It’s common to get a shingles rash on your back. It has some tell-tale symptoms but also shares symptoms with other conditions.

Shingles is a skin rash caused by the varicella zoster virus (VZV), which also causes chickenpox.

Most commonly, it appears in a stripe that wraps around one side of the body onto the flank and back.

You cannot get shingles unless you have had chickenpox. After chickenpox clears up, the virus remains in your body but lies dormant (inactive) in your nerve cells. However, it can reactivate later in life as shingles.

Read on to learn more about shingles on the back, other rashes that might appear similar, and when to call a doctor for care.

A shingles rash on your back usually appears in a series of steps. First, a day or two before the rash, you may feel pain, tingling, or burning on the part of your skin where the rash will later appear.

The rash appears as scattered small red blisters or bumps on lighter skin, or purplish, dark pink, or dark brown on darker skin tones. It usually affects only one side of the body. However, more blisters can form after the rash first appears, making it seem like it’s spreading.

The shingles rash is usually very painful. It may also come with other symptoms, including:

  • fever
  • headache
  • muscle aches
  • stomach pain
  • vomiting

When the rash starts to clear up, the blisters may crack open and bleed, then scab over. It may take 2 to 4 weeks for the rash to fully clear.

Shingles can occur anywhere on the back. It usually wraps around the side of the body from the front to the back.

Shingles results from reactivation of VZV, the virus that causes chickenpox.

If you develop shingles, it means you had chickenpox at some point earlier in life. The virus remains dormant in your body and reactivates as shingles.

The blisters from a shingles rash can leak fluid. This fluid can spread VZV to others.

If someone who has not had or been vaccinated against chickenpox comes into contact with the fluid, they may get chickenpox. If they get chickenpox, the virus will go dormant in their body after they heal, and they may develop shingles later in life.

If someone who has had chickenpox comes into contact with the fluid, they may get shingles.

Doctors treat shingles with antiviral medications. Getting early treatment can avoid possible complications like long-term nerve pain.

The most commonly used antivirals include:

These medications are most effective if you begin them soon after the appearance of the rash.

Over-the-counter pain medications, wet compresses, and oatmeal baths may help with pain and itching. In addition, a doctor may be able to prescribe a stronger pain medication for severe pain.

Other rashes can resemble shingles on the back. A doctor can spot the difference.

Eczema (contact dermatitis)

Eczema is an inflammatory reaction that causes:

  • dry, scaly patches
  • itchiness
  • blisters
  • infection

Eczema is not contagious. It’s an interaction between a person’s genetic makeup and environmental factors.

Poison ivy

The rash from poison ivy usually appears as red, itchy bumps. The redness may not be as visible on darker skin tones. If you have never reacted to poison ivy before, it can take 2 to 3 weeks for a rash to appear after exposure. If you have previously had poison ivy, the rash usually appears within hours.

The itchy bumps will break open, leak fluid, then crust over.

Reaction to medication

Some people may react to medications like antibiotics by breaking out in a raised, red or discolored, itchy skin rash called hives. This is usually an allergy to the medication.

Lichen planus

Lichen planus is a skin rash that can appear anywhere on the body. It’s triggered by an immune reaction.

When it develops on the skin, it produces shiny, firm, reddish-purple bumps. They may have white lines through them, called Wickham’s striae.

If many bumps develop together, a rough, scaly skin patch may form.

Bullous pemphigoid

This rare condition usually affects older people, beginning with an itchy, raised rash. Then, large blisters can form on the skin, sometimes filled with blood. It can start anywhere on the body.

If you develop shingles on your back (or anywhere on your body), see a doctor immediately after the blisters develop — preferably no later than 3 days after you notice them. Starting early on an antiviral medication can help limit pain and clear the rash quicker.

To treat shingles on the back, the entire condition should be treated. Contact a doctor to start on an antiviral medication as soon as you notice the rash.

Wet compresses, calamine lotion, and oatmeal baths may help relieve some of the pain and itching caused by a shingles rash on the back.

Read more about how shingles is treated.

Shingles on the back occurs when VZV, the virus that causes chickenpox, reactivates after lying dormant (inactive) in the body for some time.

Shingles breaks out in small, painful red blisters on the back, often wrapping around the side of the body.

Shingles is not contagious, but if someone comes in contact with the fluid from a shingles blister, they risk developing chickenpox. If they contract chickenpox, later in life they may develop shingles. If a person has already had chickenpox and comes into fluid from the blister, they may develop shingles.

Treatment for shingles includes antiviral medications that you should begin taking soon after the rash appears. Contact a doctor as quickly as possible after noticing shingles on your back or elsewhere on your body.