What Is shingles?
Shingles (herpes zoster) is a viral infection that causes a painful, blistering rash. It’s caused by the same virus that causes chickenpox—varicella-zoster virus. After you recover from chickenpox, the virus stays dormant in your body and can reactivate decades later as shingles.
Anyone who had chickenpox can get shingles, but it’s more common in older adults and people with weakened immune systems. About 1 in 3 people will develop shingles in their lifetime, with risk increasing significantly after age 50.
Shingles Symptoms
Common symptoms include:
- Pain: Burning, tingling, or stabbing pain often precedes the rash
- Rash: Red rash that develops into fluid-filled blisters
- Location: Usually appears as a stripe or band on one side of the body
- Itching: Intense itching around the rash area
- Flu-like symptoms: Fever, chills, headache, fatigue
The rash typically heals within 2-4 weeks, but complications can persist.
Complications: Postherpetic Neuralgia
The most common complication is postherpetic neuralgia (PHN)—persistent nerve pain that continues after the rash heals. PHN can last months or years, causing:
- Severe burning pain
- Sensitivity to touch
- Itching or numbness
- Difficulty sleeping
Older adults are at highest risk for PHN. By age 60, about 50% of shingles cases lead to PHN.
Shingles Vaccine
The CDC recommends the shingles vaccine (Shingrix) for:
- Adults 50 years and older
- Adults 19+ with weakened immune systems
Shingrix is given as two shots, 2-6 months apart, and is over 90% effective at preventing shingles and PHN.
Treatment Options
If you develop shingles:
- Antiviral medications: Start within 72 hours of rash onset (acyclovir, valacyclovir, famciclovir)
- Pain relievers: OTC or prescription medications
- Cool compresses: Apply to rash for comfort
- Calamine lotion: Helps dry blisters
Prevention Tips
- Get vaccinated (Shingrix is preferred over Zostavax)
- Practice good hygiene
- Avoid close contact with people who have active shingles or chickenpox until rash crusts
- Manage stress and maintain immune health
Frequently Asked Questions
Can I get shingles more than once?
Yes, though rare. Once you’ve had shingles, you can get it again. Vaccination is still recommended after a shingles episode.
Is shingles contagious?
You can’t give someone shingles, but you can spread the virus to someone who hasn’t had chickenpox or the vaccine, causing chickenpox. Avoid touching the rash and cover it until it crusts.
Living with Shingles: Managing Symptoms
If shingles develops despite vaccination, prompt treatment and good symptom management shorten the illness and reduce the risk of long-term nerve pain.
- Start antiviral medication (acyclovir, valacyclovir, or famciclovir) within 72 hours of the rash appearing — it speeds healing and reduces pain.
- Keep the rash clean and dry, and cover it loosely to avoid irritating the blisters; do not scratch, as this can cause infection and scarring.
- Cool compresses and calamine lotion soothe itching; oatmeal baths can also relieve discomfort.
- Over-the-counter pain relievers such as acetaminophen or ibuprofen help with mild to moderate pain — check with your doctor about interactions with your other medications.
- Rest and avoid stress during the acute phase; fatigue prolongs recovery.
- Stay away from newborns, pregnant women who have not had chickenpox, and people with weakened immune systems while the rash is blistering — the virus spreads through direct contact with the rash.
The rash typically crusts over within one to two weeks, but pain can linger. Report any rash near the eye to a doctor immediately — shingles on the face can threaten vision.
Postherpetic Neuralgia: The Long-Term Risk
The most feared complication of shingles is postherpetic neuralgia (PHN) — nerve pain that continues for months or years after the rash heals. Understanding it helps you take prevention seriously.
- PHN affects about 10 to 18 percent of people who get shingles, and the risk rises sharply with age — it is uncommon before 50.
- Pain can be burning, stabbing, or aching, and even light touch on the affected area may be unbearable.
- Age, severe pain during the shingles episode, and pain before the rash appears are the strongest predictors of PHN.
- Early antiviral treatment reduces the risk of PHN, and vaccination is the most powerful prevention — the shingles vaccine cuts the risk of PHN dramatically even in people who later develop shingles.
- If PHN develops, treatments include prescription nerve-pain medications, lidocaine patches, and nerve blocks; a pain specialist can help.
Talk with your pharmacist or provider about the Shingrix vaccine — two doses given two to six months apart provide more than 90 percent protection for adults 50 and older.
Key Takeaways
- Shingles affects 1 in 3 people, risk increases with age
- Shingrix vaccine is recommended for adults 50+
- Early antiviral treatment reduces complication risk
- Postherpetic neuralgia is a serious but preventable complication
