Shingles: What You Should Know

Medically Reviewed by Neha Pathak, MD on August 11, 2021

What Is Shingles?

You can think of shingles as a one-two punch of infections. Anyone who gets it had a case of chickenpox first, often decades earlier.

These two conditions come from the same virus, called varicella zoster.

Chickenpox causes itchy blisters that might start on your back, chest, and face and spread to the rest of your body. Shingles is a rash with shooting pain. It usually shows up on one side of your body.

The rash turns into red, fluid-filled blisters. They usually dry out and crust over within 7 to 10 days.

What Are the Symptoms of Shingles?

The early signs of shingles include:

Call your doctor quickly if you have any of these signs. There’s no cure for shingles. But treatment can lessen the chance of complications, including pain that lasts after the rash is gone, called postherpetic neuralgia.

What Causes Shingles?

When the varicella zoster virus gets into your body, the first problem it causes is chickenpox. You may think of it as a childhood disease, but adults can get it, too.

After chickenpox runs its course, the virus moves into the nerve tissues near your spinal cord and brain, where it stays.

We don’t know why, but sometimes, years later, the virus “wakes up” and travels along nerve fibers to your skin. That’s when it lands its second punch: shingles, also called herpes zoster.

What Are Risk Factors for Shingles?

A weakened immune system might wake up the virus. After you’ve had chickenpox, you’re more likely to get shingles if you:

  • Are 50 or older
  • Are under a lot of stress
  • Have cancer, HIV, or another disease that lowers your body’s defenses
  • Have had a serious physical injury
  • Take long-term steroids or other medicines that can weaken your immune system

But many people who get shingles don’t fit into any of these categories.

Are There Complications of Shingles?

Shingles can have complications that last long after the rash is gone, including:

  • Brain inflammation or facial paralysis if it affects certain nerves
  • Eye problems and vision loss if your rash was in or around your eye
  • Pain that lasts long after the outbreak, called postherpetic neuralgia. It affects up to 1 in 5 people who get shingles.

Is Shingles Contagious?

Yes. You can spread the varicella zoster virus to people who’ve never had chickenpox and haven’t been vaccinated.

You’re contagious until all of the sores have crusted over. Until then, avoid pregnant women who may not have had chickenpox or the vaccine, people with weak immune systems, and newborns.

Shingles Vaccine

The FDA has the Shingrix vaccine and it’s considered more than 90% effective. The CDC recommends two doses of Shingrix for the prevention of shingles and its complications in healthy adults 0 or older as well as those 19 years of age and older who are or will be immunodeficient or immunosuppressed due to disease or therapy. You you get it even if you’ve had shingles before. You should also get it even if you already had the earlier Zostavax vaccine, which was removed from the market in 2020.

Shingles Diagnosis

Your doctor can diagnose shingles by asking about your medical history and your symptoms and by doing a physical exam. They can also test small amounts of material from your blisters.

Treatment for Shingles

Antiviral drugs can help you heal faster and cut your risk of complications. They’re most effective if you take them within 3 days of the start of a rash, so see your doctor as soon as possible. You’ll probably get one of these three medications to fight the virus:

Treatments for shingles pain can include:

Most people who get shingles only have it once. But it can come back, usually in people with weakened immune systems. 

WebMD Medical Reference



American Academy of Dermatology: “Shingles: Overview,” “Shingles: Diagnosis and Treatment.”

Johns Hopkins Medicine: “Shingles: What Is Shingles?”

CDC: “Chickenpox: Complications,” “Shingles Vaccination: What Everyone Should Know,” “Shingles: Transmission,” “Shingles vaccination.”

Mayo Clinic: “Shingles: Definition.”

Cleveland Clinic: “Shingles: What are the Symptoms of Shingles.”

National Institutes of Health.

American Academy of Family Physicians: “Shingles.”

American Academy of Dermatology: “Shingles.”

National Institute of Neurologic Disorders and Stroke: "Shingles. Seek Early Treatment."

Mayo Clinic Health Letter, June 2002.

The New England Journal of Medicine: “A Vaccine to Prevent Herpes Zoster and Postherpetic Neuralgia in Older Adults.”

Drug Safety: “Tolerability of Treatments for Postherpetic Neuralgia.”

WebMD Health News: "Shingles Vaccine to Be Routine at 60."

FDA: "FDA Licenses New Vaccine to Reduce Older Americans' Risk of Shingles."


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