgia
You cannot catch shingles itself. However, someone who has never had chickenpox or been vaccinated against it can be infected and develop chickenpox.
The virus spreads through direct contact with fluid from the blisters. According to SZÚ, a person becomes contagious when the rash appears and stops being contagious once all the lesions have dried into scabs. In susceptible people who have been in contact with someone ill, chickenpox usually develops within 10 to 21 days.
The most common complication is postherpetic neuralgia: pain at the site of the rash that lasts for months, sometimes even years, after the rash has gone. It mainly affects people over 50. According to the Czech expert review, it disrupts everyday activities and sleep, and the best prevention is early diagnosis and treatment of shingles.
If the pain does not ease after healing, talk it through with a doctor; this can also be done in an online consultation.
Sources: SZÚ (2019); Neurologie pro praxi (2015).
Video consultation
How an online consultation deals with shingles
In a video consultation, the doctor examines the rash via the camera or in photos, asks when the pain started and when the blisters appeared, and assesses whether there is still time for antiviral treatment. Eye involvement, extensive lesions on the face or markedly weakened immunity may need an in-person or urgent examination; in that case the doctor will direct you.
Have ready when the pain started and when the rash appeared, a list of the medicines you take, and details of any illnesses or treatments that weaken immunity. Mention pregnancy and any problems with your eyes or vision. Sharp photos of the rash taken in good light help.
You have the online consultation with a doctor from home, without travelling to a surgery; available slots are shown in the booking calendar. If you would like to discuss the rash with a focus on the skin, choose the online dermatology consultation. What else a video consultation can deal with is described in our guide to what an online consultation can do.
Prevention: SZÚ states that vaccination is intended to prevent shingles and postherpetic neuralgia, not to treat them, and that the vaccines are intended for people aged 50 and over. You can discuss in the consultation whether it is suitable for you.
Source on vaccination: SZÚ (2019).
Care in Czechia
Speak to a doctor online
Have a new painful rash on one side of the body assessed by a doctor as soon as possible: the first few days decide the treatment.
- Online consultation with a doctor
- Online dermatology consultation
- Our doctors
- What an online consultation can do
The first few days matter: book now
The doctor examines the rash over video, assesses whether there is still time for antiviral treatment, and decides with you on treatment and pain relief. Have ready when the pain started and when the rash appeared.
Sources
Medical sources for this article
Sources checked on 8 October 2026.
This article is based solely on Czech sources (SZÚ, NZIP, VZP ČR and a Czech expert review), which were checked on 8 October 2026. It does not name any medicines or doses and does not recommend a specific vaccine. The 2015 review is used for the treatment time window and eye complications, not for the medicines currently available.
Questions
Frequently asked questions about shingles
How soon does shingles treatment need to start?
The Czech expert review recommends starting antiviral treatment ideally within 24 hours of the first signs and no later than 72 hours. If new lesions keep forming for longer, the medicine can be started depending on severity. So book as early as you can.
Can a doctor assess shingles over video?
The doctor examines the rash via the camera or in photos and, together with details of when the symptoms began, assesses the next steps, treatment and pain relief. If treatment is appropriate and can be safely prescribed remotely, they can issue an ePrescription.
Can shingles be passed on to others?
Shingles itself cannot. However, fluid from the blisters can cause chickenpox in someone who has never had it or been vaccinated. You remain contagious until all the blisters have dried into scabs.
What should I do if the rash is near my eye?
According to VZP, this is an urgent medical condition. Act the same day; if things get seriously worse, call 155 or 112.
