11036 Shingles

Overview

Shingles is a painful, blistering skin rash caused by the varicella-zoster virus — the same virus that causes chickenpox. After you have had chickenpox, the virus stays in your body. Years later, it can reactivate and cause shingles. It is also called herpes zoster.

Yes, shingles is quite common. Around one in three people will have it at least once in their lifetime.

Anyone who has had chickenpox can get shingles. It is most common in people over 50, and the risk rises with age. People with a weakened immune system are also more likely to develop it.

Symptoms

Common symptoms

• Burning, tingling, or itching on the skin before a rash appears
• A red rash that turns into fluid-filled blisters
• Pain that can be sharp, stabbing, or throbbing
• Fever, headache, and feeling generally unwell

Symptoms in children

• A painful or itchy rash, often on one side of the body
• Mild fever and tiredness
• Blisters that heal over time

Symptoms in older adults

• More intense pain, which can last for weeks or months after the rash heals
• A higher risk of long-term nerve pain (postherpetic neuralgia)
• The rash may take longer to heal

Causes

Main causes

• The varicella-zoster virus, the same virus that causes chickenpox
• Reactivation of the dormant virus later in life
• A drop in immune defences that allows the virus to become active again

Risk factors

• Being over 50 years old
• Having a medical condition or treatment that weakens the immune system
• Stress, physical illness, or injury
• Not having had a shingles vaccination

When to see a doctor

See a doctor urgently if:

• If you think you might have shingles, see a doctor as soon as possible — ideally within 72 hours of the rash appearing.
• If you have a weakened immune system or are pregnant, contact a doctor immediately.
• If the rash is on your face, especially near your eyes, seek medical care without delay.
• If the rash becomes very painful or shows signs of infection, get urgent advice.

Book a routine appointment if:

• Book a GP appointment if you have a painful rash and want to confirm whether it is shingles.
• Ask about the shingles vaccine if you are over 50 and have never had it.

Diagnosis

A doctor can usually diagnose shingles by looking at the rash and asking about your symptoms. They will check whether the rash is on one side of the body and whether you have any pain, tingling, or other typical signs.

Tests that may be done

• A swab of a blister may be sent to a laboratory to confirm the diagnosis
• Blood tests are rarely needed, but may be used if the rash is unusual or if there is doubt

What to expect at your appointment

The doctor will ask about your medical history, including whether you have had chickenpox or the shingles vaccine. The physical examination is quick and often confirms the diagnosis.

Treatment

Treatment for shingles aims to reduce pain, help the rash heal, and lower the risk of complications, such as long-lasting nerve pain. It works best when started early.

Self-care at home

• Keep the rash clean and dry to prevent infection
• Cover the rash loosely with a non-stick dressing
• Apply a cool, damp flannel to the area for comfort
• Wear loose clothing made from natural fibres, like cotton
• Get plenty of rest and drink enough fluids
• Avoid close contact with pregnant women, newborn babies, and people who have never had chickenpox

Medical treatments

Your doctor may prescribe antiviral medicines to help the rash heal faster and reduce complications. These are most effective when started within 72 hours of the rash appearing. For pain, you can use over-the-counter pain relievers, but always read the label and ask your pharmacist for advice. If needed, a doctor may suggest stronger prescription pain relief, topical creams, or a short course of corticosteroids to reduce inflammation. Always take any prescribed medicine as directed by your healthcare professional.

When is surgery considered?

Surgery is not used to treat shingles. In rare cases, if a secondary bacterial infection develops under the rash, a doctor might need to drain an abscess, but this is very uncommon.

Living with this condition

During a shingles episode, take it easy. Keep the rash covered and clean, and rest as much as you can. Once the blisters have crusted over, you are no longer contagious.

Lifestyle tips

• Reduce stress with relaxation techniques, such as deep breathing or gentle yoga
• Prioritise sleep to support your immune system
• Do not scratch the blisters — this can cause scarring or infection
• Avoid sharing towels or clothing with others until the rash has healed

Diet and exercise

Eat a balanced diet with plenty of fruit, vegetables, and protein to help your body heal. Gentle exercise, such as walking, can boost your mood and energy, but stop if it makes your pain worse.

Mental health and emotional wellbeing

Living with shingles can be emotionally difficult, especially if the pain is severe or long-lasting. It is normal to feel frustrated or anxious. If your mood is interfering with daily life, talk to your doctor — support and treatment are available.

Prevention

You can lower your risk of getting shingles by having the vaccine and by looking after your general health. Vaccination does not offer 100% protection, but it significantly reduces the chance of developing shingles and the long-term pain it can cause.

Vaccines

In many countries, a shingles vaccine is recommended for adults aged 50 and over. Some countries also offer it to younger people with weakened immune systems. Ask your doctor, nurse, or pharmacist about the vaccine and whether it is suitable for you.

Screening programmes

There is no routine screening test for shingles. It is usually identified when a person sees a doctor because of the rash.

Complications

If left untreated

• Long-term nerve pain that lasts for months or years after the rash heals (postherpetic neuralgia)
• Bacterial skin infections from scratching
• Eye problems, including vision changes, if the rash is near the eyes
• Very rarely, complications such as pneumonia, hearing loss, or inflammation of the brain

Long-term outlook

The outlook for most people is very good. With early care, the rash usually clears within a few weeks, and any pain eases. Even if longer-term pain does occur, there are effective ways to manage it. Most people make a full recovery and return to their normal activities.

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