Shingles (kayap): symptoms, is it contagious, treatment, myths and the vaccine

What is shingles (kayap)?

After you have had chickenpox, the virus doesn’t leave your body. It lies dormant in nerve roots near the spine, sometimes for decades. If it reactivates, it travels along a nerve to the skin and causes shingles (herpes zoster), called kayap in Malay.

Anyone who has had chickenpox can get shingles. It becomes more common after age 50, and in people whose immunity is weakened by illness, cancer treatment or medicines such as steroids. Stress is often blamed, but age and immunity are the main factors. In the United States, about 1 in 3 people get shingles during their lifetime.

Shingles symptoms

1. Before the rash: burning, tingling, itching or sharp pain in one area of skin, sometimes with a headache, fever or feeling unwell. This can last a few days and is easily mistaken for a pulled muscle or, on the chest, heart pain.
2. The rash: a red rash that turns into clusters of fluid-filled blisters, in a band or patch on one side of the body, most often around the chest or waist. It doesn’t usually cross the middle of the body.
3. Healing: the blisters scab over in 7 to 10 days, and the rash usually clears in 2 to 4 weeks.

Kayap ular, kayap sambung and other beliefs

Kayap is surrounded by folk beliefs in Malaysia:

• “Kayap ular” describes the snake-like band of the rash. It is ordinary shingles, not a different disease.
• “If the kayap meets around the body, you will die” (kayap sambung): a myth. The shingles rash follows a single nerve on one side of the body, so it doesn’t encircle the body. Shingles is painful and troublesome, but in most people it isn’t life-threatening. A rash that spreads widely or appears on both sides is rare and suggests a weakened immune system. It needs prompt medical care for that reason, not because the ends “meet”.
• Names such as “kayap api” or “kayap air” are traditional descriptions, not separate medical conditions.

Relying on traditional remedies alone can mean missing the 3-day window for antiviral treatment. Applying pastes or herbs to open blisters can also cause infection. See a doctor first.

Is shingles contagious?

You can’t catch shingles from someone with shingles. But the fluid in the blisters contains the virus, and can give chickenpox to someone who has never had chickenpox or the vaccine.

• The risk is only while there are open blisters. Once they have scabbed over, you can’t pass it on.
• Keep the rash covered, don’t touch or scratch it, and wash your hands often.
• Until the blisters have crusted, avoid pregnant women who haven’t had chickenpox, babies under 1 month old and people with weak immunity.

Treatment: why the first 3 days matter

Antiviral medicines (such as aciclovir, valaciclovir or famciclovir) can shorten the illness and reduce the risk of complications. They work best when started within 72 hours (3 days) of the rash appearing, so don’t wait to see if it gets better.

• Take pain relief as advised by your doctor or pharmacist.
• Keep the rash clean and dry, and wear loose cotton clothing.
• Cool, damp compresses can ease discomfort.

Nerve pain after shingles (post-herpetic neuralgia)

The most common complication is post-herpetic neuralgia (PHN): burning, stabbing or aching pain in the area of the rash that continues for months, or even years, after the rash heals. It is more likely in people over 50, people with weakened immunity, and those who start antivirals late.

Ordinary painkillers often don’t help nerve pain. Doctors may prescribe medicines for nerve pain, numbing skin patches, or refer you to a pain clinic. Tell your doctor if pain continues after the rash has gone.

The shingles vaccine in Malaysia

• A non-live (recombinant) shingles vaccine has been available in Malaysia since September 2024.
• Who: adults aged 50 and over, and adults aged 18 and over with a higher risk, such as weakened immunity from illness or treatment.
• Doses: 2 injections, given 2 to 6 months apart (1 to 2 months apart for people with weakened immunity).
• Protection: about 97% effective in people aged 50 to 69 and 91% in those 70 and over, with strong protection lasting at least 7 years. It also greatly reduces the risk of post-herpetic neuralgia.
• You can have it even if you have had shingles before, once the rash has gone.

The shingles vaccine isn’t part of a free government programme, so it is given at private clinics and hospitals. Ask your doctor whether it is right for you.

Where to see a doctor about shingles

See a GP as soon as the rash appears, ideally within 3 days, so antiviral treatment can start early. Our directory lists GP clinics across Kuala Lumpur, Selangor and other states, many of which offer adult vaccinations, including clinics open in the evening and at weekends.

Browse the clinic directory

Frequently asked questions