Most kids get chickenpox at an early age. This is usually short-lived and produces some vivid markings of the skin with those itchy pockmarks - although tempting to scratch, it is important to resist in order to prevent long term scarring. After a few days, the worst of the symptoms pass. Assuming you have resisted the temptation to scratch, the skin should heal leaving no obvious marks. It is easy to believe that all your troubles are over except the virus is not necessarily done with you. Around half of all adults experience a new range of symptoms arising from the same exact virus but later in life. This confirms a simple truth. This virus is almost impossible to kill and, no matter what you do, it can come back, sometimes years later. This time, the virus breaks out in the nerve endings and produce a rash along the line of the nerves affected. The rash may start off as a harmless itch, but it usually devolves into a sharp pain. With luck, the rash usually heals within one month, but there can be longer term pain in the affected nerves. If you are lucky, this pain will only last for a few months, but some people find the pain continues for more than a year. It is relatively rare for the skin rash to appear more than once.
If you start taking one of the specific antivirals within three days of the rash first appearing, there's a good chance the herpes will not develop into the most painful form. If you decide not to get treatment, the rash is much slower to clear and the pain is more likely to last more than a year. Those who are over fifty absolutely must seek treatment if they are to avoid pain. The moral of this is for you always to seek an antiviral as soon as a rash appears. To this prescription is added painkillers and corticosteroids. As to the pain, most people find the drugs available over the counter are sufficient to maintain quality of life. One of the non-steroidal anti-inflammatory drugs will be best. As the spots begin to heal, one of the painkilling topical creams can be applied.
We now come to the question of the corticosteroids. Although the evidence pointing to positive results in younger people is discouraging, it seems that Prednisone can have great benefits for the older generation of 50+ year olds. The research suggests the spots heal more quickly and there is less pain without having to rely on painkillers. With prompt treatment, there seems to be less chance of longer term pain from damaged nerves, but there is no clear evidence. The best approach therefore seems to be that you should take Prednisone if you are over 50, the rash covers a significant area and is more painful than you expect. This is a precautionary approach relying on the fact that a short burst of the drug is unlikely to harm you and will ideally speed along the cure and recovery process.