SUMMARY Herpes zoster (HZ; shingles) is frequently accompanied by significant pain that may precede rash appearance and persist as postherpetic neuralgia (PHN). PHN results in detriment to quality of life and has healthcare cost implications. Treatment for PHN often provides poor relief, with up to half of patients achieving less than 50% reduction of pain and significant treatment-related side effects. Vaccination against varicella reduces the number of individuals in the population carrying latent wild virus who can develop HZ. Enhancing zoster-specific cell-mediated immunity of older adults by HZ vaccination has been shown to reduce the incidence of both HZ and PHN. Treatments applied during the acute phase of HZ that may reduce pain duration are discussed, including antiviral drugs, anti-inflammatory steroids, effective analgesia and nerve blocks.