Common Shingles Signs and Symptoms

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Elderly woman looking at thermometer while lying on bed at home

Elderly woman looking at thermometer while lying on bed at home

Photo: Getty Images

Shingles is a common viral infection that most noticeably causes a painful rash on the skin. It develops when the varicella zoster virus (the same virus that causes chickenpox) reactivates in the body.

Anyone who has had chickenpox can later develop shingles. Usually, the condition affects older adults. This is likely because the immune system, as it weakens as you age, is no longer able to keep the virus dormant, according to the American Academy of Dermatology (AAD).¹

The telltale sign of shingles is a rash that appears as a patchy belt of fluid-filled blisters, almost always along one side of the body or face. There are symptoms of illness even before this rash appears, though.

Read on to find out more about the signs and symptoms that you or a loved one can experience during a shingles illness.

Common Shingles Signs and Symptoms

Most cases of shingles last three to five weeks, according to the National Institute on Aging (NIA).² Over the course of the illness, the signs and symptoms can change.

Painful Rash

The signature sign of shingles is the rash. Here's what you'll likely notice with the shingles rash:

  • It develops along just one side of the body or face.

    Unlike chickenpox bumps that are scattered all over the body, the shingles rash will usually appear like a band in a localized area on either the right or left side of the body.² The virus affects the nervous system underneath the skin, typically reactivating in a single nerve. Any portion of skin that is connected to that nerve pathway can produce the rash, according to MedlinePlus.³

    A common rash location is the torso.² But experts at Boston Children’s Hospital point out that the shingles rash also routinely shows up on the buttocks, arms, legs, and face.⁴ In rare cases, and generally among people with weakened immune systems, the rash may be more widespread, notes the Centers for Disease Control and Prevention (CDC).⁵

Example image of a herpes zoster or shingles rash

Example image of a herpes zoster or shingles rash

Courtesy of DermNet NZ
  • It appears as a cluster of bumps that turn into small blisters.

    The rash will start as bumps on the skin, according to the American Academy of Family Physicians.⁶ On lighter skin, the rash is red, but the UK’s National Health Service points out that the color can appear differently on darker skin.⁷ While a red rash might indeed look red on darker skin, it might also look purple, darker or lighter than the skin’s typical color, or no different from the skin’s typical color, according to Temple Health.⁸

    Within a couple days, the bumps develop into fluid-filled blisters called vesicles.² According to the National Institute of Neurological Disorders and Stroke (NINDS), the vesicles may merge to cover a larger area, or appear as distinct separate clusters.⁹

  • It will eventually ooze and scab over as it heals.

    After the blistery rash develops, the vesicles will burst and ooze before they start to dry out and crust over. This scabbing process can take up to 10 days. The scabs usually fully clear up within two to four weeks.⁵

Example image of a person with herpes zoster or shingles rash on their back

Example image of a person with herpes zoster or shingles rash on their back

Courtesy of DermNet NZ

Expect to feel discomfort, such as pain, itching, or tingling, with the rash, per the CDC.¹⁰ The pain may outlast the rash, usually stopping after a month or two, according to the AAD.¹¹

Skin Sensitivity

About one to five days before a rash even develops, you might experience skin sensitivity or discomfort.² The sensations are often described as feeling like:

  • Shooting pain
  • Itching
  • Tingling
  • Burning
  • Numbness

Also notice where the skin sensitivity occurs. Discomfort will be felt in the area that the shingles rash will soon appear, Johns Hopkins Medicine notes.¹²

The discomfort can be mild, intense, or somewhere in between.²

Flu-Like Symptoms

Even before the rash shows, you might develop symptoms that are typical of other viral infections like the flu.⁵ These symptoms include:

  • Fever⁵
  • Chills⁵
  • Headache⁵
  • Upset stomach⁵
  • Generally feeling unwell¹⁰
  • Sensitivity to light¹⁰

These symptoms will typically go away as the rash itself clears, per the AAD.¹³

When to See a Health Care Provider

If you think you might have shingles, it’s important to see a health care provider. Getting your rash checked and receiving treatment within three days can help you feel better faster and avoid any potential complications, according to the AAD.¹⁴

Some people may be at an increased risk for developing shingles-related complications, so seeing a health care provider and receiving treatment is especially important if:

  • The rash is near your eye. Eye damage and blindness are possible if there are blisters near or in the eye.²
  • You have a weakened immune system due to a medical condition or medication. People who are immunocompromised are more likely to be hospitalized for shingles, according to the CDC.¹⁵
  • You are an older adult. Older adults are more likely to be hospitalized for shingles.¹⁵ They’re also more likely to experience shingles complications like postherpetic neuralgia, a condition that causes intense nerve pain long after the shingles rash has cleared, per the CDC.¹⁶

During the appointment, the health care provider will ask if you've had chickenpox in the past, look at your rash, and make note of your symptoms. Usually, the provider will be able to diagnose shingles just by your medical history and the rash's appearance.³

Your provider might also confirm infection with a laboratory test. They will either swab fluid from the blister or draw your blood and send the sample to the lab for testing, MedlinePlus reports.¹⁷

Recap

Shingles is a viral infection that develops when the chickenpox virus becomes active again in the body. Shingles is usually associated with its main feature: a distinct painful and blistery rash. Other common signs of a shingles infection include typical viral symptoms, like fatigue, fever, chills, and headache.

Getting proper treatment as quickly as possible can help you better manage the illness, so consider contacting your health care provider if you think you may have shingles.

Sources:

  1. American Academy of Dermatology. Shingles: Who Gets and Causes.
  2. National Institute on Aging. Shingles.
  3. MedlinePlus. Shingles.
  4. Boston Children’s Hospital. Herpes Zoster (Shingles).
  5. Centers for Disease Control and Prevention. Shingles (Herpes Zoster): Signs & Symptoms.
  6. American Academy of Family Physicians. Shingles.
  7. National Health Service. Shingles.
  8. Temple Health. How Common Skin Conditions Affect People of Color.
  9. National Institute of Neurological Disorders and Stroke. Shingles: Hope Through Research.
  10. Centers for Disease Control and Prevention. Shingles (Herpes Zoster): Clinical Overview.
  11. American Academy of Dermatology. Shingles: Diagnosis and Treatment.
  12. Johns Hopkins Medicine. Shingles.
  13. American Academy of Dermatology. Signs and Symptoms.
  14. American Academy of Dermatology. Shingles: Diagnosis and Treatment.
  15. Centers for Disease Control and Prevention. Shingles (Herpes Zoster): Burden and Trends.
  16. Centers for Disease Control and Prevention. Shingles (Herpes Zoster): Complications of Shingles.
  17. MedlinePlus. Chickenpox and Shingles Tests.