What are the symptoms of shingles?
The virus usually affects one nerve only, on one side of the body. Symptoms occur in the area of skin that the nerve supplies. The usual symptoms are pain and a rash. Occasionally, two or three nerves next to each other are affected.
The most commonly involved nerves are those supplying the skin on the chest or tummy (abdomen). The upper face (including an eye) is also a common site.
The pain is a localised band of pain. It can be anywhere on your body, depending on which nerve is affected. The pain can range from mild to severe. You may have a constant dull, burning, or gnawing pain. In addition, or instead, you may have sharp and stabbing pains that come and go. The affected area of skin is usually tender.
The rash typically appears 2-3 days after the pain begins. Red blotches appear that quickly develop into itchy blisters. The rash looks like chickenpox but only appears on the band of skin supplied by the affected nerve. New blisters may appear for up to a week. The soft tissues under and around the rash may become swollen for a while due to inflammation caused by the virus. The blisters then dry up, form scabs and gradually fade away. Slight scarring may occur where the blisters have been. The picture shows a scabbing rash (a few days old) of a fairly bad bout of shingles. In this person, it has affected a nerve and the skin that the nerve supplies, on the left side of the abdomen.
Images above by Mariegriffiths via Wikimedia Commons
An episode of shingles usually lasts 2-4 weeks. In some cases there is a rash but no pain. Rarely, there is no rash but just a band of pain.
You may also feel you have a high temperature (feel feverish) and feel unwell for a few days.
Is shingles contagious?
You can catch chickenpox from someone with shingles if you have not had chickenpox before. But most adults and older children have already had chickenpox and so are immune from catching chickenpox again. You cannot get shingles from someone who has shingles.
The shingles rash is contagious (for someone else to catch chickenpox) until all the blisters (vesicles) have scabbed and are dry. If the blisters are covered with a dressing, it is unlikely that the virus will pass on to others. This is because the virus is passed on by direct contact with the blisters. If you have a job, you can return to work once the blisters have dried up, or earlier if you keep the rash covered and feel well enough. Similarly children with shingles can go to school if the rash is covered by clothes and they do not feel unwell.
Pregnant women who have not had chickenpox should avoid people with shingles. See separate leaflet called Chickenpox Contact and Pregnancy for more details. Also, if you have a poor immune system (immunosuppression), you should avoid people with shingles. (See below for a list of people who have a poor immune system.) These general rules are to be on the safe side, as it is direct contact with the rash that usually passes on the virus.
Further reading and references
Immunisation against infectious disease - the Green Book (latest edition); Public Health England
Gagliardi AM, Andriolo BN, Torloni MR, et al; Vaccines for preventing herpes zoster in older adults. Cochrane Database Syst Rev. 2016 Mar 33:CD008858. doi: 10.1002/14651858.CD008858.pub3.
Who is eligible for the shingles vaccine beyond 2016; Public Health England
Cohen JI; Clinical practice: Herpes zoster. N Engl J Med. 2013 Jul 18369(3):255-63. doi: 10.1056/NEJMcp1302674.
After three visits to the ER with horrible pain and three ultrasounds, three CT’s w/ contrast later with no findings! During my 3rd visit I suggested can this be shingles? I only had a small...Believe2128
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