Shingles Stages and Symptoms

Medically Reviewed By Raechele Cochran Gathers, MD
Was this helpful?
12

Shingles, also called herpes zoster, is a painful viral infection that affects the skin and nerves. Shingles progresses through 3 basic stages. These include initial skin sensations, a painful blistering and oozing rash breakout, and finally scabbing and healing. Overall, most shingles can last around 3–5 weeks. Some people experience long-term pain where the rash occurred. This is called postherpetic neuralgia (PHN).

This article discusses the stages of shingles, symptoms, duration, when you can transmit it, and when to call your doctor. 

What is shingles?

Older woman consulting with a doctor
PER Images/Stocksy United

The varicella-zoster virus is the virus responsible for shingles. When a person is first infected, they get chickenpox. These are red, itchy, and sometimes painful bumps on the skin. After the chickenpox infection goes away, the virus does not leave the body. It lives in the nerve cells in an inactive state. 

In most adults, the virus never leads to shingles. For 1 in 3 adults, the virus reactivates and causes shingles.

Shingles is a painful rash that can happen anywhere. However, it typically occurs in one area or on one side of the body. The rash has painful, fluid-filled blisters that open, ooze fluid, and then scab over toward the end of the infection. 

Along with the rash, other symptoms may include:

What are the stages of shingles, and how long do they last?

The timespan of shingles breaks down into 3 stages based on how the infection progresses.

Stage 1

During the stage 1, you may experience skin sensations, including:

  • burning
  • itching
  • tingling
  • electrical sensations
  • hypersensitivity

Common areas for shingles include the waist, chest, or back, usually on one side of the body. Shingles can also form on the face or other areas of the body.

This stage may last several days before the rash appears. During this stage, flu-like symptoms may occur. Shingles is not contagious during this stage.

Stage 2

During stage 2, a red, blistering rash appears in the area where the skin has sensitivity. Flu-like symptoms may continue.

The fluid-filled blisters appear. The rash can be very painful and interfere with your daily activities. The blisters typically scab up in 7–10 days.

Shingles is contagious during this blistering stage until the shingles lesions dry out. While you can not spread shingles, you can spread the virus that causes shingles. The virus is in the blister fluid.

Coming into contact with fluid from the blisters exposes people to the virus. People who have not had chickenpox can contract the virus. If infected, they may get chickenpox which can lead to shingles later.

Keeping your blisters covered greatly reduces the risk of spreading the varicella-zoster virus. Other tips include:

  • Avoid people who have a weakened immune system.
  • Avoid people who have not had chickenpox or the chickenpox vaccine.
  • Wash hands often.
  • Do not touch or scratch the rash.

Stage 3

When the rash starts to clear, the blisters may burst open and bleed before they scab over. Anytime there is liquid still present from your blisters, you can transmit the virus. The scabs usually clear up after 2–4 weeks. 

Overall, shingles typically runs its course between 3–5 weeks. 

What is the duration and progression of shingles?

StageDurationSymptomsContagious?
11–3 daysskin sensitivity, flu-like symptomsno
27–10 daysred rash, fluid-filled blisters that can break open, skin and nerve pain yes
32–4 weeksrash begins to clear, blisters scab over and healyes, if blister
fluid is present

What are the potential complications of shingles?

PHN is the most common complication of shingles. It occurs in 1 in 5 people who had shingles, and it can last 90 days or longer after the rash has cleared.

PHN is long lasting pain that can make routine daily activities difficult. Some people with PHN also experience:

The older you are when you have shingles, the more at risk you are for developing PHN. Talk with your doctor if you experience long lasting symptoms after shingles, including PHN.

Treatment for PHN includes:

  • lidocaine or capsaicin, topical pain control
  • gabapentin or pregabalin, oral nerve pain control
  • tricyclic antidepressants  

When to call your doctor?

Contact your doctor as soon as you notice skin sensations, and certainly once the rash develops.

There is no cure for shingles. However, antiviral medications can help the blisters heal faster and lower the risk of severe pain.

Antiviral treatment should begin within 72 hours of the rash developing. Treatment can reduce the severity of your infection and lower your risk of developing the long-term complication PHN.

Rash or blisters on the face requires urgent medical care. Notify your doctor right away. Shingles on the face or near the eyes or ears can cause:

  • eye damage
  • blindness
  • hearing loss
  • temporary paralysis of the face
  • inflammation of the brain

Older adults and people with reduced immune systems are more at risk for complications.

How is shingles treated?

Antiviral medications help lessen the severity of shingle symptoms and can lower your risk of complications. Acyclovir is a common antiviral medication that doctors prescribe to treat shingles.

Your doctor may also give you medication to manage pain. 

To learn more about the treatment of shingles, read here.

What you can do at home for shingles?

Here are a few things you can try at home to help you feel more comfortable. 

  • Place a cool wet washcloth on your rash.
  • Take a soothing colloidal oatmeal bath or starch bath.
  • Use calamine lotion and Zostrix cream to help calm the skin.
  • Take antihistamines (oral or topical) to reduce skin itching.
  • Take nonsteroidal anti-inflammatory drugs (NSAIDs), such as Ibuprofen, to help manage pain.
  • Take acetaminophen (Tylenol) to help relieve your pain and fever.

How can you prevent shingles?

People over 50 years old — or over 19 years with reduced immune systems — can get the Shingrix vaccine. This vaccine can help reduce the risk of getting shingles. The shingles vaccine will also lessen the severity of the condition if you do get shingles.

Summary

Shingles is a painful viral infection that affects the skin and nerves. The varicella-zoster virus causes it.

Shingles progress through 3 basic stages and can last 3–5 weeks. Stages include:

  1. uncomfortable skin sensation and possibly flu-like symptoms
  2. rash breakout with painful blistering and oozing
  3. scabbing and healing 

Antiviral medications can help the blisters heal faster and lower the risk of severe pain and long-term nerve complications. Contact your doctor immediately when you recognize the skin sensations or as soon as you notice the rash. It is best to begin antiviral treatment within 72 hours of the rash developing. 

A shingles infection is most contagious from when blisters form to when they are completely scabbed over. 

Was this helpful?
12
Medical Reviewer: Raechele Cochran Gathers, MD
Last Review Date: 2022 May 20
View All Shingles Articles
THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.
  1. Nair, P. A., et al. (2021). Herpes zoster. https://www.ncbi.nlm.nih.gov/books/NBK441824/
  2. Shingles (herpes zoster). (2022). https://www.cdc.gov/shingles/index.html
  3. Shingles vaccination: What everyone should know about the shingle vaccines (Shingrix). (2022). https://www.cdc.gov/vaccines/vpd/shingles/public/shingrix/index.html
  4. Shingles: Diagnosis and treatment. (n.d.). https://www.aad.org/public/diseases/a-z/shingles-treatment
  5. Shingles. (2021). https://www.nia.nih.gov/health/shingles
  6. Shingles. (2022). https://medlineplus.gov/shingles.html