What Does Shingles Look Like?

Shingles, also known as herpes zoster, occurs when the dormant chickenpox virus (varicella zoster) is reactivated in your nerve tissue.

Usually, the shingles rash lasts 3–5 weeks, and most people completely recover.

Doctors can often quickly diagnose shingles from the appearance of the skin rash.

Before the rash starts, you may develop a burning sensation, itchiness, or tingling on one side of the body, often on the trunk. You may also develop:

• a headache
• sensitivity to light
• general fatigue

When the rash starts, you may notice pink or red blotchy patches on one side of your body along nerve pathways.

These are not contagious yet, but fluid-filled blisters like chickenpox soon develop, possibly accompanied by itching. In most cases, the blisters appear over a localized area, but widespread blistering is possible.

Blisters usually appear on the face and torso but can occur elsewhere. In rare cases, there’s no rash.

It’s impossible to pass on shingles. But you can get chickenpox from someone with shingles through contact with active blisters due to the same virus causing both illnesses.

Once a rash starts, it’s important to consult your doctor within 3 days. In the first 3 days, they can prescribe an antiviral, which can help speed up recovery and lower symptom severity.

Scabbing and crusting

Blisters

The blisters sometimes erupt and ooze. They may then turn slightly yellow and begin to flatten. As they dry out, scabs form. Each blister can take 7–10 days to crust over, per the National Institute on Aging.

During this stage, your pain may ease a little, but it can continue for months or, in some cases, years.

Once all blisters have completely crusted over, there’s a low risk of transmitting the virus.

The shingles “belt”

Shingles often appears around the rib cage or waist and may look like a “belt” or “half belt.” You might also hear this formation called a “shingles band” or a “shingles girdle.”

This classic presentation is easily recognizable as shingles. The belt can cover a wide area on one side of your midsection. Its location can make tight clothing particularly uncomfortable.

Shingles on the face (ophthalmic shingles)

Ophthalmic shingles, also known as herpes zoster ophthalmicus, occurs around the eye. Often, it starts as a burning or tingling sensation on the scalp, cheeks, or forehead.

Like when shingles appears on other areas of the body, the tingling sensation can turn into an itchy, painful rash on the scalp, forehead, or cheeks.

Learn more about the symptoms of ophthalmic shingles. If you’re having these symptoms, it’s a medical emergency. You need to get medical attention right away to avoid a complication like vision loss.

Widespread shingles

Though less common, people who develop shingles may develop a rash that crosses multiple dermatomes. Dermatomes are separate skin areas that are supplied by separate spinal nerves.

When the rash affects three or more dermatomes, it’s called “disseminated or widespread zoster.” In these cases, the rash may look more like chickenpox than shingles.

If you have a weakened immune system, you’re more likely to develop widespread shingles.

The varicella-zoster virus causes shingles. If you had chickenpox as a child or got the chickenpox vaccine, you can develop shingles at some point in your life. However, you have a lower risk of developing shingles if you’ve received the vaccine.

The exact reason why the virus resurfaces is still not fully understood. But as you age and your defense against the virus decreases, you may become more susceptible. The chance of developing shingles and related complications increases drastically at age 50 years.

Learn more about what causes shingles to activate.

A secondary bacterial infection is a possible complication of shingles.

Open sores of any kind are always susceptible to bacterial infection. To lower the possibility of secondary infection, keep the area clean and avoid scratching.

People with weakened immune systems have a higher chance of developing infections or other complications.

Other rarer complications include:

• postherpetic neuralgia
• vision problems
• Ramsay Hunt syndrome
• pneumonia
• hepatitis
• brain or spinal cord inflammation

Learn more about shingles complications.

Most doctors can visually examine and diagnose shingles based on the rash and other symptoms. In most cases, the rash:

• appears a few days after other symptoms, such as a tingling sensation
• develops only on one side of the body
• often occurs around the trunk
• appears only in one or two areas
• develops a blistering effect that lasts about 2–4 weeks

Shingles rash vs. herpes

Shingles, also known as herpes zoster, is in the same viral family as herpes simplex. At first, it may be difficult to tell the two conditions apart because they cause blistering rashes.

But shingles, unlike herpes, typically does not cross the body’s midline and often appears on the trunk. Herpes often appears around the genitals or in the mouth. In both cases, a person may not develop a rash at all or may develop other symptoms that can help a doctor distinguish between the two conditions.

It’s important to talk with a doctor if you’re not sure which virus may be causing the rash.

Learn more about herpes versus shingles.

Shingles rash vs. poison ivy

Poison ivy, oak, or sumac can cause an allergic reaction that results in a painful, itchy rash. When the rash appears, it often appears as a straight line.

One way to distinguish between the two conditions is that poison ivy often appears on exposed areas of skin and both sides of the body.

Learn more about the difference between shingles and poison ivy rash, as well as its differences from psoriasis.

According to the Centers for Disease Control and Prevention (CDC), about 1 in 3 adults in the United States will develop shingles at least once in their lifetime. Several factors, including age, can raise your risk of developing shingles at least once in your lifetime.

Possible risk factors include:

• being age 50 years or older
• living with human immunodeficiency virus (HIV)
• being a bone marrow or solid organ transplant recipient
• taking immunosuppressive medications, such as chemotherapy, steroids, or those related to transplants
• living with cancer, particularly leukemia, and lymphoma

The CDC notes that other factors may play a part in who develops shingles. But more research is needed to further explain, better understand, and confirm these factors. According to research:

• There’s a higher prevalence of shingles diagnoses in white people compared with Black people.
• Females assigned at birth (FAABs) may be more likely to develop shingles than males assigned at birth (MAABs).

How long does shingles last?

Most people can expect the rash to heal within 2–4 weeks, according to the CDC. Although some people may be left with minor scars, most will completely recover with no visible scarring.

You may have heard that once you get shingles, you cannot get it again. However, the CDC cautions that shingles can return multiple times in some people.

What’s a mild case of shingles like?

In mild shingles, you may only experience tingling or itching but without the painful blistering. This is more likely in younger people with healthy immune systems. Learn more about mild shingles.

Shingles, or herpes zoster, is caused by the reactivation of the dormant chickenpox virus (varicella zoster) in your nerve tissue. This can lead to tingling sensations and localized pain.

Eventually, a rash with blisters may appear, which can be itchy, uncomfortable, or painful. You cannot transmit shingles to someone else.

However, they can develop chickenpox from contact with active shingles blisters if they never had chickenpox or never received the chickenpox vaccine. Most people recover within a few weeks.