Shingles: Early Symptoms, Is It Contagious, Treatment and Who Should Get the Vaccine

Shingles often starts with pain you can’t explain: a burning, tingling or itchy patch of skin on one side of the body. A few days later, a rash of blisters appears in the same place. Spotting it early matters, because antiviral medicine works best when it starts quickly.

Imagine putting a sharp pain across your ribs down to a pulled muscle, then seeing blisters three days later. By then the best window for treatment is closing. Knowing the early signs gets you to a doctor or pharmacist in time.

Early symptoms

• A tingling, burning or painful patch of skin, usually on one side of the chest, back, tummy or face
• Headache or feeling generally unwell
• A few days later, a rash of red blotches that turn into itchy blisters, often in a band on one side of the body
• The blisters scab over; the rash usually takes 2 to 4 weeks to heal

Is shingles contagious?

You cannot catch shingles from someone with shingles. But the virus in the blisters can give chickenpox to someone who has never had chickenpox or the vaccine. You are infectious until all the blisters have crusted over. Until then, keep the rash covered and avoid pregnant people who haven’t had chickenpox, newborn babies and anyone with a weakened immune system.

Treatment

• Antiviral tablets such as aciclovir or valaciclovir, best started within 3 days of the rash appearing
• Pain relief such as paracetamol
• Loose cotton clothing, cool compresses and keeping the rash clean and dry

When to get help urgently

• The rash is near your eye, or your eye is red or painful
• You have a weakened immune system or are pregnant
• The rash is widespread or the pain is severe
• You are unwell and the rash is spreading

A common complication is post-herpetic neuralgia, nerve pain that lasts after the rash has gone. Early treatment and the vaccine reduce the risk.

Who should get the shingles vaccine?

Eligibility depends on your country. In the United States, the CDC recommends two doses of the shingles vaccine for adults aged 50 and over, and for adults from 19 with a weakened immune system. In the UK, the NHS offers it from age 65 and to people aged 50 and over with a severely weakened immune system. Ask your own health service what applies to you.

But I had chickenpox as a child. Am I protected?

No. Having had chickenpox is exactly what puts you at risk of shingles, because the virus stays in your body for life. Risk rises with age and with anything that weakens the immune system, which is why the vaccine targets older adults.

Sources: NHS, “Shingles”; US Centers for Disease Control and Prevention (CDC), “Shingles vaccination”; NHS, “Shingles vaccine”. This guide is for general information and does not replace advice from your own nurse, doctor or pharmacist.