Shingles (Herpes Zoster)
Sources consulted
This article is original patient-education content.
- WHO—Health topics A–Z(2024)
- NHS—Health A to Z(2024)
- CDC—Health topics(2024)
Based on international clinical guidelines
Overview
Shingles, also known as herpes zoster, is a painful rash that usually appears as a band of blisters on one side of the body. It is caused by the same virus that causes chickenpox, called the varicella-zoster virus.
Key facts
- Shingles can happen to anyone who has had chickenpox, even many years later.
- The rash usually appears on one side of the body, often around the waist, chest, or face.
- Most people recover fully within a few weeks, but some may have lasting pain.
Yes, shingles is quite common. About 1 in 3 people will develop shingles at some point in their life, especially as they get older.
Shingles most often affects older adults over 50 and people with weakened immune systems, such as those on certain medical treatments or with chronic conditions. It can also occur in younger people, though less often.
Symptoms
- Rash near the eye, nose, or on the tip of the nose that could affect vision or lead to blindness
- Sudden vision changes, eye pain, or redness in the eye
- Severe pain that is not relieved by usual pain medicines
- Signs of a serious infection, such as high fever, chills, or the rash becoming very red, warm, or oozing pus
- ⚠Contact your healthcare provider within 3 days of the rash starting because early treatment can help
- ⚠If the rash is widespread or covers a large area of your body
- ⚠If you have a weakened immune system (for example, due to cancer treatment or an organ transplant)
Common symptoms
- Tingling, burning, or itching on one area of the skin before the rash appears
- A red rash that turns into blisters filled with fluid
- Pain that can be mild to severe, often described as a sharp, stabbing, or burning sensation
- Fever, headache, or feeling generally unwell
Symptoms in children
- Milder rash and pain compared to adults
- Blisters that heal faster, usually within a week or two
- Less likely to have long-term pain afterward
Symptoms in older adults
- More intense and longer-lasting pain
- Higher risk of complications like postherpetic neuralgia (ongoing pain after the rash heals)
- Rash may be more extensive and take longer to heal
Causes
Main causes
- Shingles is caused by the varicella-zoster virus, the same virus that causes chickenpox. After you recover from chickenpox, the virus stays dormant (inactive) in your nerve cells. Years later, it can reactivate and cause shingles.
Risk factors
- Age over 50
- A weakened immune system from illness, stress, or medical treatments (like chemotherapy or steroids)
- Physical trauma or injury to the area where the virus reactivates
- Emotional stress or a major life event
When to see a doctor
See a doctor urgently if:
- If you have a rash or blisters near your eye, nose, or on the side of your face
- If you have a weakened immune system and think you may have shingles
- If the pain is severe or the rash is spreading rapidly
Book a routine appointment if:
- If you suspect you have shingles, see your healthcare provider as soon as possible, ideally within 3 days of the rash appearing
- If you have had shingles before and are concerned about a recurrence
Diagnosis
Healthcare providers usually diagnose shingles by looking at the rash and asking about your symptoms. The distinctive pattern of blisters on one side of the body is often enough to confirm the diagnosis.
Tests that may be done
- In some cases, a small sample of fluid from a blister may be sent to a lab to confirm the virus (PCR test or culture)
- A swab test can also identify the virus quickly
What to expect at your appointment
The doctor will examine your skin, ask about pain and other symptoms, and may ask about your medical history. The process is quick and usually does not require any special preparation.
Treatment
Treatment focuses on reducing pain, helping the rash heal faster, and preventing complications. Starting treatment within 3 days of the rash appearing gives the best results.
Self-care at home
- Keep the rash clean and dry to prevent infection
- Apply a cool, wet cloth or calamine lotion to soothe itching and pain
- Rest as much as possible and avoid scratching the blisters
- Wear loose, comfortable clothing to avoid irritating the rash
Medical treatments
Healthcare providers may prescribe antiviral medications to help the rash heal faster and reduce pain. They may also recommend pain relievers, including over-the-counter options like paracetamol or ibuprofen, or stronger prescription pain medicines if needed. In some cases, numbing creams or patches may be suggested. Always follow your provider’s advice — never take more than the recommended dose.
When is surgery considered?
Surgery is not used to treat shingles itself. In very rare cases, if the virus affects the eye or causes severe nerve damage, a specialist may recommend a procedure, but this is uncommon.
Living with this condition
Take care of your rash by keeping it clean and covered. Avoid close contact with people who have not had chickenpox or the chickenpox vaccine, especially pregnant women, newborns, and people with weak immune systems, until the blisters have scabbed over.
Lifestyle tips
- Rest as much as you need, especially during the first few days of the rash
- Avoid stress, which can make pain worse or trigger a recurrence
- Avoid sharing towels, bedding, or clothing until the rash heals
Diet and exercise
Eat a balanced diet with plenty of fruits and vegetables to support your immune system. Light exercise like walking can help if you feel up to it, but listen to your body and rest when needed.
Mental health and emotional wellbeing
The pain and discomfort of shingles can be worrying and affect your mood. It’s normal to feel frustrated, anxious, or down. If the pain lasts a long time, it may increase the risk of depression. Talking to a trusted friend, family member, or counsellor can help.
Prevention
Yes, shingles can be prevented or made less severe with a vaccine. If you have had chickenpox, you can still get the shingles vaccine to reduce your risk. The vaccine is recommended for adults aged 50 and over, and for some younger people with weakened immune systems.
Vaccines
A shingles vaccine is available and is recommended for most adults over 50. It is given as two doses, usually a few months apart. The vaccine can reduce your risk of shingles by more than 90% and also lower the chance of long-term pain if you do get shingles. Talk to your healthcare provider about whether the vaccine is right for you.
Screening programmes
There is no routine screening test for shingles. The best form of prevention is vaccination and staying healthy to support your immune system.
Complications
If left untreated
- Postherpetic neuralgia (PHN): ongoing pain in the area where the rash was, lasting for months or even years after the rash heals
- Eye complications: if shingles affects the eye, it can lead to vision loss or other eye problems
- Skin infections: bacterial infection of the blisters can cause scarring or cellulitis
- Nerve damage: rarely, shingles can cause weakness or paralysis in the affected area
Long-term outlook
Most people recover fully from shingles within 3 to 5 weeks, and the rash usually heals without scarring. Even if you develop long-term pain, there are effective treatments to manage it. The shingles vaccine can prevent future episodes or make them milder. With proper care and support, you can manage the condition and maintain a good quality of life.
Find support
International organisations
Local organisations
- Shingles Support Society (UK) ↗ · United Kingdom
Helplines
External links open third-party websites. Ruqelo Health is not responsible for external content. Listing an organisation does not imply endorsement.
Always verify with your doctor
Health guidelines vary by country and region. The information in this article is based on international clinical guidelines but may not reflect the specific guidelines, medications, or practices in your country. Always discuss your health concerns with your own doctor or healthcare provider, and refer to your local national health guidelines where available.
Important notice This information is for educational purposes only. It does not replace professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider about your specific situation. If you are experiencing a medical emergency, call your local emergency services immediately.