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Shingles

What is shingles?

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Shingles, also called herpes zoster, is a disease that triggers a painful skin rash. It is caused by the same virus as chickenpox, the varicella-zoster virus. After you recover from chickenpox (usually as a child), the virus continues to live in some of your nerve cells.

For most adults, the virus is inactive and it never leads to shingles. But, for about one in three adults, the virus will become active again and cause shingles.

What are the symptoms of shingles?

Usually, shingles develops on just one side of the body or face, and in a small area. The most common place for shingles to occur is in a band around one side of the waistline.

Most people with shingles have one or more of the following symptoms:

  • Fluid-filled blisters
  • Burning, shooting pain
  • Tingling, itching, or numbness of the skin
  • Chills, fever, headache, or upset stomach

For some people, the symptoms of shingles are mild. They might just have some itching. For others, shingles can cause intense pain that can be felt from the gentlest touch or breeze. It’s important to talk with your doctor if you notice any shingles symptoms.

If you notice blisters on your face, see your doctor right away because this is an urgent problem. Blisters near or in the eye can cause lasting eye damage and blindness. Hearing loss, a brief paralysis of the face, or, very rarely, inflammation of the brain (encephalitis) can also occur.

How is shingles diagnosed and treated?

If you think you might have shingles, talk to your doctor as soon as possible. It’s important to see your doctor no later than three days after the rash starts. The doctor will confirm whether you have shingles and can make a treatment plan. Most cases can be diagnosed from a visual examination, but the doctor may order a shingles test if you have a condition that weakens the immune system. Although there is no cure for shingles, early treatment with antiviral medications can help the blisters clear up faster and limit severe pain. Shingles can often be treated at home.

How long does shingles last?

Most cases of shingles last three to five weeks.

  • The first sign is often burning or tingling pain; sometimes it includes numbness or itching on one side of the body.
  • Somewhere between one and five days after the tingling or burning feeling on the skin, a red rash will appear.
  • A few days later, the rash will turn into fluid-filled blisters.
  • About one week to 10 days after that, the blisters dry up and crust over.
  • A couple of weeks later, the scabs clear up.

Long-term pain

After the shingles rash goes away, some people may be left with ongoing pain called postherpetic neuralgia, or PHN. The pain is felt in the area where the rash occurred. The older you are when you get shingles, the greater your chances of developing PHN.

The PHN pain can cause depression, anxiety, sleeplessness, and weight loss. Some people with PHN find it hard to go about their daily activities, such as dressing, cooking, and eating. Talk with your doctor if you are experiencing PHN or have any of these symptoms. Usually, PHN will lessen over time.

Am I at risk for shingles?

Everyone who has had chickenpox is at risk for developing shingles. Researchers do not fully understand what makes the virus become active and cause shingles. But some things make it more likely:

  • Older age. The risk of developing shingles increases as you age. About half of all shingles cases are in adults age 60 or older. The chance of getting shingles becomes much greater by age 70.
  • Trouble fighting infections. Your immune system is the part of your body that responds to infections. Age can affect your immune system. So can HIV, cancer, cancer treatments, too much sun, and organ transplant drugs. Even stress or a cold can weaken your immune system for a short time. These all can put you at risk for shingles.

Most people only have shingles one time. However, it is possible to have it more than once.

When should I get the shingles vaccine?

The current shingles vaccine (brand name Shingrix) is a safe, easy, and more effective way to prevent shingles than the previous vaccine. In fact, it is over 90% effective at preventing shingles. Most adults age 50 and older should get vaccinated with the shingles vaccine, which is given in two doses. You can get the shingles vaccine at your doctor’s office and at some pharmacies.

You should get the shingles vaccine if you:

  • Have already had chickenpox, the chickenpox vaccine, or shingles
  • Received the prior shingles vaccine called Zostavax
  • Don’t remember having had chickenpox

Medicare Part D and private health insurance plans may cover some or all of the cost. Check with Medicare or your health plan to find out if it is covered.

You should not get vaccinated if you:

  • Currently have shingles
  • Are sick or have a fever
  • Had an allergic reaction to a previous dose of the shingles vaccine

If you are unsure about the above criteria or have other health concerns, talk with your doctor before getting the vaccine.

Tips for coping with shingles

If you have shingles, here are some tips that might help you feel better:

  • Wear loose-fitting, natural-fiber clothing.
  • Take an oatmeal bath or use calamine lotion to soothe your skin.
  • Apply a cool washcloth to your blisters to ease the pain and help dry the blisters.
  • Keep the area clean and try not to scratch the blisters so they don’t become infected or leave a scar.
  • Do things that take your mind off your pain. For example, watch TV, read, talk with friends, listen to relaxing music, or work on a hobby such as crafts or gardening.
  • Get plenty of rest and eat well-balanced meals.
  • Try simple exercises like stretching or walking. Check with your doctor before starting a new exercise routine.
  • Avoid stress. It can make the pain worse.
  • Share your feelings about your pain with family and friends. Ask for their understanding.

Also, you can limit spreading the virus to other people by:

  • Staying away from anyone who has not had chickenpox or the chickenpox vaccine, or who might have a weakened immune system
  • Keeping the rash covered
  • Not touching or scratching the rash
  • Washing your hands often

Read about this topic in Spanish. Lea sobre este tema en español.

For more information about shingles

Centers for Disease Control and Prevention (CDC)
800-232-4636 (toll-free)
888-232-6348 (TTY/toll-free)
cdcinfo@cdc.gov
www.cdc.gov

MedlinePlus
National Library of Medicine      
www.medlineplus.gov

National Institute of Neurological Disorders and Stroke
800-352-9424 (toll-free)
braininfo@ninds.nih.gov
www.ninds.nih.gov

National Shingles Foundation
212-222-3390
shingles@shinglesfoundation.org
www.vzvfoundation.org

This content is provided by the NIH National Institute on Aging (NIA). NIA scientists and other experts review this content to ensure it is accurate and up to date.