If you’ve ever had chickenpox — and most adults have — the virus never fully leaves your body. It goes dormant, hiding quietly in your nervous system for years or even decades. For about 1 in 3 Americans, that virus will eventually wake up and cause shingles. Here’s what you need to know.
What Is Shingles?
Shingles (medically known as herpes zoster) is a painful viral infection caused by the reactivation of the varicella-zoster virus — the same virus responsible for chickenpox. After chickenpox clears, the virus retreats into the nerve tissue near your spinal cord and brain, where it stays dormant. When the immune system weakens enough to allow reactivation, the virus travels along nerve pathways to the skin, causing a distinctive, often painful rash.
The shingles rash typically appears as a stripe or band of blisters wrapping around one side of the torso, though it can also develop on the face, neck, or around one eye. Before the rash even appears, most people experience a few days of burning, tingling, or shooting pain in the affected area — which can make early diagnosis tricky.
Who Gets Shingles — and Why?
Anyone who has had chickenpox can develop shingles, but certain factors make reactivation much more likely.
Age is the biggest risk factor. The immune system naturally becomes less robust over time, and shingles rates climb significantly after age 50. The condition is most common in people between their 60s and 70s, but it can affect younger adults too — particularly those with weakened immune systems.
A compromised immune system plays a major role. People living with HIV, those undergoing chemotherapy, and individuals taking long-term corticosteroids or immunosuppressive medications face a meaningfully higher risk of shingles. Autoimmune conditions can also elevate risk.
Chronic stress and illness are also contributing factors. High levels of prolonged stress and physical exhaustion can suppress immune function enough to allow the virus to reactivate.
It’s worth noting: you cannot “catch” shingles from someone who has it. However, a person with an active shingles rash can spread chickenpox to someone who has never had it or hasn’t been vaccinated.
What Are the Symptoms?
Shingles symptoms typically unfold in stages:
Prodrome phase: Pain, burning, or tingling in a localized area, sometimes with sensitivity to touch — this can begin several days before any rash appears.
Rash phase: Red patches develop, followed by fluid-filled blisters that break open and crust over, usually within 7–10 days. The rash typically clears in 2–4 weeks.
Pain: Even after the rash heals, nerve pain can linger. This complication — called postherpetic neuralgia (PHN) — affects roughly 10–18% of shingles patients and can persist for months or years.
Treatment Options
Act fast. Antiviral medications — such as valacyclovir, acyclovir, or famciclovir — are most effective when started within 72 hours of the rash appearing. They can shorten the outbreak, reduce its severity, and lower the risk of long-term nerve pain. This is why seeing a provider as soon as symptoms begin is so important.
In addition to antivirals, treatment may include:
- Pain relievers (over-the-counter or prescription) to manage discomfort during the outbreak
- Topical treatments to soothe the rash and reduce irritation
- Nerve pain medications such as gabapentin or certain antidepressants, if postherpetic neuralgia develops
- Corticosteroids in select cases to reduce inflammation
Prevention matters too. The CDC recommends that adults 50 and older receive the Shingrix vaccine, which is highly effective at reducing the risk of shingles and its complications. Adults 19 and older with weakened immune systems should also be vaccinated. If you haven’t received it yet, ask your provider about it at your next visit.
Don’t Wait on Shingles Symptoms
Shingles can escalate quickly, and the window for the most effective treatment is short. If you’re experiencing unusual skin pain, burning, or a new rash — especially on one side of your body — it’s time to be seen.
At Uderm, our board-certified dermatologists can evaluate your symptoms, confirm a diagnosis, and get you started on treatment right away.
Schedule your appointment today:
📞 Call us to speak with our team
💻 Book online anytime!
Don’t wait — with shingles, early care makes all the difference.