Patient information from BMJ

Shingles

Last published:Apr 29, 2025

Shingles is a painful rash that is more common in older people. The illness happens when the virus that causes chickenpox ‘reactivates’ in the body.

Usually, shingles goes away on its own and doesn’t cause any long-term problems. But it can cause more serious issues in some people.

What is shingles?

Shingles (also known as herpes zoster) is a painful rash that happens when the virus that causes chickenpox ‘reactivates’ in your body.

Once you’ve had chickenpox, the virus lives in your nerve cells. Usually, it stays in those cells for many years and doesn’t cause any problems. This is because your immune system keeps the virus under control.

But as you get older, or if your immune system becomes weakened, the virus may ‘reactivate’, or ‘wake up’, and start replicating in your nerve cells. This then causes a painful rash on the skin. 

Shingles isn’t contagious. That means you can’t catch it from someone else who has shingles, or from someone who has chickenpox. You can only get shingles if you’ve had chickenpox before. 

Shingles is more common in people over the age of 50, and in people who have weakened immune systems because of certain conditions or treatments including:

• HIV infection

• cancer (in particular, cancers such as lymphomas, myelomas, and leukemias)

• chemotherapy

• long-term corticosteroid use (corticosteroids, also known as steroids, are drugs that work to suppress the immune system).

Most people will be offered a vaccine against shingles when they get older. The vaccine is very effective at reducing your chances of getting the illness. It also helps to reduce your chance of getting seriously unwell if you do get shingles. But having it doesn’t fully guarantee that you still won’t get the illness.

What are the symptoms of shingles? 

Shingles usually starts with pain in the affected area, before developing into a rash.

Typically, a patch of your skin will start to feel tingly and painful, and may itch. The pain may feel like a burning, stabbing, or throbbing sensation. It may be constant or come and go. Your skin may feel worse if you touch it. This pain may be more severe for some people with shingles than for others.

After two or three days, you will likely get a rash on the affected area. This rash will develop small blisters and will probably be on one side of your body. Many people get it on their waist, although it can occur anywhere on the body. After a week, the blisters will weep and ooze fluid, before crusting over.

Some people may also feel generally unwell with tiredness, fever, and headache.

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. Having 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. Your doctor will recommend you see an eye specialist to get the right treatment to avoid any problems with your eye or eyesight.

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

What happens next?

Shingles usually resolves on its own within a few weeks. Blisters from the rash will crust over and heal, but sometimes they can leave a scar or change the colour of the skin.

Treatment can help shorten the illness and prevent long-lasting issues like post-herpetic neuralgia. This long-lasting pain is uncommon in younger people, but the risk increases with age. The pain usually goes away within six months, but some people have it for longer. 

More information about treatment for shingles is available in our patient information Shingles: what are the treatment options?

It’s important to remember that you can’t catch shingles from someone who has shingles. But you can catch chickenpox from someone who has shingles. If you have shingles and know someone hasn’t had chickenpox before (or the chickenpox vaccine), try to avoid close contact with them. You should avoid contact if the shingles rash is still weeping (i.e., oozing fluid), and cannot be properly covered with a non-sticky dressing, or until the rash becomes dry.