The biggest mistake people make with shingles is waiting too long to get treatment. Starting antiviral medication within 72 hours of the rash appearing can reduce your risk of lingering nerve pain by nearly half. Beyond that critical window, every choice you make about skincare, clothing, activity, and social contact can either speed your recovery or drag it out. Here’s what to avoid.
Don’t Wait to Start Antiviral Treatment
This is the single most consequential mistake. A meta-analysis of five clinical trials found that starting antiviral medication within 72 hours of rash onset reduced the incidence of residual pain over the following six months by 46%. Delaying treatment is also one of the top risk factors for developing postherpetic neuralgia, a condition where burning or stabbing nerve pain persists for months or even years after the rash clears.
If you suspect shingles, getting to a doctor the same day matters. The rash often starts as a tingling or burning sensation on one side of the body before blisters appear. Don’t dismiss that early pain as a pulled muscle or allergic reaction. Antivirals are most effective while new blisters are still forming and offer little benefit once lesions have fully crusted over.
Don’t Scratch, Pick, or Leave the Rash Uncovered
Touching or scratching the rash is one of the fastest ways to introduce bacteria and cause a secondary skin infection. It also spreads the virus to other parts of your skin and to surfaces other people touch. The American Academy of Dermatology recommends washing the rash gently with a fragrance-free cleanser, applying a thin layer of pure petroleum jelly, and covering it with a sterile, non-stick bandage.
Avoid putting anything harsh or scented on the blisters. Antibiotic ointments with added fragrances, alcohol-based products, and heavily perfumed lotions can all irritate the broken skin and slow healing. Stick to plain petroleum jelly and clean bandages, changing them regularly.
Don’t Wear Tight or Synthetic Clothing
Tight clothing rubs directly against blisters and inflamed skin, increasing pain and the risk of popping blisters open. Even when the rash is bandaged, friction from a snug shirt or waistband adds unnecessary irritation. Synthetic fabrics like polyester trap heat and moisture against the skin, creating an environment where bacteria thrive.
Switch to loose-fitting clothes made from natural fibers like cotton or linen. These breathe better and reduce friction. If your rash is on your torso, an oversized cotton t-shirt is far kinder to your skin than a fitted synthetic top. Keep this up until the scabs have fully cleared, which typically takes two to five weeks.
Don’t Push Through Intense Exercise
Running, cycling, and other high-intensity cardio can irritate a shingles rash in two ways: friction from movement and sweat pooling on broken skin. Sweat is salty and acidic, which stings open blisters and can delay the drying and crusting process your skin needs to heal.
This doesn’t mean you need to be completely sedentary. Walking and gentle stretching are fine for most people, as long as the movement doesn’t create friction over the rash area. Hold off on intense workouts until the scabs have completely cleared. For most people, that means two to five weeks of taking it easier than usual.
Don’t Expose Vulnerable People to Your Rash
Shingles itself isn’t contagious, but the virus that causes it (the same one behind chickenpox) can spread to someone who has never had chickenpox or the chickenpox vaccine. The contagious period runs from when blisters first appear until the rash fully scabs over. During that window, avoid close contact with three groups in particular:
- Pregnant women who never had chickenpox or the vaccine, since the virus can harm a developing baby
- Premature or low birth weight infants
- People with weakened immune systems, including those on chemotherapy or immunosuppressive medications
Covering the rash and washing your hands frequently (at least 20 seconds each time) lowers transmission risk significantly. Once every blister has scabbed over, you’re no longer able to spread the virus.
Don’t Rely on Over-the-Counter Painkillers Alone
Shingles pain is nerve pain, not the kind of inflammation that ibuprofen or acetaminophen handles well. Standard over-the-counter painkillers have not been shown to be highly effective against the deep, burning nerve pain that shingles causes. They may take the edge off, but many people find they barely make a difference.
If your pain is interfering with sleep or daily activities, talk to your doctor about treatments specifically designed for nerve pain. The severity of your acute pain is itself a risk factor for developing long-term postherpetic neuralgia, so managing it properly during the outbreak isn’t just about comfort. It’s about protecting yourself from chronic pain down the road.
Don’t Assume Dietary Supplements Will Help
You may come across advice to load up on lysine supplements or avoid foods high in arginine (like nuts, chocolate, and seeds) during a shingles outbreak. The theory is that lysine suppresses arginine, and arginine has been linked to viral replication in lab studies. The problem: there are no clinical studies supporting the use of lysine as a treatment for shingles. What happens in a petri dish doesn’t reliably translate to what happens in your body. Delaying real treatment while experimenting with supplements is a risk not worth taking.
Don’t Skip the Vaccine Afterward
Having shingles once doesn’t prevent it from coming back. The Shingrix vaccine significantly reduces your risk of a repeat episode and of postherpetic neuralgia. According to the CDC, there’s no required waiting period after a shingles outbreak before getting vaccinated. You just need to wait until the rash has fully resolved. Once your skin has healed, bring it up with your doctor. People over 50 are eligible, and the vaccine is recommended regardless of whether you’ve had shingles before.