Shingles: Causes, Symptoms, and Effective Treatments

Shingles is a painful, contagious rash caused by the varicella-zoster virus. Learn about shingles causes, symptoms like blisters and nerve pain, and treatment options.

Shingles is a painful rash that spreads easily. It’s caused by the same virus that brings on chickenpox.1 Once you’ve had chickenpox, the virus stays in your body. It can come back as shingles later on.2

Shingles usually shows up as a rash on one side of your body. It comes with blisters that have fluid in them. This rash can stay for 2-6 weeks. After it’s gone, some people feel nerve pain that lasts for months or even years. Though there’s no shingles cure, you can use antiviral medications and pain relief methods. These can make you feel better and lower the chance of more problems.

Key Takeaways

  • Shingles is a painful, contagious rash caused by the varicella-zoster virus, the same virus that causes chickenpox.
  • The Shingrix vaccine is over 90% effective in preventing shingles and postherpetic neuralgia, and its effectiveness remains high for at least four years.3
  • Shingles typically affects people over the age of 50, with a higher occurrence rate in individuals over the age of 60.2
  • Prompt treatment with antiviral medications and pain management strategies can help alleviate symptoms and reduce the risk of complications.
  • Maintaining a healthy lifestyle and getting the recommended shingles vaccines can help prevent and manage this condition.

What is Shingles?

Shingles comes from the varicella-zoster virus. It’s the same virus as chickenpox. Once you’ve had chickenpox, the virus doesn’t go away. Instead, it hides near the spinal cord and brain.1

We don’t fully know why, but it can become active again, often later in life. Then, it travels along nerves to the skin, bringing the shingles rash and symptoms.1 Shingles is also known as “herpes zoster.”

Overview of the Varicella-Zoster Virus

This virus belongs to the herpes family. It first causes chickenpox. After that, it stays in the body, near the spinal cord and brain.1 If it reactivates, shingles appears.

How Shingles Develops

The virus wakes up and goes from the nerves to the skin, causing the shingles rash and symptoms.1 It can wake up for many reasons. A weak immune system, stress, or getting older are common triggers.2 This waking up is what causes shingles, also called “herpes zoster.”

Shingles Symptoms

At first, shingles might feel like a slight tingle or burn on your skin. Then, you might see a painful rash start to form, with fluid-filled blisters. This rash shows up on just one side of your body. The way it looks can change based on your skin color. For dark skin, it may seem pink, grayish, or even purple. But for lighter skin, it usually looks red.1

Shingles Rash Appearance

After a while, the blisters will begin to dry up and form crusts. But, the pain from the nerve pain can stick around for weeks or even months. This lasting pain is called postherpetic neuralgia.4 Shingles can bring other issues too, like problems with your eyes, paralysis in your face, and sometimes even trouble in your lungs or brain.1

Nerve Pain and Other Complications

Postherpetic neuralgia (PHN) keeps your nerve pain around after the rash goes away. It affects about 10% to 18% of shingles patients.4 The older you are, the higher your chances of getting PHN are. Older adults can wind up with more intense and longer-lasting pain than younger folks.4 Shingles on your face might cause you to lose some vision. And the rash can also get infected. In really rare cases, shingles might make you sick enough to get pneumonia, have trouble hearing, get encephalitis, or even die.4

shingles symptoms

Causes of Shingles

Shingles comes from the varicella-zoster virus. It’s the same virus that makes you have chickenpox.2 Once you’ve had chickenpox, the virus stays asleep in your body. It can act up again later in life, leading to shingles.2

Getting older than 50 or having a weak immune system due to diseases such as cancer or HIV makes it more likely to get shingles.2 So does having a lot of stress. If you weren’t vaccinated against chickenpox as a kid or adult, your risk is higher too.2

Risk Factors for Shingles

Being 50 or older puts you at risk for shingles.2 Also, if you’re very stressed or have certain illnesses, the chances go up.1 Certain medications and not getting the chickenpox shot also play a role.1 As does having a weak immune system or getting older.2

Risk Factors for ShinglesDetails

Shingles usually hits folks over 50. It gets more serious for those over 60.2

About 10% of ex-chickenpox folks get shingles later.1

Weakened Immune System

Having diseases like cancer or HIV heightens the shingles risk. So does taking certain meds.2

