Shingles is a painful rash, usually occurring on one side of the body. The herpes zoster, or chickenpox virus, causes it. The rash will initially look like flat areas of discolored skin.

After someone has had chickenpox, the virus remains in the body in a dormant — or inactive — state. Sometimes, the virus can reactivate, leading to shingles.

Every year, around 1 million people in the United States will get shingles. The first symptoms may include tingling or itchy skin before the rash even appears. People may experience further symptoms as the rash progresses, such as blistering, scabbing, or crusting.

This article explains shingles and outlines the first symptoms people may experience. It also answers some frequently asked questions about the condition.

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The symptoms of shingles tend to come in stages. Initially, a person may experience:

Atypical skin sensations

Before the rash appears, people may feel pain, itching, or tingling on the skin. This can happen several days or at least 48 hours before the rash appears.

The pain can be mild or intense.

People may also experience the following:

Doctors may call this the pre-eruptive stage of shingles.

The rash appears differently in darker skin tones than in white skin. According to the United Kingdom’s National Health Service, the rash can often be red, but it can be harder to see on brown and black skin.

When the rash does appear, it may show as macules and eventually become vesicles.

Early macule rash

Macules are flat, discolored areas of skin that can resemble a burn. They may appear different depending on a person’s skin tone.

In shingles, macules usually appear as a single stripe across the body’s right side. However, shingles can appear anywhere on the skin.

Shingles is not usually contagious at this stage. That means there is a low risk of it spreading from one person to another.

Vesicles rash

Next, the macules will turn into vesicles, or small fluid-filled blisters that can be painful.

Vesicles can also appear differently depending on a person’s skin tone.

Eventually, the blisters rupture, scab over, and dry out. During this process, the blister may flatten and change color.

Doctors call the macule and the vesicle rash the acute eruptive stage of shingles, lasting around 2–4 weeks.

This is when shingles is most contagious. The virus can transmit from one person to another through contact with the fluid contained in the rash. People who have never had chickenpox or the chickenpox vaccine are most likely to acquire the herpes zoster virus.

People can avoid transmitting the virus by:

  • covering the blisters
  • avoiding skin-to-skin contact with others
  • avoiding touching the rash whenever possible
  • washing their hands frequently

A person can also avoid contact with people at high risk of developing shingles. That includes:

  • pregnant people who have never had chickenpox or the chickenpox vaccine
  • infants who were born prematurely or with a low birth weight
  • people who have weakened immune systems, including those who:

People may still experience pain after the rash has resolved, such as:

  • a burning or prickling sensation on the skin
  • a shock-like sensation on the skin
  • itching

Doctors call this the chronic infection stage of shingles. Sometimes, it can last up to 12 months or longer.

Learn how shingles can affect the eyes.

The following section answers common questions about shingles:

How long do shingles symptoms last?

Typically, most cases of shingles last between 2–4 weeks. However, the exact time it takes the fluid-filled blisters to dry up, crust over, and clear, may vary.

After the rash disappears, some people can still experience long-term pain. They can even develop a condition called postherpetic neuralgia.

What causes shingles to suddenly appear?

The herpes zoster virus causes shingles. After someone has had chickenpox, the virus stays in the body in a dormant or inactive state. Sometimes, the virus can reactivate, leading to shingles.

Some triggers that might cause the virus to reactivate include:

  • stress
  • illness
  • certain medications, such as immunosuppressants
  • re-exposure to the virus

Sometimes, cancer can reactivate the herpes zoster virus.

How do doctors treat the symptoms of shingles?

Antiviral medications can shorten the length or the severity of shingles. Doctors may recommend:

These drugs are most effective if people take them as soon as the rash appears.

There are other ways people can help ease symptoms. Over-the-counter pain medications may help with the pain. Doctors may suggest prescription-strength pain relief if the pain is not tolerable.

To help with the itching, people could try:

Shingles refer to a painful rash that the herpes zoster virus causes. The first symptoms are usually pain, tingling, or itching on the skin.

Next, a rash of macules, which might look like burns, will appear. Over time, the macules will turn into painful blisters that rupture, scab over, and dry out.

People may experience pain and other symptoms for up to 12 months after the rash disappears.