Shingles
Also known as: Herpes Zoster
Painful blistering rash in a band on one side of the body. Caused by reactivation of the chickenpox virus. Vaccine available.
What to look for
Side-by-side comparison
Normal skin
No blistering bands
Shingles
Painful blisters in a band
Shingles (herpes zoster) occurs when the varicella-zoster virus - the same virus that causes chickenpox - reactivates from dormancy in nerve cells, typically decades after the initial chickenpox infection.
The hallmark presentation is a painful, blistering rash that follows a single dermatome (nerve distribution), almost always on just one side of the body. The most common locations are the trunk (wrapping from the spine around to the front) and the face. Pain, tingling, or burning often precedes the rash by 1-5 days.
The rash progresses through stages: red patches → grouped blisters on a red base → pustules → crusting (over 7-10 days). The most significant complication is postherpetic neuralgia (PHN) - persistent nerve pain lasting months to years after the rash heals, occurring in approximately 10-18% of patients and more commonly in older adults.
Prevention is key. The Shingrix vaccine (recombinant, two-dose series) is over 90% effective at preventing shingles and PHN and is recommended for all adults over 50, regardless of whether they remember having chickenpox. Early antiviral treatment (within 72 hours of rash onset) with valacyclovir or famciclovir reduces severity and PHN risk.
Quick self-check
Does this look like shingles? Answer 2 questions.
Is it a painful rash in a band or strip on ONE side of the body?
Did pain or tingling start before the rash appeared?
Risk factors
- Age over 50 (risk increases significantly with age)
- History of chickenpox (required for shingles to occur)
- Weakened immune system
- Stress and illness
- Not having received the Shingrix vaccine
When to see a dermatologist
- ⚠Painful rash in a band on one side of the body - seek treatment within 72 hours
- ⚠Any rash near the eye (ophthalmic shingles - urgent)
- ⚠Severe pain preceding or accompanying a rash
- ⚠Blistering rash in an immunocompromised person
Often confused with
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Full ABCDE check →Frequently asked questions
Can you get shingles more than once?
Yes. Although uncommon, shingles can recur, particularly in immunosuppressed individuals. The Shingrix vaccine reduces recurrence risk even in people who have already had shingles.
Is shingles contagious?
You cannot catch shingles from someone. However, the virus in the blisters can cause chickenpox in someone who has never had chickenpox or been vaccinated. Once the blisters crust over, the person is no longer contagious.
Should I get the Shingrix vaccine?
Yes, if you are over 50. Shingrix is over 90% effective at preventing shingles and postherpetic neuralgia. It is recommended regardless of whether you remember having chickenpox (over 99% of adults over 50 carry the virus).