In people with weakened immune systems, the Shingrix vaccine works between 61% to 91% of the time.1


Lots of stress can make shingles more likely.1

Lack of Vaccination

If you weren’t vaccinated against chickenpox, shingles is more probable.2

Most people in the U.S. got chickenpox before regular vaccinations started.2

Diagnosing Shingles

Health care providers mainly look at the skin for shingles diagnosis. They search for a painful rash with blisters on just one side of the body.5 They do this because shingles’ rash and pain are quite unique. Little to no extra tests are needed to confirm shingles.5 Still, some other skin problems can mimic shingles. These include contact dermatitis, Candida infection, and more.5

Clinical Examination

Doctors gather details on the symptoms and check the skin closely. This helps them figure out if shingles is the real issue.5 Shingles, or herpes zoster, usually shows up on just one body or face half.5 Patients often feel a mix of stinging, burning, and itchy feelings in the affected area.5

Laboratory Tests

If the signs aren’t clear, extra tests might be needed. This is more common for certain groups or when symptoms don’t fit the usual picture.5 There are tests to look for either the virus’s proteins in the blood or the virus itself in skin samples.5 The time for test results is between 1 to 3 days. Sometimes, more testing is necessary for a clear shingles diagnosis.5

diagnosing shingles

Treatment Options for Shingles

There’s no cure for shingles, but taking prescription antiviral drugs early can make a big difference. These drugs include acyclovir, famciclovir, and valacyclovir. They target the virus, slowing down its growth.6

Antiviral Medications

Prescription antiviral drugs are vital for shingles treatment. They cut short the illness and reduce complications risk.6 You should take them for 7 to 10 days, starting within 72 hours of noticing the rash for the best results.6

Pain Management Strategies

Alongside antiviral drugs, your doctor might suggest ways to manage pain. This can include topical creams, oral medicines, and even numbing agents.6 Corticosteroid and anesthetic injections might help some patients as well.6

Using cool baths or compresses can ease the shingles rash. It’s also crucial to reduce stress since it can make shingles worse.6

For most shingles cases, a mix of antiviral meds and pain management is enough. Early treatment and working closely with your doctor are critical steps.6

Shingles in Specific Populations

Shingles is more challenging for some groups. This includes pregnant women and those with weak immune systems. They may need extra care when dealing with this disease.

Shingles During Pregnancy

Getting shingles while pregnant is rare but serious.7 Pregnant women must get medical help fast if they think they have shingles. Antiviral drugs can lower the risk of severe problems. There’s not a lot of research on shingles in pregnancy, but it likely doesn’t raise the chance of losing the baby or birth defects.

Shingles in Immunocompromised Individuals

If you have a weak immune system due to cancer, HIV, or certain medicines, shingles is a bigger risk.8 The symptoms might be more severe. In such cases, special care is taken, like using the Shingrix vaccine. This vaccine isn’t live, making it safer for these individuals. Getting vaccinated is really important. Vaccination with Shingrix is recommended over Zostavax, which isn’t suggested for people with weak immune systems.

Complications of Shingles

Shingles can lead to many problems, with postherpetic neuralgia (PHN) being the most common. PHN is a type of nerve pain. It often stays after the shingles rash is gone.4

Many people who have had shingles, around 10% to 18%, get PHN. This risk is higher as you get older. Younger people rarely get PHN.4

Other Potential Complications

Shingles can cause eye issues, brain swelling, and more. For example, shingles on the face may cause eye problems.9

The risk of these issues goes up as you get older. But, early treatment helps lower the risk.9

Other complications include PHN, problems like loss of vision, facial paralysis, or even skin infections. People with weak immune systems are at a higher risk.2

Most deaths from shingles are in the elderly or those with weak immune systems.9

The shingles rash normally lasts 2-4 weeks, with blisters clearing in 7-10 days. But nerve pain can last a lot longer, even forever.9

It can lead to rare issues like pneumonia and more. These can sometimes lead to needing hospital care.9

Is Shingles Contagious?

