The varicella-zoster virus (VZV) causes shingles and chickenpox. While shingles is not contagious, VZV can transmit chickenpox to unvaccinated people, usually through direct contact with the liquid that seeps from the rash. In rare cases, transmission is airborne.

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After an individual develops chickenpox, VZV remains inactive in the body. Later it can reactivate, causing shingles. This generally only happens once but can occur more than once. The shingles vaccine can lower the likelihood of developing shingles.

Shingles forms a rash of blisters that weep clear fluid. Direct contact with the liquid can spread VZV.

If someone who has never had chickenpox or the chickenpox vaccine comes in contact with the fluid, they may develop chickenpox, not shingles. Their risk of developing shingles later on increases.

Airborne transmission of shingles is rare. However, it is possible. It is more likely in close living situations such as a home or group living facility.

This article outlines shingles, how it spreads, how to prevent it from spreading, vaccination, and more.

According to the American Academy of Dermatology (AAD), doctors in the United States diagnose more than 1 million cases of shingles every year.

Once an individual has chickenpox, the virus remains in their body in a dormant state. Later in life, it can reactivate, causing shingles.

Shingles, also called herpes zoster, often begin as pain, itching, or a tingling feeling. In a few days, a rash develops in the same area.

Generally, the rash occurs in a strip around the right or left side of the torso. Sometimes it can appear on the face, which may affect vision. In people with weakened immune systems, it may occur on the entire body, although this is rare.

The rash will form blisters that may weep clear fluid and scab in 7–10 days. Typically, they will begin to heal in 2–4 weeks.

Although shingles is called herpes zoster, it is different from genital herpes. It is not a sexually transmitted infection and cannot cause genital herpes or cold sores. The herpes simplex virus causes these.

For 1–2 days before the appearance of the rash, the skin where the rash will appear may feel painful, itchy, or have a tingling sensation.

Blisters form, usually in a strip around one side of the torso. They can appear anywhere on the body, however, including the face. The rash may continue to grow after it first appears.

The blisters may open, ooze fluid, bleed, and scab over. It generally takes 2–4 weeks for the blisters to heal.

Some people may also experience systemic symptoms such as:

Systemic symptoms will subside along with the rash.

Learn more about shingles symptoms here.

Shingles spreads through direct contact with the fluid from the blisters. If someone who has never had chickenpox comes in contact with this fluid, they will contract chickenpox, not shingles. Later in life, they may develop shingles.

Although airborne transmission is rare, it is possible.

A 2021 study in Japan found one example of a 15-year-old boy who had no contact with his father’s shingles rash but still contracted chickenpox. This transmission type is most likely in close living situations such as a house or group home.

Learn more about VZV transmission here.

Covering the shingles rash best prevents spreading the virus to others, according to the Centers for Disease Control (CDC).

People should avoid scratching or touching the rash and wash their hands often.

The virus cannot spread before blisters form or after the rash crusts over. Shingles are only contagious when the rash sores are open, weeping fluid, or bleeding.

If an individual has shingles, they should avoid anyone who has not had chickenpox or the chickenpox vaccine, pregnant people, or anyone who has a weakened immune system.

To avoid contracting the shingles virus, people may wish to get the shingles vaccine at the age of 50, as recommended by the CDC. They also recommend the vaccine for anyone over 19 who has a weakened immune system.

People should avoid touching the rash of anyone who has developed shingles. It is also best to avoid touching any discarded wound dressings.

Consider wearing a mask indoors and wash hands often with soap and water. People should limit close contact with the person who has shingles.

Some people are at greater risk from shingles. According to the AAD, these include:

  • those who are pregnant
  • babies younger than 12 months
  • those with weakened immune systems, particularly from cancer or AIDS
  • anyone who has not had chickenpox

Shingles can lead to long-term nerve pain called postherpetic neuralgia (PHN). Other possible complications include:

For these reasons, everyone should take precautions to avoid contracting shingles.

The CDC recommends the Shingrix vaccine for adults 50 years and older or those 19 and older with weakened immune systems.

This vaccine is a two-dose series, 2–6 months apart, as an injection in the upper arm. It is available at local pharmacies or through healthcare services.

Shingrix is more than 90% effective at preventing shingles in healthy adults and 68-91% effective among adults with weakened immune systems.

The CDC does not recommend Shingrix for those who:

  • have had a severe allergic reaction to any component of the Shingrix vaccine
  • currently have shingles
  • are pregnant
  • currently have moderate or severe illness

Shingrix creates a strong immune system response in many people, leading to 2–3 days of discomfort and flu-like side effects.

The CDC recommends over-the-counter pain relievers such as acetaminophen or ibuprofen. A person should contact a doctor if the side effects do not diminish or get worse in 2–3 days.

The Zoster live vaccine (Zostavax) is no longer available in the United States.

Learn more about the Shingrix vaccine here.

Contact a doctor within 3 days of the rash appearing. Shingles is treatable with antiviral medications to help the rash clear more quickly.

The doctor can usually diagnose shingles with a visual examination, although they may order a shingles test. During the test, a medical professional may draw blood or take a sample of fluid from the blisters.

Learn about treatment for shingles here.

Shingles is a painful rash that currently does not have a cure. However, it is treatable with quick medical intervention.

According to the CDC, the blisters usually scab over in 7–10 days, and the rash fully clears in 2–4 weeks.

Shingles usually spreads through contact with fluid or blood from the blisters. In rare cases, it spreads through virus particles in the air. Wearing a mask around someone with the virus may protect a person from developing the virus.

To avoid transmitting the virus, a person with shingles can keep the rash covered, avoid scratching, wear a mask, and wash their hands often.

VZV causes shingles and chickenpox.

If someone with shingles spreads the virus to someone who has never had chickenpox, that individual will contract chickenpox, not shingles. Once someone has had chickenpox, the virus lies dormant in the body and can reactivate later in life as shingles.

Shingles often clears up on its own. However, a doctor may prescribe antiviral medications.