Shingles, also called herpes zoster, is an infection that causes a painful, blistering rash, often on one side of the body or face. There may also be ongoing neurologic pain.

Shingles happens when the chickenpox virus reactivates, often many years later. It affects about 1 million people each year in the United States. There may also be a fever, chills, headache, gastrointestinal disturbances, and headache.

In most cases, shingles is not a life threatening condition, but it can cause severe pain, and the effects can linger for months or years as postherpetic neuralgia.

Vaccinations against the chickenpox virus and the shingles virus can help prevent shingles.

The first symptoms of shingles are usually:

  • pain
  • itching
  • tingling

Next, the following may start to appear:

  • a painful rash of blistering sores, which appears as a single stripe around one side of the trunk
  • a rash around the eye
  • fever and chills
  • headache
  • gastrointestinal symptoms
  • a rash or ulcers in the mouth, known as oral shingles

The rash from shingles tends to develop in a hallmark pattern, usually on the trunk. People sometimes call it a “shingles band” due to the striped pattern. They appear over 3–5 days.

Pain occurs because the virus causes inflammation in the nerves.

Over the next 7–10 days, the blisters often rupture, form sores, and then crust over and heal. The rash usually disappears in 2–4 weeks.

Disseminated shingles involves a widespread rash. It can affect people with a weakened immune system.

In some people, the rash heals, but the pain continues for 4 weeks or longer. In some cases, there may be severe pain lasting 90 days or more, known as postherpetic neuralgia (PHN).

According to the Centers for Disease Control and Prevention (CDC), PHN affects 10–18% of people who have had shingles. It rarely affects those under 40 years, but 13% of individuals aged 50 years or over will develop PHN after shingles. By the age of 70, this figure rises to around 75%.

In some cases, shingles can lead to:

In some cases, the virus affects the internal organs, such as the lungs, liver, brain, spinal cord, or blood vessels. In this case, it can become life threatening. Having a weakened immune system may increase the risk of internal involvement.

What is internal shingles?

The symptoms of shingles can sometimes resemble those of other conditions, such as:

The best way to work out if a rash is shingles is to speak with a doctor. In most cases, a doctor can make a diagnosis according to a person’s medical history, a physical exam, and symptoms. However, they may take a sample of skin, mucus, or blood for testing to confirm the diagnosis.

Anyone who suspects they have shingles needs to seek medical advice. Treatment can help speed recovery and reduce the risk of complications.

What do skin infections look like?

A virus called varicella zoster causes shingles. It also causes chickenpox, which used to be a common childhood illness before health experts developed a vaccine for it.

Once a person has a chickenpox infection, the virus remains in their nervous system, even after they recover. Although the virus stays in the body, doctors consider it latent, meaning it is inactive and does not cause any symptoms.

At some point, the virus can reactivate and cause shingles. The reason the virus reactivates is not entirely clear — it may become active again if a person’s immune system becomes weakened or stressed.

What treatment options are there for shingles?

A person cannot get shingles from another individual, but they can get chickenpox from someone who has shingles if they do not have immunity to chickenpox.

Transmission can occur through contact with the fluid that comes from the blisters.

When is shingles contagious?

Vaccination

According to the CDC, the shingles vaccine (Shingrix) is safe and can provide up to 97% protection against shingles, depending on the person’s age and the status of their immune system.

The Department of Health and Human Services advises everyone to have the shingles vaccine if they are:

  • are aged 50 years or older
  • are aged 19 or older and have a weakened immune system due to a health condition or treatment, such as chemotherapy
  • are aged 19 or older and are at risk of a weakened immune system because of upcoming treatments

People should have the vaccine even if they:

  • have already had shingles
  • have previously been vaccinated with Zostavax, a vaccine that is no longer in use
  • are not sure if they have had chickenpox

The vaccine comes in two doses, the second being 2–6 months after the first.

Here are some questions people often ask about shingles symptoms.

What are the first signs of shingles?

Early symptoms include a feeling of pain, burning, and itching in one area of the skin. After this, a rash appears, and fluid-filled blisters form. The rash is painful because the virus causes infection in the nerve cells.

What are the triggers for shingles?

Possible triggers for shingles include:

  • emotional stress
  • the use of immunosuppressant medications
  • having a health condition that affects immunity

Will shingles go away without treatment?

There is currently no cure for shingles, but the rash usually clears up in 2–4 weeks. However, treatment can help manage it. If a person takes antiviral medication soon after the rash appears, it may shorten the duration of the infection and reduce the severity of symptoms.

Over-the-counter pain relief, wet compresses, calamine lotion, and lukewarm baths with colloidal oatmeal may help manage discomfort.

What are some natural treatments for shingles?

How long does shingles last?

The first symptoms of shingles are often pain, tingling, itching, and then a rash. The rash often forms a band around one side of the trunk. In time, blisters can form. These usually heal within 2–4 weeks, but some people have ongoing pain known as postherpetic neuralgia.

The rash can also affect the eyes and mouth, with a risk of vision loss.

Vaccination can help prevent shingles. Health experts recommend it for people aged 50 years and above and those aged 19 and over who have or are at risk of having a weakened immune system.