Shingles
A painful, usually one-sided rash caused by reactivation of varicella-zoster virus years after chickenpox infection.
What causes Shingles?
Shingles occurs when latent varicella-zoster virus reactivates in a sensory nerve. Risk rises with age and immune suppression; shingles is not acquired from another person’s shingles.
Symptoms and what to notice
Burning, tingling, itching, or pain followed by grouped blisters in a band on one side of the body or face. Fever, headache, chills, or upset stomach can occur.
How long can it last?
New blisters usually form over several days and scab in 7 to 10 days; the rash generally clears within 2 to 4 weeks. Nerve pain can continue for months or years.
How serious is Shingles?
Postherpetic neuralgia is the most common complication. Eye involvement can threaten vision; facial weakness, hearing problems, bacterial infection, pneumonia, encephalitis, or disseminated disease may occur.
Treatment and management
Oral antivirals such as acyclovir, valacyclovir, or famciclovir work best when started early, ideally within 72 hours of rash onset. Pain treatment, skin care, and urgent eye evaluation may also be needed.
Vaccine: who and when?
Shingrix is the only U.S. shingles vaccine. CDC recommends two doses 2-6 months apart for adults 50 or older and immunocompromised adults 19 or older; an accelerated 1-2 month interval may be used for selected immunocompromised patients. Zostavax is no longer available in the United States.
Cost note: Patient cost varies by product, provider, insurance, location, and eligibility. Many recommended vaccines are covered in network without cost sharing, and qualifying children may use the Vaccines for Children program.
Trusted source
Patient cost varies by insurance, provider, location, and eligibility. Coverage and public-health access differ, so listed prices are examples rather than guaranteed patient prices. This page is for general education and does not replace individualized medical advice, diagnosis, vaccination assessment, or treatment.
Shingles: Symptoms, Causes, Treatment, Prevention, and Vaccine Information
After chickenpox, varicella-zoster virus remains dormant in nerve tissue. Reactivation causes shingles, a painful dermatomal eruption. About one in three people in the United States develops shingles during life, with risk and complications rising after age 50 and during immune suppression. Shingrix provides strong, non-live protection.
Important: This page is for general education. It does not replace diagnosis, treatment, vaccination advice, or emergency care from a qualified healthcare professional.
Quick Facts
| Topic | Current information |
|---|---|
| Cause | Shingles occurs when latent varicella-zoster virus reactivates in a sensory nerve. Risk rises with age and immune suppression; shingles is not acquired from another person’s shingles. |
| Main symptoms | Burning, tingling, itching, or pain followed by grouped blisters in a band on one side of the body or face. Fever, headache, chills, or upset stomach can occur. |
| Typical course | New blisters usually form over several days and scab in 7 to 10 days; the rash generally clears within 2 to 4 weeks. Nerve pain can continue for months or years. |
| Treatment | Oral antivirals such as acyclovir, valacyclovir, or famciclovir work best when started early, ideally within 72 hours of rash onset. Pain treatment, skin care, and urgent eye evaluation may also be needed. |
| Vaccine status | Shingrix is the only U.S. shingles vaccine. CDC recommends two doses 2-6 months apart for adults 50 or older and immunocompromised adults 19 or older; an accelerated 1-2 month interval may be used for selected immunocompromised patients. Zostavax is no longer available in the United States. |
History and Public-Health Importance
The relationship between chickenpox and shingles was established through clinical and virologic study. Antivirals improved acute treatment, while vaccines shifted prevention. The older live vaccine Zostavax is no longer used in the United States; the recombinant adjuvanted Shingrix vaccine provides more durable protection and is suitable for many immunocompromised adults.
What Causes Shingles?
Shingles occurs when latent varicella-zoster virus reactivates in a sensory nerve. Risk rises with age and immune suppression; shingles is not acquired from another person’s shingles.
A person with active shingles can transmit varicella-zoster virus through blister fluid and cause chickenpox—not shingles—in someone without immunity. Localized rash should be covered and direct contact avoided until lesions crust. Airborne spread is a concern with disseminated disease and in certain healthcare settings.
Symptoms and Typical Course
Burning, tingling, itching, or pain followed by grouped blisters in a band on one side of the body or face. Fever, headache, chills, or upset stomach can occur.
Pain or tingling may precede rash by days. Blisters usually follow one or two adjacent dermatomes and do not cross the body’s midline. Shingles without rash is difficult to diagnose. Pain may persist after skin healing, especially in older adults.
Complications and Who Is at Higher Risk
Postherpetic neuralgia is the most common complication. Eye involvement can threaten vision; facial weakness, hearing problems, bacterial infection, pneumonia, encephalitis, or disseminated disease may occur.
Postherpetic neuralgia can be severe and disabling. Ophthalmic shingles may damage the cornea or other eye structures. Ramsay Hunt syndrome can cause facial paralysis and hearing problems. Disseminated infection, encephalitis, pneumonia, stroke, and secondary bacterial infection are uncommon but serious.
How It Is Diagnosed
Typical unilateral vesicles and nerve pain often establish the diagnosis. PCR from a lesion is the preferred laboratory confirmation when presentation is atypical, disseminated, or occurs after vaccination. Herpes simplex, contact dermatitis, insect bites, and other rashes can resemble shingles.
Treatment and Recovery
Oral antivirals such as acyclovir, valacyclovir, or famciclovir work best when started early, ideally within 72 hours of rash onset. Pain treatment, skin care, and urgent eye evaluation may also be needed.
Valacyclovir, famciclovir, or acyclovir shortens viral replication and may reduce acute severity when started promptly. Treatment may still be useful after 72 hours if new lesions appear or complications are present. Pain care may include acetaminophen, NSAIDs, neuropathic agents, or specialist treatment. Eye or neurologic disease is urgent.
Vaccine Information
Shingrix is the only U.S. shingles vaccine. CDC recommends two doses 2-6 months apart for adults 50 or older and immunocompromised adults 19 or older; an accelerated 1-2 month interval may be used for selected immunocompromised patients. Zostavax is no longer available in the United States.
Shingrix is a recombinant, non-live vaccine and can be used in immunocompromised adults. Two doses are needed even after prior shingles, varicella vaccine, or Zostavax. The usual interval is two to six months; selected immunocompromised patients may complete it in one to two months. There is no routine booster recommendation after the two-dose series.
Prevention
Receive Shingrix when eligible, cover an active rash, wash hands, avoid touching lesions, and avoid contact with susceptible pregnant people, premature infants, and immunocompromised people until lesions crust.
When to Seek Medical Care
Seek same-day care for a painful blistering rash, especially near the eye or ear, on the face, in pregnancy, or with immune suppression. Emergency care is needed for vision change, facial weakness, confusion, widespread rash, or breathing difficulty.
Frequently Asked Questions
Can someone catch shingles from another person?
No, but contact with shingles lesions can give chickenpox to a susceptible person.
Should someone who had shingles get Shingrix?
Yes. Prior disease does not guarantee against recurrence.
Is Shingrix a live vaccine?
No. It is a recombinant adjuvanted vaccine.
How quickly should antivirals start?
Ideally within 72 hours, though later treatment may still help in selected situations.
Key Takeaway
Early antiviral treatment limits acute shingles, while two-dose Shingrix is the best protection against shingles and long-lasting nerve pain.
Medical, treatment, and vaccine information was reviewed against official U.S. public-health guidance available through September 2026.