Introduction: Herpes zoster commonly known as shingle__ampersandsignrsquo;s caused by the varicella-zoster virus (VZV). Current studies have shown that exosomes play a significant role in the pathogenesis as well as the spread of herpes. Combination therapy has shown pain reduction, reduction in burning and arrest the progression of the disease. This approach is cost-efficient and simple to implement. Pittaj visarga may be linked with herpes in Ayurveda. The treatment principles are Raktmokshan (~Bloodletting) and Pradeha (Local application of medicines). Case presentation: A 28-year-old male presented in OPD of Kayachikitsa at Datta Meghe Ayurved Medical College Hospital and Research Centre. We treated his Herpes zoster on the basic principles of management of Vata-Pittaj Visarpa. Results: Rapid decrease in pain severity was observed after 3 days of Combination Therapy according to the Zoster Specific Brief Pain Inventory (ZBPI) Questionnaire. Conclusion: Repeated application of Ayurvedic Formulation Lepa along with internal medications gave complete relief. Adap tive trials are necessary to discover further practical applicability of Ayurveda and modern treatment together. Future research on the effect of combination therapy on exosomes is necessary.