Yes, shingles is contagious. It can be spread to those who have not had chickenpox or the vaccine. The virus from shingles spreads through touching the blisters’ fluid or through the air when infected people cough or sneeze.10

A shingles patient can pass on the virus until their blisters dry and crust over, which usually takes 2-4 weeks.10 It is important for shingles cases to not come into contact with those sensitive groups. Pregnant women, newborns, and those with weak immune systems are more likely to get chickenpox from the virus.10

Shingles is not as easily passed as chickenpox.10 The chance of spreading the virus is low if the rash is hidden. It’s most contagious before the rash shows blisters or after it has crusted.10 Shingles itself does not spread, yet its fluid can give someone chickenpox.10

If you have shingles, avoid spreading the virus by keeping the rash covered. Also, don’t scratch it and wash your hands often.10 Knowing how shingles spreads and taking care can stop the virus from reaching others.

Shingles Vaccines

Two vaccines are available in the United States for shingles and its effects: Shingrix and Zostavax. Since 2017, the Shingrix vaccine has been highly recommended. It is chosen by the Advisory Committee on Immunization Practices (ACIP).11

Shingrix Vaccine

Shingrix is a two-dose series that is very effective. Studies show it works over 90% of the time in stopping shingles and its pain in healthy adults over 50.11 In those with weak immune systems, Shingrix is still pretty good, with 68%-91% success based on their health.11 It was 97% effective in adults 50 to 69 who were healthy. For those over 70, it reached 91% effectiveness.11

Shingrix also does well in preventing the pain from shingles, known as postherpetic neuralgia (PHN). For those over 50, it reached 91% effectiveness against PHN. Among those over 70, it was still strong at 89% effective.11

Zostavax Vaccine

The Zostavax vaccine is older and given in just one shot. It’s not as effective as Shingrix, working about 51% of the time. Because Shingrix is more powerful, the ACIP prefers using it to prevent shingles.11

Prevention Strategies

Shingrix is a strong vaccine against shingles and its complications. It lowers the risk of PHN effectively12. Another helpful step is getting the chickenpox vaccine. It’s crucial, especially if you’ve never had chickenpox before. This is because the virus that causes shingles is related to the one causing chickenpox. If you’ve had chickenpox, your shingles risk goes down by about 98%12.

Vaccination Recommendations

The CDC suggests the Shingrix vaccine for healthy adults aged 50+ and certain others. For maximum effect, take two doses. The second shot happens between 2 to 6 months after the first12. This vaccination is proven to work well in preventing shingles and its effects, even for older people12.

Lifestyle and Immune System Support

Leading a healthy life aids your immune system, which can guard against shingles. It’s important to reduce stress, sleep well, eat right, and keep moving. These habits can make your immune system stronger and possibly decrease the chance of getting shingles again.13.

Statistics show us that about 55% to 60% of older folks who received a special chickenpox vaccine had stronger immunity afterwards. Additionally, 85% to 90% of other healthy elderly individuals saw their immune responses improve after getting another kind of chickenpox vaccine13.

Self-Care for Shingles

There is no cure for shingles, but you can relieve its symptoms at home.14 Taking cool baths or using cold compresses helps the itch and pain.14 Avoid stress because it can make symptoms worse.14 You might need prescription medication for severe pain.14

Home Remedies for Symptom Relief

Along with medical treatments, home remedies can ease shingles discomfort.14 A colloidal oatmeal bath or antihistamine cream can soothe the rash.14 Clean the rash area well and wash clothes in hot water to stop the virus spread.14

Shingles can spread to those without chickenpox or pregnant women.14 Rest and use pain relievers like ibuprofen are recommended, but use Tylenol carefully if you have liver issues.14 If pain is severe, your doctor might prescribe stronger painkillers. Remember to follow the instructions given.14

Contact your doctor if you see a rash like shingles, have ongoing pain, or still have symptoms after weeks.14 Quick and proper shingles treatment can lessen how long and how bad it is.1415

When to See a Doctor

If you think you have shingles, see a doctor promptly.16 Getting early treatment is crucial. It can quicken your recovery and lower the chance of complications.17

The advice is to get to a dermatologist within three days of noticing shingles symptoms.17 If a rash shows up on your face, you should seek help right away. This area is risky, especially for your eyes.17

Your healthcare provider will diagnose you and offer the right treatment. They’ll also guide you on easing symptoms and preventing the virus’s spread.

