Shingles

Shingles (herpes zoster) affects approximately 1 in 4 people during their lifetime. It is caused by the reactivation of the varicella-zoster virus — the same virus that causes chickenpox — which lies dormant in nerve tissue after a chickenpox infection and can reactivate, usually in later life or when the immune system is under pressure. In the Medway area, we see shingles presentations throughout the year, and prompt antiviral treatment is essential to reduce the severity and duration of the episode.

The NHS Pharmacy First service for shingles allows our pharmacist Emmanuella Torto-Doku to assess adults aged 18 and over and supply antiviral medication during the same consultation. Speed matters with shingles: antivirals are most effective when started within 72 hours of the rash first appearing, though they can be given up to 7 days in certain cases. Our pharmacy on Canterbury Street in Gillingham is open until 10pm every day, which means you can access treatment quickly without having to wait for a GP appointment the following morning.

Shingles typically causes a painful, blistering rash on one side of the body — often wrapping around the torso in a band-like pattern. Before the rash appears, many patients experience several days of burning or tingling pain in the affected area, which can be confusing. If you suspect shingles, seek assessment as soon as the rash develops.

Symptoms of shingles

• Burning, shooting, or tingling pain on one side of the body or face — often before the rash appears
• A blistering rash that typically forms a band or patch on one side of the torso, back, or face
• Fluid-filled blisters that break open and crust over
• Sensitivity of the skin, often described as extreme tenderness to touch
• Itching at the site of the rash
• Fever, headache, or sensitivity to light in some cases
• Fatigue and general feeling of being unwell

Who is eligible for Pharmacy First Shingles treatment?

The Pharmacy First shingles pathway is for adults aged 18 and over who are not pregnant. It covers the treatment of non-ophthalmic shingles — that is, shingles that does not involve the eye area. Pregnant patients and those with ophthalmic shingles (where the rash affects the eye or tip of the nose — Hutchinson's sign) must be referred urgently to a GP or hospital. Patients who are severely immunosuppressed (for example those on biologics or chemotherapy) should also be referred for specialist management.

What can the pharmacist prescribe?

Our pharmacist can supply aciclovir 800mg tablets (taken 5 times daily for 7 days) or valaciclovir 1g tablets (taken 3 times daily for 7 days) as antiviral treatment. Valaciclovir has a more convenient dosing schedule and is often preferred. Analgesics including paracetamol and ibuprofen are recommended for pain management. In some cases, a pharmacist may also advise on nerve pain (neuropathic pain) and when to seek further treatment if postherpetic neuralgia develops after the rash resolves.

What to expect at Medway Pharmacy

Shingles is particularly common in older residents of the Medway towns, and at Medway Pharmacy we regularly see patients from Gillingham, Chatham, Rochester, and Rainham who present with early signs of a shingles outbreak. Emmanuella has treated many cases under the Pharmacy First pathway and emphasises the importance of early treatment: patients who start antivirals within 24–48 hours of the rash appearing generally have a shorter, less severe episode. Our 10pm closing time means you do not need to wait until the next morning — come in as soon as you notice the rash.

Frequently asked questions

When to see a GP or call 999

While Pharmacy First covers many cases of Shingles, you should seek further care if:

• You are pregnant — antivirals under Pharmacy First are not suitable during pregnancy
• The rash affects the eye area (ophthalmic shingles) — seek urgent same-day care
• You are under 18 years of age
• You have signs of severe immunosuppression or are on cancer treatment