We include products we think are useful for our readers. If you buy through links on this page, we may earn a small commission. Here’s our process.

Medical News Today only shows you brands and products that we stand behind.

Our team thoroughly researches and evaluates the recommendations we make on our site. To establish that the product manufacturers addressed safety and efficacy standards, we:
  • Evaluate ingredients and composition: Do they have the potential to cause harm?
  • Fact-check all health claims: Do they align with the current body of scientific evidence?
  • Assess the brand: Does it operate with integrity and adhere to industry best practices?
We do the research so you can find trusted products for your health and wellness.
Was this helpful?

Shingles is a viral infection that results from the varicella-zoster virus (VZV), the same virus that causes chickenpox. It typically affects a single sensory nerve ganglion and the skin that the nerve supplies.

Anyone who has had chickenpox can later develop shingles.

In fact, according to the Centers for Disease Control and Prevention (CDC), an estimated 1 in 3 people in the United States develop shingles during their lifetime.

People can develop shingles if they had chickenpox in the past. This virus can lie dormant for years, and then reactivate as shingles. A person who has not had chickenpox before can get chickenpox through exposure to someone with shingles.

Shingles is most common after the age of 50, but it can appear at any age if a person has previously had chickenpox.

In this article, learn more about shingles, including symptoms, complications, and treatments.

Shingles usually affects one side of the body. This is most often the waist, chest, abdomen, or back. Symptoms can also appear on the face and in the eyes, mouth, ears. The virus can also affect some internal organs.

Shingles typically affects a single sensory nerve ganglion near the spinal cord, called a dorsal root ganglion. This is why the symptoms occur in specific areas of the body, rather than all over it. The pain results from nerve involvement, rather than the rash itself.

Symptoms can vary in nature, depending on where on the body they appear.

Some people have pain but no rash. Others may have a rash with pain that is accompanied by other symptoms, such as fever, chills, or headache.

Most common symptoms

Some of the most common symptoms of shingles include:

  • a constant dull, burning, or gnawing pain, or a sharp, stabbing pain that comes and goes
  • a skin rash that resembles a chickenpox rash but only affects certain areas
  • fluid-filled blisters that develop as part of the rash

Symptoms on the body

A blistering skin rash may appear in one or more distinct bands with sensory nerves of the skin, called dermatomes.

Common locations for this include:

  • the chest
  • the abdomen
  • the back
  • around the waist

It usually occurs only on one side of the body.

The location of the symptoms will depend on which dermatome distribution the virus affects.

Facial symptoms

If the rash affects the face, symptoms usually appear on one side only — usually around one eye and the forehead.

They can include:

  • pain over the affected dermatome
  • a rash
  • muscle weakness
  • headache

Eye symptoms

If the virus affects an ophthalmic nerve, it means that a person has herpes zoster ophthalmicus (HZO).

This can cause pain, redness, and swelling in and around the eye, as well as temporary or permanent loss of vision.

Ear symptoms

Shingles can also occur in or around the ear, leading to problems with balance and hearing, as well as muscle weakness on the affected side of the face.

These changes can be long-term or even permanent.

A person who develops symptoms in or around the ears and eyes should seek immediate medical attention to reduce the risk of complications.

Mouth symptoms

If shingles affects the mouth, a person may experience:

  • facial tenderness
  • pain in the mouth
  • toothache
  • lesions in hard and soft palate tissues

The pain and discomfort of these symptoms can make it difficult to eat or drink.

Internal shingles

Shingles can also affect the internal organs. There will not be a rash, but other problems can arise.

For example, researchers have found evidence of shingles in the digestive system, which can lead to gastrointestinal dysfunction, and in the arteries in the brain, which may increase the risk of stroke and dementia.

Other symptoms

There may also be other symptoms, including:

Symptom progression

Symptoms typically progress as follows:

  • Pain, tingling, numbness, and itching start to affect a specific part of the skin.
  • After up to 2 weeks, a rash appears.
  • Red blotches and itchy, fluid-filled blisters develop and continue to do so for 3–5 days.
  • The blisters may merge, forming a solid red band that looks similar to a severe burn. The gentlest touch may be painful.
  • Inflammation may affect the soft tissue under and around the rash.
  • After 7–10 days, the blisters gradually dry up and form scabs or crusts. As the blisters disappear, they may leave minor scarring.

Shingles usually lasts around 2–4 weeks. It is contagious until the blisters dry up and crust over.

Most people will only have an episode of shingles once, but it can recur in some people.

When to see a doctor

Getting treatment shortly after the onset of symptoms can help decrease the duration and severity of infection.

This is especially important for people over 60 and those who have a weakened immune system, as this could increase the risk of developing serious complications.

If the rash continues spreading to other parts of the body or other symptoms occur, such as high fever, it is best to consult with a doctor.

Additionally, those who develop a rash near the eye should seek immediate medical attention, as this can be a sign of HZO. The condition can cause scarring, vision loss, and permanent eye damage if left untreated.

A doctor may prescribe antiviral drugs to stop the virus from multiplying.

Antiviral treatment can help with:

  • reducing the severity and duration of symptoms
  • preventing complications from developing
  • lowering the risk of the rash coming back

In addition to antiviral drugs, there are several other ways to help manage symptoms, including:

  • using pain relief medication
  • reducing stress as much as possible
  • eating regular, nutritious meals
  • getting some gentle exercise
  • wearing loose fitting clothes for comfort
  • doing relaxing activities that will reduce stress and take a person’s mind off the pain, such as watching television, reading books, socializing, listening to music, or engaging in hobbies

To relieve itching, the CDC recommends:

  • applying calamine lotion
  • taking a lukewarm, oatmeal bath
  • placing a cool, damp washcloth on the blisters

Calamine lotion is available for purchase online.

