How Do You Know if Someone Has Shingles?

A fellow caregiver asked...

How do you know if someone has shingles?

Expert Answer

Dr. Leslie Kernisan is the author of a popular blog and podcast at She is also a clinical instructor in the University of California, San Francisco, Division of Geriatrics.

The telltale symptoms of shingles (herpes zoster, a viral infection in a nerve) usually include:

  • First: The skin may tingle or there may be a burning or stinging pain, usually felt on just one side of the body (frequently the trunk, neck, or face), often in a band-like formation. Some people may also experience headache, fever, tiredness, or general achiness.
  • Within a few days or weeks: A small rash of raised, reddish bumps appears, which can vary in appearance from person to person. The rash may appear in the same area as the pain, usually in a stripe or band (roughly following a nerve path) and on only one side of the body or face.
  • A few days after the rash begins: Fluid-filled blisters that tend to resemble chicken pox replace the bumps and crust over, lasting up to two weeks.

The pain of shingles can be mild or severe. It can last for days, weeks, months, or occasionally even years. When pain outlasts the blisters, it's a sign of postherpetic neuralgia, a common complication of shingles.

It's a good idea to have any suspicious rash, especially one that's accompanied by pain, checked out by a doctor. Always see a doctor promptly if the pain or rash is near the eye, forehead, or nose. A condition called herpes zoster ophthalmicus (shingles of the eye) can lead to eye infections, glaucoma, or even blindness.

Shingles can also become very severe and dangerous in people who are immune-suppressed (for example, on chemotherapy, with a history of transplant, or with a disease such as HIV). For most people, however, shingles is painful and uncomfortable but eventually gets better on its own. If started within a few days of the appearance of rash, treatment with antiviral medications can reduce the risk of post-herpetic neuralgia.

The shingles vaccine does make it less likely that one will develop shingles and is recommended for all adults over age 60.