Can Telemedicine Treat Shingles (Herpes Zoster)? - Triage Guidance

Audience: adult

Shingles, also called herpes zoster, is a painful rash caused by the reactivation of the chickenpox virus. It often appears as a stripe of blisters on one side of the body. Early treatment can help reduce pain and complications. Telemedicine can be a helpful way to get advice and start treatment quickly, especially if you notice symptoms early. During a telemedicine visit, a healthcare provider can assess your symptoms, suggest medications, and guide you on managing pain and preventing spread. However, some cases need in-person care, such as if the rash is near your eyes or if you have severe symptoms. Telemedicine is a useful option for initial assessment and follow-up but is not a substitute for emergency or specialized care. If you have red flag symptoms or worsening signs, seek urgent medical attention in person.

Red flags — go in person / ER

• Rash near or involving the eyes — seek urgent in-person care to prevent eye damage.
• Severe pain not relieved by prescribed medications — contact healthcare provider immediately.
• Signs of bacterial infection like increased redness, swelling, warmth, or pus — get prompt medical evaluation.

What telemedicine can do

• Initial assessment of rash and symptoms.
• Starting antiviral treatment early.
• Providing advice on pain management and rash care.
• Monitoring mild to moderate symptoms remotely.
• Answering questions about the condition and prevention.

What telemedicine cannot do

• Emergency situations such as eye involvement.
• Severe or worsening symptoms needing physical examination.
• Complications like bacterial skin infections requiring in-person treatment.
• Neurological symptoms such as weakness or numbness.
• Management of immunocompromised patients with shingles.

What is Shingles (Herpes Zoster)?

Shingles is caused by the varicella-zoster virus, the same virus that causes chickenpox. After chickenpox, the virus stays inactive in nerve cells and may reactivate years later as shingles. It usually causes a painful, blistering rash on one side of the body or face. Other symptoms may include itching, burning, fever, and fatigue.

How Telemedicine Can Help with Shingles

Telemedicine allows you to connect with a healthcare provider remotely using video or phone. For shingles, telemedicine can help by:

When Telemedicine May Not Be Enough

Certain situations require in-person evaluation, such as:

In these cases, urgent or specialist care is important.

Preparing for Your Telemedicine Visit

To get the most from your telemedicine appointment:

After Your Telemedicine Visit

Follow your provider's instructions carefully. This may include:

If symptoms worsen or new red flags appear, seek in-person care promptly.

How to prepare for your tele-visit

• Ensure a stable internet connection for video calls.
• Have good lighting to show the rash clearly.
• Prepare a list of your symptoms and when they started.
• Gather a list of current medications and allergies.
• Find a quiet, private space for the consultation.
• Have a notepad ready to write down instructions or questions.

After your tele-visit

• Take antiviral medications exactly as prescribed.
• Use recommended pain relief methods.
• Keep the rash clean and avoid scratching.
• Monitor for any new or worsening symptoms.
• Schedule follow-up visits if advised by your provider.
• Seek immediate in-person care if red flags develop.

FAQs

How soon should I see a healthcare provider if I suspect shingles?

It's best to contact a healthcare provider as soon as you notice symptoms like pain, tingling, or a rash. Early treatment with antiviral medications often works best within 72 hours of rash onset.

Can shingles be contagious?

Yes, shingles can spread the varicella-zoster virus to people who have never had chickenpox or the vaccine. They may develop chickenpox, not shingles. Avoid direct contact with the rash until it has crusted over.

Is telemedicine safe for diagnosing shingles?

Telemedicine can be effective for initial assessment and treatment advice for shingles, especially when you can show the rash clearly. However, some cases need in-person evaluation.

What treatments are typically recommended for shingles?

Antiviral medications are commonly prescribed to reduce the severity and duration. Pain relievers and topical creams may also be used to ease discomfort.

Can shingles cause long-term problems?

Some people may develop postherpetic neuralgia, which is pain lasting after the rash heals. Early treatment may reduce this risk.

Sources

1. Shingles (Herpes Zoster) — MedlinePlus, U.S. National Library of Medicine.
2. Shingles (Herpes Zoster) — Centers for Disease Control and Prevention (CDC).
3. Herpes Zoster (Shingles) — Mayo Clinic.
4. Herpes Zoster (Shingles) — Merck Manuals Consumer Version.

This telemedicine guidance is for educational purposes only and is not a substitute for professional in-person medical care, diagnosis, or treatment. If you have any concerning symptoms or red flags, seek urgent in-person medical attention.