The varicella-zoster virus causes both shingles and chickenpox. Typically, the peak pain of shingles is felt within 4 or 5 days after the first symptoms develop, and it comes along with a blistering rash.

Shingles is a viral infection that leads to pain and itching that can last 3 to 5 weeks.

As the blisters scab over, shingles pain usually starts to disappear. In some cases, the pain does not go away. This is known as a condition called postherpetic neuralgia.

Antiviral medications, especially when started at the first signs of infection, can often shorten the duration and discomfort of shingles.

There are three main stages of shingles. Their duration is somewhat predictable, but the time spent in each stage along with the symptom severity can vary from person to person.

Prodromal stage

According to a 2017 research article, the prodromal stage occurs before any signs of a rash appear on the skin, and it typically lasts 1 to 5 days.

Some symptoms are felt just under the skin’s surface and can include:

  • pain
  • tingling
  • numbness
  • burning

Active stage

In the part of the body where the pain and tingling was felt, a rash develops a few days later during the active stage.

The rash usually shows up on one side of the body and appears as a band on the:

  • torso
  • neck
  • shoulders
  • around one eye

Fluid-filled blisters form within a few days and then crust over within the next week. Expect the rash to clear up entirely within a month or so.

Postherpetic neuralgia

An estimated 10–18% of people with shingles go on to develop postherpetic neuralgia (PHN) — a continuation of symptoms after the rash disappears. Common symptoms include:

  • pain and itching in the area of skin affected by shingles
  • greater sensitivity to pain generally
  • feeling pain from otherwise harmless stimuli, such as a light breeze or a gentle touch

These symptoms often disappear within a year. However, for some people, the nerve hypersensitivity and other symptoms can last for years or a lifetime. These symptoms can lower quality of life.

In addition to pain and a rash, other symptoms of shingles may include:

  • fever
  • headache
  • nausea
  • general flu-like symptoms

For people with PHN, other symptoms can develop, such as:

  • insomnia
  • depression
  • anxiety
  • weight gain

The physical symptoms of PHN may also make it difficult to exercise or perform everyday tasks, such as housework or even getting dressed.

The duration of shingles pain and other symptoms depends on the person and how soon you begin treatment.

An outbreak can often resolve on its own within a month without treatment, but that timeline often can be reduced to several days if antiviral medications are taken at the earliest signs of a shingles rash.

PHN is usually diagnosed if pain, burning, tingling, or other symptoms continue 3 months or so after the rash has disappeared.

It’s not always possible to predict who will develop PHN.

The condition occurs when the nerve fibers involved in the initial shingles outbreak are damaged and cannot communicate properly with the brain. As a result, pain signals can become intensified.

PHN is more common in older adults. People younger than 40 who have shingles are unlikely to experience long lasting symptoms.

Like many other viral infections, such as a common cold, shingles has to run its course. However, treatments can often help shorten that course.

The primary treatment for shingles is an antiviral medication. Three common antivirals include:

If taken soon after a rash develops, antiviral medications can speed up the healing process by a week or more and lessen the severity of symptoms.

Over-the-counter pain relievers may also be helpful during the beginning stages of a shingles outbreak.

Topical treatments may ease itching, such as:

Depending on your symptoms and their severity, treatment options for PHN can include:

  • antiviral medications
  • antiseizure medications
  • antidepressants
  • opioid pain medications
  • over-the-counter pain relievers

In some cases, patches containing lidocaine and other pain-relieving agents can be worn on the skin to ease symptoms.

Early shingles symptoms, such as pain or flu-like feelings, are not obvious signs of a shingles outbreak.

Once a rash appears, you should see your primary care physician or a dermatologist. A trained eye can often diagnose shingles by visually inspecting the rash.

If you have shingles, you may never experience the extreme pain that can often come with it. You may only feel itching and some minor discomfort.

Even without the painful symptoms of shingles, it’s recommended that you see a healthcare professional and start antiviral treatment within 72 hours of a rash’s appearance.

It’s especially important to seek prompt medical care if a rash forms near one or both eyes. Shingles in the eye may cause permanent vision loss.

What are the 3 stages of shingles?

The 3 main stages of shingles are:

  • Prodomal stage: Pain and tingling may be felt beneath the skin with no signs of rash. These symptoms may also be accompanied by fever, fatigue, and headache. This stage typically lasts from 1–5 days.
  • Active stage: A rash develops in the area where pain and tingling were felt and fluid-filled blisters form and crust over with the following week.
  • Postherpetic neuralgia. Approximately 10–18% of people with shingles develop postherpetic neuralgia. Symptoms, which typically disappear within a year, include greater sensitivity, pain, and itching in the area affected by shingles.

What are the stages of shingles healing?

The recovery or healing phase of shingles typically begins when the rash has cleared and scabs have formed over the fluid-filled blisters. It typically takes about 3 to 5 weeks for the blisters to completely heal. During this time, you may continue to have tingling, burning, or itching sensations.

Some people may develop postherpetic neuralgia which can cause longer-term pain and sensitivity in the area where the shingles rash occurred.

What are the worst days of shingles?

Pain from shingles peaks within 4–5 days after the first symptoms develop and fluid-filled blisters appear.

How do you know when shingles is getting better?

You know you’re recovering from shingles when your fluid-filled blisters turn into dry hard scabs, although it can still take up to 5 weeks for the scabs to fully heal and disappear.

About 1 in 3 adults get shingles, and the odds of infection increase with age. Shingles can be an extremely uncomfortable experience, with pain peaking within a week of the first symptoms emerging.

Pain can sometimes linger for months or years. To avoid any of these complications, talk with your doctor about getting a shingles vaccine if you are ages 50 or older of if you have condition that affects your immune system.

If you are affected by shingles, see a medical professional as soon as possible to begin treatment. Treatment can shorten the time you spend in pain and discomfort.