Patient information from BMJ

Shingles

Last published:Aug 03, 2021

Anyone who has had chickenpox is at risk of getting shingles in later life. Shingles can be very painful, but there are good treatments that may shorten an attack and help prevent long-lasting problems. There is also a vaccine to help prevent shingles.

What is shingles?

Shingles is caused by the same virus that causes chickenpox. It’s called the varicella-zoster virus. Once you’ve had chickenpox, the virus lives in your nerve cells. Usually, it stays in your nerve cells for many years and doesn’t cause any problems. Your immune system keeps it in check.

But as you get older, or if your immune system is weak, the virus may ‘wake up’ and start reproducing in your nerve cells. The virus travels to the nerve endings in your skin. This can cause a painful rash and make you feel ill.

You can’t catch shingles from someone else who has shingles, or from someone who has chickenpox. You can only get shingles if you’ve already had chickenpox. However, if you have shingles, you should avoid close contact with people who haven't had chickenpox (or the chickenpox vaccine), as you can pass the virus to them. They may then get chickenpox.

What are the symptoms?

These are the most common symptoms of shingles.

• You may feel unwell, tired, and have a headache.

• A patch of your skin will probably feel tingly and painful, and may itch. The pain may feel burning, stabbing, or throbbing. It may be constant or come and go. Your skin may feel worse if you touch it.

• After two or three days, you will get a rash on the affected area. This rash will develop small blisters. The rash will probably be on one side of your body. Many people get it on their waist area, although it can occur anywhere on the body.

If you have symptoms of shingles, it's important to see your doctor quickly. That's because treatment works best if you start taking it within three days of getting the rash. Treatment can also lower your chances of getting more serious problems from shingles, such as long-lasting pain (called post-herpetic neuralgia).

It’s particularly important to see a doctor quickly if you have a shingles rash near your eye. If your eye is affected by your shingles attack, your doctor will recommend you see an eye specialist. Your eye could be damaged by the virus if you don’t have the right treatment.

Doctors can usually diagnose shingles from looking at the rash and asking you about your symptoms and whether you've had chickenpox. You probably won’t need any tests.

What will happen to me?

The rash from shingles usually lasts about two to four weeks. The tiny blisters crust over and heal up. Sometimes they leave a scar or change the colour of the skin.

Long-lasting pain after shingles (post-herpetic neuralgia) is uncommon in younger people, but the risk increases with age. By age 60, around 4 in 10 people who have shingles get post-herpetic neuralgia. This can make people feel very low, but treatments can help. The pain usually goes away within six months, but some people have it for longer.

For more information on treatments for shingles see our leaflet: Shingles: what treatments work?