When the virus that causes
chickenpox reactivates, it causes
shingles. Early symptoms of shingles include headache,
sensitivity to light, and flu-like symptoms without a fever. You may then feel
itching, tingling, or pain where a band, strip, or small area of rash may
appear several days or weeks later. A rash can appear anywhere on the body but
will be on only one side of the body, the left or right. The rash will first
form blisters, then scab over, and finally clear up over a few weeks. This band
of pain and rash is the clearest sign of shingles.
rash caused by shingles is more painful than itchy.
nerve roots that supply sensation to your skin run in
pathways on each side of your body. When the virus becomes reactivated, it
travels up the nerve roots to the area of skin supplied by those specific nerve
roots. This is why the rash can wrap around either the left or right side of
your body, usually from the middle of your back toward your chest. It can also
appear on your face around one eye. It is possible to have more than one area
of rash on your body.
Shingles develops in stages:
Prodromal stage (before the rash appears)
- Pain, burning, tickling, tingling, and/or
numbness occurs in the area around the affected nerves several days or weeks
before a rash appears. The discomfort usually occurs on the chest or back, but
it may occur on the belly, head, face, neck, or one arm or
- Flu-like symptoms (usually without a fever), such as chills,
stomachache, or diarrhea, may develop just before or along with the start of
- Swelling and tenderness of the
lymph nodes may occur.
Active stage (rash and blisters appear)
- A band, strip, or small area of rash appears.
It can appear anywhere on the body but will be on only one side of the body,
the left or right. Blisters will form. Fluid inside the blisters is clear at
first but may become cloudy after 3 to 4 days. A few people won't get a rash,
or the rash will be mild.
- A rash may occur on the forehead, cheek, nose, and around one
eye (herpes zoster ophthalmicus), which may threaten your
sight unless you get prompt treatment.
- Pain, described as "piercing needles in the skin," may occur
along with the skin rash.
- Blisters may break open, ooze, and crust
over in about 5 days. The rash heals in about 2 to 4 weeks, although some scars
Postherpetic neuralgia (chronic pain stage)
Postherpetic neuralgia (PHN) is the most
common complication of shingles. It lasts for at least 30 days and may continue
for months or years. Symptoms are:
- Aching, burning, stabbing pain in the area of the earlier
- Persistent pain that may linger for
- Extreme sensitivity to touch.
- The pain associated with PHN most commonly affects the forehead or chest. This pain may make it
difficult for the person to eat, sleep, and do daily activities. It may
also lead to
Shingles may be confused with
other conditions that cause similar symptoms. The rash from shingles may be mistaken for an infection from herpes simplex virus (HSV), poison oak or ivy, impetigo, or scabies. The pain from PHN may feel like appendicitis, a heart attack, ulcers, or migraine headaches.