16 Doctors have medicines that can lower shingles’ long-term risks.17 Taking these medicines early helps control the virus better. It makes the illness shorter and less severe.16

Start your treatment within 72 hours of the rash popping up for the best chance at beating shingles effectively.16

16 Over a million people tackle shingles yearly.16 A third will face it at some stage.16 It’s common among those over 50, especially if their immune systems are weak.17

The top complication from shingles is PHN. This issue leads to nerve pain that can stick around for months or even years.17

Shingles Recurrence

Most people only get shingles once in their life. But, some may have it again. Around 6-8% might have it again within a year. The older you are, the more likely it becomes.18

Certain factors raise the chances of getting shingles again. These include a weak immune system and not getting the shingles vaccine.19

About 5% of those who previously had shingles might get it again within seven years. This figure is the same as the chance of getting shingles for the first time.1 If your immune system is weak, the chance of recurrence can go up to 18%. This makes repeated shingles more common in people with immunity issues.18

Elderly individuals aged 50 and above, especially women, are at higher risk. This is also true for people with diseases like leukemia or HIV.19

If you’ve had shingles, talking to your doctor is crucial. They can advise on how to lower the risk of getting shingles again. For example, the Shingrix vaccine is great at preventing shingles. It’s over 90% effective.19

This vaccine is recommended for those 50 and over. It’s also good for people who have a weak immune system. So, it helps decrease the risk of shingles returning and complications like postherpetic neuralgia.18

Doctors often prescribe antiviral medicines for shingles symptoms.19 For itching, things like oatmeal baths or applying calamine lotion can help. If you have nerve pain after shingles, treatments include gabapentin or antidepressants.19 Sometimes, steroids might be used for the pain.19


Shingles is a painful condition caused by the varicella-zoster virus, which also leads to chickenpox.10 Early treatment with antiviral drugs and managing symptoms well helps lessen the illness’s impact. Getting vaccinated, living healthily, and seeking quick medical help if you suspect shingles are vital for prevention. By knowing about shingles’ causes, symptoms, and treatments, people can safeguard their health against this viral infection.

Age, immune health, and stress are major in shingles onset and recurrence.1020 It’s more common in those over 50 and with weak immune systems, including HIV and some cancers. Moreover, research shows a link between high stress and shingles risk. This stress can also lead to complications like postherpetic neuralgia (PHN).20

Thankfully, there are ways to lessen the shingles risk. The Shingrix vaccine is highly recommended for adults over 50 by the CDC.10 By working on a strong immune system and lowering stress, the risk of shingles can be lowered. This approach helps in avoiding the severe impacts this condition can have later on.20


What is shingles?

Shingles is a painful rash that spreads easily. It’s caused by the same virus as chickenpox. This virus stays in your body after chickenpox and can come back as shingles.

What are the symptoms of shingles?

At first, you might feel a tingling or burning on your skin. Then, a rash with painful blisters shows up. This rash usually only appears on one side of your body.

What causes shingles?

The varicella-zoster virus is behind shingles, just like chickenpox. After you get chickenpox, the virus can activate again. This happens more often as people get older, their immune systems weaken, or from stress.

How is shingles diagnosed?

Doctors can usually tell it’s shingles by the rash and blisters. They might take a fluid sample from the blisters to be sure. This sample is tested for the varicella-zoster virus.

How is shingles treated?

There’s no cure for shingles, but antiviral medicines can make it better. These medicines can make the symptoms go away faster. Doctors might also give you things to ease the pain.

Is shingles contagious?

Yes, shingles can spread to those who haven’t had chickenpox or the vaccine. It spreads through the fluid in the blisters or the air we breathe around someone with shingles.

What vaccines are available for shingles?

Two vaccines – Shingrix and Zostavax – can help prevent shingles. The Shingrix vaccine is the one experts recommend more.

When should I see a doctor for shingles?

If you think you have shingles, see a doctor right away. Early treatment helps a lot and can lower the chances of complications.

Can you get shingles more than once?

Although most get shingles just once, it can happen again. The chance of it coming back goes up with age and some health issues.

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