Shingles
Also known as: herpes zoster, zoster
Shingles is a painful rash caused by the chickenpox virus becoming active again after lying dormant in the body.
When to seek care
NHS inform says to call NHS 111 or contact the GP practice urgently if shingles is suspected and the person is pregnant, is breastfeeding with the rash on the breasts, has a rash on the eye or nose, has changes to vision, has a severely weakened immune system, or is aged 17 or under. NHS England pharmacy guidance refers shingles near the eye with visual symptoms urgently to A&E. For other suspected cases, NHS England advises getting advice from a pharmacist or NHS 111 as soon as possible, because antivirals work best within 3 days. In an emergency, such as collapse, call 999.
Overview
Shingles is caused by the chickenpox virus becoming active again after lying dormant in the body. The NHS describes a tingling or painful feeling in an area of skin as an early sign, usually followed a few days later by a rash on one side of the body. The NHS says the rash can take up to 4 weeks to heal, and the skin can stay painful for some weeks afterwards.
Causes
- Reactivation of the varicella-zoster virus, which causes chickenpox and stays dormant in the body afterwards
Risk factors
- Older age: NHS inform says shingles is more common as people get older, especially over 50
- A weakened immune system or medicines that affect immunity, which NHS inform and the CDC link to a higher risk
Symptoms
What a clinician may find
- A rash on one side of the body, with itchy blisters that later dry and scab
- In some people the rash is in and around the eye, which can affect sight
Complications
- Long-lasting nerve pain after the rash (postherpetic neuralgia)
- Infection of the rash and scarring
- Eye problems that can lead to sight loss
- Hearing problems and brain inflammation (encephalitis), which the CDC describes as very rare
- Ramsay Hunt syndrome, which occurs when shingles affects the facial nerve
Diagnosis
A clinician can usually diagnose shingles from the rash itself. The CDC notes it can be harder to recognise in children and younger adults when the rash is mild.
Treatment
The NHS says there is no cure for shingles, but symptoms can be eased. Antiviral tablets may be offered for a weakened immune system, moderate or severe pain or rash, or a rash spreading beyond the chest, tummy and back, and the NHS says they work best when started within 3 days of the rash appearing. NHS inform also describes painkillers such as paracetamol for pain.
Prevention
The CDC recommends Shingrix vaccination to prevent shingles and its complications. UKHSA says the UK programme uses Shingrix, a two-dose vaccine, because the older Zostavax vaccine is no longer used. Eligibility depends on age and immune status and has changed over time, so the NHS and UKHSA pages give the current rules.
Key facts
| Fact | Detail |
|---|---|
| Also called | Herpes zoster |
| Cause | Reactivation of the chickenpox virus (varicella-zoster virus) |
| Typical rash | Usually on one side of the body, with itchy blisters that later scab |
| Healing time | The NHS says up to 4 weeks for the rash, with pain sometimes lasting longer |
| Spread | Shingles is not passed on, but chickenpox can be caught from contact with blister fluid |
| Vaccine | Shingrix, a two-dose vaccine, is used in the UK programme |
What are the symptoms of shingles and how is it diagnosed?
The NHS describes the first signs as a tingling or painful feeling in an area of skin, sometimes with a headache or feeling generally unwell. A rash usually follows a few days later, typically on one side of the body. The rash turns into itchy blisters that ooze fluid, and scabs then form where the blisters were, which may leave slight scarring. Pain can range from mild to severe. The CDC lists fever, headaches, chills and upset stomach as other symptoms that can occur.
NHS 111 Wales says the rash can sit in and around the eye and can affect sight or hearing. A clinician can usually diagnose shingles from the rash itself. The CDC notes that shingles can be harder to diagnose in children and younger adults, especially when the illness is mild.
What causes shingles, and can it spread to other people?
Shingles is caused by varicella-zoster virus, the virus behind chickenpox. After chickenpox, the virus stays dormant in the body and can reactivate later. NHS inform says shingles can affect people of all ages but is more common as people get older, especially over 50, and that people with a reduced ability to fight infections, or who take medicines that affect immunity, are also at higher risk. The CDC also names older age and weakened immune systems as risk factors.
The NHS says shingles itself cannot be passed from person to person, but someone who has never had chickenpox or the chickenpox vaccine could catch chickenpox from a person with shingles. The CDC says this happens through direct contact with fluid from the blisters or by breathing in virus particles from them. NHS advice is to stay off work or school while the rash is oozing and cannot be covered. Scottish NHS guidance lists pregnant women who have not had chickenpox, people with weakened immune systems and babies under one month old as people to avoid direct contact with.
How is shingles treated, and how long does it take to heal?
