Shingles is a painful viral infection that can affect anyone who has had chickenpox. The virus that causes chickenpox, then later shingles, can pass from person to person.

Shingles itself is not contagious. But the virus that causes it can pass to someone who has never had chickenpox or its vaccine. That person may then develop chickenpox, and later in life, shingles.

This virus is called the varicella-zoster virus (VZV), and it is a type of herpes virus.

A person with the VZV may develop chickenpox. After these symptoms go away, the virus stays latent in the body. Later, it can reactivate as herpes zoster, which is the medical name for shingles.

For years, the virus can remain inactive. It stays dormant in a dorsal root ganglion of the peripheral nervous system, sensory nerve tissue close to the spinal cord. At some point, the VZV can reactivate and trigger the symptoms of shingles.

Over 99% of people born in the United States before 1980 have had chickenpox. In other words, nearly everyone in that age group has the VZV.

The risk of the virus reactivating increases with age. Overall, about 1 in 3 people in the country will develop shingles at some point.

Shingles can also lead to a number of potentially severe complications.

For this reason, health experts recommend vaccinating children to protect them from chickenpox and shingles. Adults who have already had chickenpox can still have the vaccination to prevent shingles.

Shingles spreads via contact with the fluid or pus in a person’s blisters.

If a person comes into contact with this, they may develop chickenpox if they have never had it or the varicella vaccine, also known as the chickenpox vaccine.

Shingles can transmit via coughing and sneezing only if blisters have developed in the person’s oral cavity.

Before shingles blisters develop and after they have dried and crusted, there is no risk of transmitting the virus. The virus can transmit at any time between the appearance of the blisters and when they dry up.

It is not possible to treat or prevent shingles with antibiotics — these are only effective for bacterial infections, and shingles is viral.

Although many people who get shingles are older adults, younger people can contract it, as well.

Tips for stopping the virus from spreading to other people include:

  • not touching or scratching the rash, especially before it has dried and crusted
  • covering the rash with a loose dressing
  • practicing good hand hygiene by frequently washing both hands

Who should avoid contact with shingles?

One way of preventing the spread is to avoid contact with people who have shingles blisters.

If a person gets chickenpox, they usually only have it once. This is also true for shingles. A person is unlikely to have shingles more than once, unless they have a weakened immune system, which may result from a health issue or immunosuppressant treatments, such as chemotherapy or radiation therapy.

Anyone with shingles blisters should especially avoid contact with:

  • Pregnant people who have never had chickenpox or its vaccination: If chickenpox develops during pregnancy, especially 5–21 days before birth, it can be dangerous for the fetus.
  • Children who have not had chickenpox or its vaccination: Until a child is vaccinated, they should avoid contact with anyone who has chickenpox or shingles blisters.
  • People with weakened immune systems, such as:
    • infants born early or with a low birth weight
    • people with HIV, leukemia, lymphoma, or other health issues that have this immune effect
    • people who take immunosuppressant medications, such as chemotherapy
    • people who have had organ transplants

After contact with the varicella virus, a person in any of the above groups may be unable to ward off the infection. Their risk of developing chickenpox, then shingles and its complications may be higher.

These groups are also likely to have the illnesses for longer, and the symptoms may be more severe.

People at risk of developing shingles include:

  • anyone who has had chickenpox, which includes almost everyone born before 1980
  • people with weakened immune systems
  • people over the age of 60, as the risk increases with age

The risk of shingles may be increased for people with:

Also, experiencing physical trauma and using medications called statins can each increase the risk of shingles.

Anyone with concerns about developing shingles should speak with a doctor, who can advise about vaccination and other ways to reduce the risk.

A person with shingles may have common symptoms of a viral infection, such as a fever, chills, fatigue, and a headache.

However, shingles primarily involves a painful rash. This often develops on:

  • the waist, back, abdomen, or chest, often as a stripe on one side of the body
  • the face, including the ears, eyes, and mouth
  • internal organs, such as those in the digestive tract or arteries in the brain

When a person has shingles, they usually first experience a tingling, burning, or numb sensation in the skin, usually on one side of the body.

After a few days, clusters of small, fluid-filled blisters appear, sometimes surrounded by reddish skin.

After 7–10 days, the blisters start to dry up, and the symptoms usually disappear after 2–4 weeks.

Some shingles complications can be severe, lasting, or both. The complications include:

  • a loss of vision, if the rash occurs in or near an eye
  • hearing and balance problems, if the rash occurs in or around an ear
  • muscle weakness
  • facial paralysis
  • pneumonia
  • encephalitis, which is inflammation of the brain
  • stroke

Another complication is postherpetic neuralgia (PHN), which affects 10–18% of people who have had shingles.

A person with PHN has prolonged pain in the area of the rash after it has gone away. The pain can be severe, and it can last for several years.

Diagnosing shingles usually involves looking at the rash and asking about the symptoms. In some cases, doctors need to test for the virus.

It is not possible to cure shingles or remove the virus from the body. However, antiviral medications can help manage the symptoms, shorten the duration of the illness, and reduce the risk of complications.

Examples include:

Ways of managing the symptoms include:

  • using over-the-counter or prescription medications to relieve pain
  • applying wet compresses to soothe the skin and help the rash resolve
  • taking lukewarm colloidal oatmeal baths or applying calamine lotion to reduce itchiness
  • using topical treatments, such as lidocaine cream, gel, skin patches, or spray
  • keeping the rash clean and dry
  • covering the rash with a loose dressing
  • wearing loose-fitting clothing for comfort

Vaccination can prevent a person from developing chickenpox and, later, shingles. If a person has already had chickenpox, vaccination can prevent shingles. If a person has already had shingles, the vaccine can still have benefits.

The Centers for Disease Control and Prevention (CDC) recommend that children have the varicella, or chickenpox, vaccination in two doses: at 12–15 months of age and then at 4–6 years.

Teens and adults aged 13 years or older who have never had chickenpox or the vaccine and request vaccination should receive two doses at least 28 days apart.

Some people should not have the chickenpox vaccine, including people who are pregnant and anyone with a moderate or severe illness.

Vaccination against shingles is available for adults who are 50 or older and who have had chickenpox or are not sure if they have had it.

The shingles vaccine is available to people who meet these criteria, regardless of whether they have had shingles in the past. Anyone who currently has shingles should not receive the vaccine.

The vaccine in the U.S. is called Shingrix. Two doses administered 2–6 months apart provide at least 90% protection from shingles and PHN.

A healthcare professional can provide guidance to anyone who is unsure if they should have the shingles vaccine.

Learn more about why vaccination can be helpful, and even lifesaving, here.

Shingles itself does not transfer from person to person. However, the underlying virus, which causes chickenpox first, can transmit through shingles blisters.

Anyone who has never had chickenpox or its vaccination may develop chickenpox, and later shingles, after coming into contact with this fluid.

Anyone who has had chickenpox can develop shingles because the same virus causes both and it stays in the body. The risk of shingles and its complications is higher for people with weakened immune systems.

Receiving the varicella vaccination during childhood is the best way to reduce the risk of developing chickenpox and shingles.

Older people who have already had chickenpox should consider having herpes zoster vaccination from the age of 50 years. This reduces the risk of developing shingles and related complications.