Shingles (herpes zoster)

Shingles (herpes zoster)

What is shingles?

Shingles is a painful  rash with blisters. It is caused by the  chickenpox virus reappearing on your skin. 

Both chickenpox and shingles are caused by the same virus. This is called varicella zoster virus: 

  • Shingles is the everyday name for the condition herpes zoster. 
  • Chickenpox is the everyday name for the condition varicella zoster.  

Keep up to date with the latest research about shingles (herpes zoster) and all things skin related with our newsletter.

More on this conditionintroduction

What does it look like?

See image in full
introduction

Main body location

All over / widespread

introduction

Can it appear anywhere?

Yes

introduction

Find your nearest clinic

Explore the map

What causes shingles?

After a person has had chickenpox, the virus stays in their body, hiding in the nerves. If the virus becomes active later, it can move along the nerves to the skin they supply. This causes the shingles rash. The rash can appear anywhere on the body, depending on which nerves are affected by the virus. 

Most people have had chickenpox during childhood because it spreads very easily in family and school situations. Like the flu, it is spread through the air.  Chickenpox can be caught by being near an infected person for just a short time . Not everyone notices, however, when they have chickenpox as it can be very mild. 

About 1 in 5 people will develop shingles at some time. Most episodes of shingles occur for no obvious reason, but it is more likely to develop in people who are:  

  • aged 65 and over 
  • experiencing physical or emotional stress, 
  •  living with conditions that weaken the immune system. This could be something common such as the flu, or it could be leukaemia, lymphoma, other cancers or HIV infection, 
  • taking treatments that suppress the immune system, including: 
  • chemotherapy,  
  • drugs taken to prevent organ rejection, and  
  • immunosuppressant drugs or biologics used to treat other conditions such as psoriasis, rheumatoid arthritis or Crohn Disease. 

Is shingles contagious?

Shingles is not caught from someone who has shingles or chickenpox. It develops when your own body’s inactive chickenpox virus re-activates. This could be when your immune defences are weaker than normal. However: 

  • A person who has never had chickenpox can catch chickenpox from someone with shingles.  
  • Shingles is transmitted by direct contact with the fluid from the blister. This could happen from the time when the first blister appears until all the blisters crust over (approximately 7 days). 

Is shingles hereditary?

No.

What does shingles feel and look like?

The first sign of shingles is usually pain in the area where the virus is becoming active. This can happen before any blisters show up. However, not all people affected by shingles will experience pain. For example, some people only experience an itching or mild burning sensation.  

If pain does occur, it usually affects just one part of the body. The pain can range from mild to severe. It could be a constant dull ache, tingling, stabbing or burning sensation, or a patch of extra sensitive skin (this is called allodynia). The rash usually appears a day or two after the start of the pain. Many people also experience fever, headache and/or feel unwell. 

Shingles appears as a group of  raised, inflamed spots within a painful area of skin, which may vary in appearance depending on skin tone. These spots quickly turn into small blisters with fluid inside. Some of the blisters burst, others may fill with blood or pus. The area then slowly dries, forms crusts and scabs. These will fall off over two to three weeks. 

The rash usually appears in a patch of area on just one side of the body, either on the right or on the left: it does not cross to the other side of the body.. Shingles can affect any area, but the most common areas are the torso or one side of the face. Occasionally, it can affect one eye and surrounding skin. 

Click below to view images
Sensitive images

How is shingles diagnosed?

Shingles can usually be diagnosed by looking at the symptoms. It often starts with pain, tingling, or itching, followed by a rash with blisters. The rash usually appears in one area of the body, along a line of nerves – this is called a dermatomal pattern. 

If there is doubt about the diagnosis, your healthcare professional may take a sample from a blister and send it to the lab for examination under a microscope, or a swab can be rubbed on the blisters and tested 

Can shingles be cured?

The shingles rash usually heals on its own within a few weeks. Antiviral pills may help clear the rash sooner and can reduce its unpleasant after-effects. See below for more details on treatment.  

Can shingles cause complications?

Yes, sometimes shingles can cause other problems. If shingles appears on the face, it can affect the eye. This may cause swelling, ulcers and even scarring. If left untreated, it could lead to vision problems or blindness.  

If you have blisters near your eye or on the side of your nose,  this will alert your doctor to this risk. You may need to see an eye specialist (ophthalmologist) for further advice.  

Sometimes, shingles on the face can affect the muscles. This may cause part of the face feel  weak or become difficult to move. This condition is called temporary facial paralysis – it means you might not be able to move one side of your face for a short while. 

The pain caused by shingles may continue long after the rash has healed. This is called post-herpetic neuralgia. This condition needs different treatment; your GP will be able to advise on this. 

In rare cases, shingles can lead to serious complications such as inflammation of the brain (encephalitis), lung infection, or secondary bacterial infections. 

Self help (What can I do?)

  • Contact your healthcare professional as early as possible if you think you have shingles, particularly if the rash is on the face, as antiviral treatment works best if taken early. 
  • Rest will help you to recover more quickly. The decision to work from home or your place of work should be discussed with your employer and/or occupational health provider 
  • While you have the shingles rash, avoid direct skin contact with any high-risk people. These include: 
  • newborn babies 
  • elderly people,  
  • people with reduced immunity, and  
  • those who have not previously had chickenpox (especially pregnant women). 
  • You are no longer contagious once all the blisters have dried and crusted over. 
This information is provided by the British Association of Dermatologists.

Keep up to date with the latest research and all things skin related with our newsletter.
introduction
introduction

Sign up for the latest research

Discover more news and information about

Enter your details below to get updates about this condition that may help you or read more on our website if you need further information right now.

introduction

Before you go…sign up for the latest research

Discover more news and information about our research

Enter your details below to get updates about this condition that may help you or read more on our website if you need further information right now.

lightbox
lightbox

Before you go…sign up for the latest research

Discover more news and information about our research

Enter your details below to get updates about this condition that may help you or read more on our website if you need further information right now.

Sensitive images

This directory contains sensitive content of skin conditions

This icon will show when the sensitive content is present.