The NHS says there is no cure for shingles, but symptoms can be eased. Antiviral tablets may be offered if a person has a weakened immune system, moderate or severe pain or rash, or a rash affecting areas beyond the chest, tummy and back. The NHS says they work best when started within 3 days of the rash appearing. The CDC says antivirals can shorten the length and severity of the illness. NHS inform says early treatment may help reduce the severity of the condition and the risk of complications.
For self-care, NHS inform describes taking paracetamol to ease pain, keeping the rash clean and dry, wearing loose-fitting clothing, using a cool damp cloth and trying calamine lotion for itching. The NHS says the rash can take up to 4 weeks to heal and that skin can stay painful for some weeks after the rash has gone, but this usually improves over time. NICE CKS says specialist advice or referral is considered for people who are immunosuppressed, with clinical judgement guiding management.
What complications can shingles cause, and when is urgent help needed?
The most common complication is postherpetic neuralgia, pain that continues after the rash has cleared. MedlinePlus says that for some people the pain lasts for years and can interfere with daily life. The CDC says the risk rises with age. NHS inform also lists infection of the rash, eye problems that can lead to sight loss, and scarring. Ramsay Hunt syndrome occurs when shingles affects the facial nerve and can cause weakness on one side of the face and sometimes hearing problems. The CDC describes pneumonia, hearing problems and brain inflammation as very rare.
NHS inform says to call NHS 111 or contact the GP practice urgently if shingles is suspected and the person is pregnant, is breastfeeding with the rash on the breasts, has a rash on the eye or nose, has changes to vision, has a severely weakened immune system, or is aged 17 or under. NHS England pharmacy guidance refers shingles near the eye with visual symptoms urgently to A&E. For other suspected cases, NHS England advises getting advice from a pharmacist or NHS 111 as soon as possible. In an emergency, such as collapse, call 999.
Can a vaccine prevent shingles?
The CDC recommends Shingrix, a recombinant zoster vaccine given as 2 doses, for adults aged 50 and older, and for adults aged 19 and older with weakened immune systems. That is US advice. The CDC says the vaccine is over 90% effective at preventing shingles and postherpetic neuralgia in adults aged 50 and older with healthy immune systems.
UKHSA says the UK programme uses Shingrix, a two-dose vaccine, because the older live vaccine Zostavax is no longer used. UKHSA describes an age-based programme for adults with healthy immune systems that is being phased in over several years. It says that from 1 September 2025 eligibility extended to everyone who is severely immunosuppressed and aged 18 and over. Because eligibility has changed over time, the NHS and UKHSA pages give the current rules.
Frequently asked questions
Can shingles be cured?
The NHS says there is no cure for shingles, but symptoms can be eased. Antiviral tablets may be offered in some cases and work best when started within 3 days of the rash appearing. NHS inform says early treatment may help reduce the severity of the condition and the risk of complications. The NHS says the rash can take up to 4 weeks to heal.
Is shingles contagious?
The NHS says shingles itself cannot be passed on. However, someone who has never had chickenpox or the chickenpox vaccine could catch chickenpox from a person with shingles. The CDC says exposure is through direct contact with fluid from the blisters. NHS advice is to stay off work or school while the rash is oozing and cannot be covered.
Who is more likely to get shingles?
NHS inform says shingles can affect people of all ages but is more common as people get older, especially over 50. People with a reduced ability to fight infections, or who take medicines that affect immunity, are also at higher risk. The CDC says anyone who has had chickenpox can develop shingles.
What is postherpetic neuralgia?
The CDC describes postherpetic neuralgia as long-term nerve pain that can persist for months or years after the rash clears, and as the most common complication of shingles. The NHS says skin can stay painful for some weeks after the rash has gone, but this usually improves over time. CKS directs readers to its post-herpetic neuralgia topic if pain continues.
What does the NHS say about shingles in pregnancy?
The NHS says that if a person is pregnant and gets shingles, it is mostly mild and there is usually no risk to the person or the baby. NHS inform still lists pregnancy as a reason to call NHS 111 or contact the GP practice urgently when shingles is suspected. Local NHS guidance advises a pregnant woman who has never had chickenpox and is exposed to chickenpox or shingles to contact her midwife or GP promptly.
Connected pages in detail
What each linked page on Anatomy Nexus covers, in a line, for Shingles.
Symptoms
- Rash Any change in the colour or texture of the skin.
- Tingling (pins and needles) Prickling, buzzing or crawling sensations without an outside cause, produced when sensory nerves fire abnormally.
- Fever A body temperature of 38 °C (100.4 °F) or more, produced when the hypothalamus raises its set point in response to inflammatory signals.