Learn more home remedies for itching here.

Most people will recover with home treatment, but a person should seek medical help if other symptoms appear, such as a fever. Around 1–4% of people will need to spend time in the hospital due to complications.

Shingles results from VZV, the same virus that causes chickenpox. After a person recovers from chickenpox, the virus remains dormant in the sensory ganglia of their cranial nerve or the dorsal root ganglia within the peripheral nervous system.

VZV belongs to a group of viruses called herpes viruses. This is why shingles also has the name “herpes zoster.”

All herpes viruses can hide in the nervous system, where they can remain indefinitely in a latent state.

Under the right conditions, the herpes zoster virus can reactivate, similarly to waking up from hibernation, and travel down nerve fibers to cause a new active infection.

What triggers this is not usually clear, but it may happen when something weakens the immune system, prompting the virus to reactivate.

It is not possible to directly transmit shingles to another person. However, a person who has never had chickenpox can contract the virus by coming into direct contact with the fluid in the blisters of a person who currently has shingles.

If this happens, and the person has not received a vaccination against chickenpox, they would develop chickenpox first, not shingles.

Shingles does not spread through coughing or sneezing. Only direct contact with fluid from the blisters can spread the virus. Therefore, covering the blisters reduces the risk of contagion.

It is important to note that the virus is only active from when the blisters first appear to when they dry up and crust over. Transmission is not possible before the blisters develop or after the crusts form. If a person does not develop blisters, the virus cannot spread in the traditional sense.

Taking the following precautions can help prevent the transmission of the virus:

  • covering the rash
  • washing the hands often
  • avoiding touching or scratching the rash

It is also important for someone with shingles to avoid contact with:

  • infants who are preterm or have a low birth weight
  • pregnant people who have never had chickenpox or the vaccine for it
  • those with a weakened immune system

Doctors usually diagnose shingles through a physical exam by evaluating the appearance of the rash and blisters on the body.

In some cases, they may collect a tissue sample from the fluid of the blisters and send it to a lab to check if the virus is present.

They may also conduct a blood test to look for antibodies, which can determine whether a person has ever been exposed to the virus.

Vaccination can offer protection from both chickenpox and shingles.

For children: Chickenpox vaccine

Experts recommend routine immunization with the varicella vaccine (chickenpox vaccine) during childhood.

With two doses of the vaccine, there is at least a 90% chance of preventing chickenpox. Preventing chickenpox will also prevent shingles.

Children should receive the first dose at 12–15 months. The second dose is at 4–6 years.

Tests have shown the vaccine to be safe, though some children may experience:

  • pain at the injection site
  • a fever and a mild rash
  • temporary joint pain and stiffness

Since vaccination started in children, the number of shingles cases has dropped.

Are vaccines safe or not? Learn more here.

Also, click here to learn more about the brands of childhood chickenpox vaccines.

For older adults: Shingles vaccine

A different vaccine, the herpes zoster vaccine, is available for people aged 50 and older who have had chickenpox and therefore carry VZV. Experts also recommend this vaccine for those who have not had chickenpox or shingles.

In the U.S., 99.5% of people born before 1980 already have this virus in their system. The herpes zoster vaccine can help prevent shingles in people who already have the virus.

The options available are Zostavax and a newer vaccine called Shingrix.

After two doses of Shingrix, a person will have more than 90% protection against shingles, falling to just above 85% after 4 years, according to the CDC.

Who should not have the vaccine?

People who should not have the shingles vaccine without first discussing it with their doctor include those who:

  • have an allergy to any component of the shingles vaccine
  • have a weakened immune system
  • are or might be pregnant

Although anyone who has had chickenpox can develop shingles, some people may be at a higher risk.

Possible risk factors and triggers include:

  • older age
  • certain cancers or cancer treatment options
  • HIV
  • treatments that suppress the immune system
  • stress or trauma

Complications

Rarely, complications can arise — especially in people with an impaired immune system.

Possible complications of shingles include:

  • postherpetic neuralgia (PHN)
  • inflammation of the brain or spinal cord, increasing the risk of stroke, encephalitis, and meningitis
  • eye and vision problems
  • weakness
  • problems with balance and hearing
  • damage to blood vessels, which could lead to stroke
  • pneumonia

According to the CDC, around 10–18% of people who have shingles will develop PHN, a long-term complication in which the pain of a shingles rash lasts long beyond the rash itself.

It is more likely to occur if a person develops shingles after the age of 40, and the risk continues to increase with age.

In people with weak immune systems

People with a weakened immune system will have a higher risk of developing shingles and of experiencing severe symptoms and complications.

This includes people who:

These people should seek medical attention as soon as possible if they have concerns about shingles-related symptoms.

What other precautions should a person take if they have a weak immune system? Find out here.

Anyone who has had chickenpox can develop shingles.

Most people make a full recovery from shingles within 3–5 weeks, but some experience severe complications. Those most at risk are people with a weakened immune system.

Getting the varicella vaccination during childhood can prevent both chickenpox and shingles. For those who did not have the vaccination in childhood, vaccines against shingles are available.

People aged 50 and older should talk to their doctor about the shingles vaccination.