In the comments section of the herpes zoster science popularization articles I have written, some people leave messages claiming that applying certain "folk remedies" cures it instantly—healing it in two to three days, or three to four days, without leaving any sequelae. Why such a penchant for boasting? If modern medicine cannot resolve it that quickly, can the folk remedies you speak of really fix it in two or three days?

Whether you admit it or not, the pathogen of herpes zoster was identified long ago: the varicella-zoster virus (VZV). It usually lies dormant within the nerve ganglia and emerges to cause trouble when the body's immunity declines. This results in manifestations of varying severity; mild cases may only present as localized erythema, papules, and vesicles without pain or itching, while severe cases present as dense clusters of erythema, papules, and vesicles, sometimes with large bullae and intense pain.

The onset and progression of herpes zoster (shingles) follow a narrative arc: it has a beginning, a development phase, a peak, and a gradual resolution. Consequently, patients will experience a process where vesicles progress from few to many, and pain intensifies from mild to severe before eventually subsiding. Generally, herpes zoster reaches its peak severity between 5 to 7 days after onset. However, many individuals with robust immune systems may not reach a severe stage; the condition may remain localized to a small area of the body, present without pain or itching, and resolve very quickly—sometimes even without treatment. For severe cases of herpes zoster, pharmacological intervention is essential. Relying on folk remedies is a waste of time and may lead to localized secondary infections, delaying proper diagnosis and treatment, which in turn increases the risk of developing postherpetic neuralgia.

How long does it take for herpes zoster (shingles) to heal? This varies from person to person. For very mild cases, it generally takes about two weeks. For severe cases in elderly patients, I usually inform them that it will take 3 to 4 weeks. However, antiviral medications must be administered in sufficient doses within 48 hours of onset and should be taken for approximately 10 days before discontinuing. In the later stages, symptoms are managed through neurotrophic agents and analgesics. Even with timely early intervention, a small percentage of elderly patients may experience prolonged pain, which we refer to as postherpetic neuralgia (PHN). This requires comprehensive intervention involving not only dermatologists but also pain management specialists and traditional Chinese medicine practitioners. It is difficult to predict exactly when this type of pain can be completely eliminated.

It is therefore easy to understand why clinical guidelines and expert consensuses regarding herpes zoster and postherpetic neuralgia (PHN) are constantly being updated, both domestically and internationally. These updates aim to help patients recover from herpes zoster as quickly as possible and to reduce or prevent the occurrence of postherpetic neuralgia. At such a time, will you trust science or folk remedies? You must not miss the "golden window" for herpes zoster treatment!

Here, I would like to call for action: if finances allow, one should still receive the herpes zoster vaccine. Whether it is the imported recombinant zoster vaccine or the domestically produced zoster vaccine, both provide excellent prevention against herpes zoster for middle-aged and elderly individuals over the age of 50. In the future, the eligible age for recombinant zoster vaccination in China may align with international standards, meaning that young people over the age of 18 who are immunocompromised or at risk of herpes zoster infection will also be able to get vaccinated.

Only after you have truly listened to the grievances of those suffering from postherpetic neuralgia will you realize how terrifying herpes zoster can be; only then will you understand how vital it is to receive proactive, full-dose, and full-course antiviral treatment during the golden window; and only then will you realize how necessary it is to be vaccinated at the appropriate age.

It is my sincere hope that no one suffers from herpes zoster, and even if one does contract it, that they are spared from the lingering pain of postherpetic neuralgia.

Wishing everyone a happy life!