What Does Shingles Feel Like?

The Stages Before and After Rash Development

The most well-known symptom of shingles (herpes zoster) is a severe skin rash. However, before any signs of blisters, what shingles can feel like is very much as if you're only coming down with the flu.

You may experience chills and fever, as well as intense pain in one part of the body. It's not until a few days later that a rash finally joins these shingles symptoms, with clusters of tiny, pimple-like blisters progressing quickly once they appear. The rash usually appears in a band around the left or right side of your torso (back or chest). It can also occur on the side of your face.

This article explains what shingles feels like, the typical stages of a shingles outbreak that begin with pain, and complications to avoid, such as nerve issues or bacterial skin infections. It offers information about when to see a healthcare provider for your symptoms.

shingles symptoms
Verywell

What Shingles Feels Like Before the Rash

Shingles develops in two stages. The first is called the prodromal period.

Shingles is a reactivation of the varicella virus, which is what causes chickenpox. After an initial infection, the virus lays dormant in the body. Once reactivated, which can happen years later, shingles can occur.

Often, the earliest signs this is occurring are similar to what you'd expect at the start of any infection. These symptoms sometimes occur at times when you're feeling stressed or run down. They are also systemic, meaning they affect the whole body.

Shingles pain
With shingles, you typically have a painful rash on one side of your torso. aradaphotography/Shutterstock

You may assume you're just overtired or coming down with a cold when you actually have shingles.

What First Symptoms of Shingles Feel Like

Systemic symptoms may appear in the first few days of the prodromal stage of shingles. These symptoms feel like:

  • Pain in a specific, localized area of the body
  • Fever
  • Chills
  • Upset stomach
  • A headache

The most telling first symptom of shingles typically is the pain. Often excruciating, the discomfort has been described as burning, stinging, tingly, prickly, itchy, numbing, achy, or shooting. It can be persistent or intermittent, but will always be limited to one side of the body.

Because the pain from shingles is localized, it can be mistaken for other conditions depending on where it's focused.

For example, a stabbing or persistent pain on one side of the lower back may mistakenly be attributed to sciatica or a kidney problem. Shingles pain around the lips could suggest a cold sore coming on, while pain focused on the eye or ear might seem like the start of a migraine.

What Does Nerve Pain From Shingles Feel Like?

The skin will be sensitive to any pressure, even a light touch, around the damaged nerves. Pain is often described as sharp, stabbing, or burning. It can be constant or come and go, and it may feel worse with movement.

What Shingles Feels Like When the Rash Appears

The eruptive stage of shingles begins a few days later. This is when a rash appears.

The skin in the area of the prodromal pain caused by shingles will often be sensitive to the touch and reddish in appearance. As these symptoms get worse, it may begin to feel like a sunburn.

Within three to five days of the initial pain, a few tiny pimple-like spots appear and quickly multiply into clusters, forming a rash that feels prickly to the touch.

From there, sometimes within hours, the pimples develop into water-filled blisters, or vesicles, that then consolidate into larger blisters. Often, redness and swelling accompany the rash.

Shingles rash on back of a younger person

Getty Images

The shingles rash looks very much like the chickenpox rash, with a key difference: Chickenpox blisters are widely scattered over the entire body. With shingles, the rash almost always occupies a finite strip of skin.

Ultimately, the pain of shingles may get so excruciating that simply grazing the skin with clothing can set off what feels like an electric shock.

What Triggers a Shingles Outbreak?

While researchers aren't sure, one theory is that a weakened immune system can allow the virus to reemerge. This can happen as you get older and your immune system becomes less robust.

Where a Shingles Rash Forms

A shingles rash typically occurs on the face, neck, or chest, on just one side of the body.

The affected area of skin is called a dermatome, a region supplied by the sensory fibers of a specific spinal nerve. Outbreaks can involve two adjacent dermatomes, but rarely two non-adjacent dermatomes.

The exception may be in people whose immune systems are severely comprised, such as those with advanced HIV infection. They're more at risk of reactivation, or recurrence, of shingles than the general population, and the rash can spread beyond a specific dermatome or two and become more generalized.

How Long It Takes for Shingles to Go Away

The shingles rash forms over a period of three to five days and then gradually crusts over. Symptoms usually get better within two to four weeks. However, pain that accompanies it can sometimes last for weeks, months, and occasionally years.

What Shingles Feels Like When There’s Complications

Aside from the discomfort that can come along with shingles, it is particularly concerning because of its potential complications.

Postherpetic Neuralgia

The most common complication of shingles is a potentially debilitating condition called postherpetic neuralgia (PHN) that develops when nerve fibers become damaged. It's characterized by persistent pain in the area where a shingles rash has been. For instance, when shingles affect nerves in the head, tenacious facial pain may continue for long after the rash clears up.

Symptoms of PHN can be severe enough to interfere with daily life and include:

  • Burning, sharp, or deep, achy pain that lasts for three months or longer after the shingles rash has healed
  • Allodynia (sensitivity to light touch) in which even the sensation of clothing on the skin can be excruciating. 
  • Itching and numbness
  • Difficulty sensing temperature and vibration

The CDC reports that between 10% and 18% of people who have shingles will develop PHN. The risk increases with age; it is rarely seen in people under age 40.

A particularly severe and painful shingles rash can be associated with PHN. Having the rash on the face or torso also increases the risk of the condition. 

Treating PHN can be complicated, but it's important, as the condition can lead to further complications such as depression, fatigue, trouble concentrating, sleep issues, and appetite loss.

There's no one-size-fits-all approach, and it often takes several medications to relieve the pain and other symptoms. Among the drugs used most often to treat PHN are:

  • Lidocaine patches (sold under the brand name Lidoderm)
  • Capsaicin, a natural derivative of chili peppers, in the form of a cream or patch
  • Anticonvulsant medications such as Neurontin (gabapentin) and Lyrica (pregabalin)
  • Antidepressants such as Cymbalta (duloxetine)
  • Steroid injections

Bacterial Skin Infections

The blisters caused by shingles can leave open sores, making skin vulnerable to microbes that can cause what the CDC describes as "bacterial superinfection of the lesions." The bugs most often responsible for such infections are Staphylococcus aureus and group A beta hemolytic streptococcus.

One bacterial skin infection sometimes associated with shingles is impetigo, which most often affects children. It starts with itchy sores that burst and then form honey-colored crusts. Impetigo is extremely contagious but can be treated effectively with antibiotics.

Cellulitis is another skin infection known to result from shingles. Unlike impetigo, which affects the outermost layer of skin, cellulitis is an infection of the deeper layers and even the tissue beneath the skin.

Cellulitis starts with an area that's red, swollen, and feels warm and tender to the touch. If it's not treated, cellulitis can spread quickly and even affect the lymph nodes, eventually leading to a blood infection. As long as it's treated right away with oral antibiotics and good care of the affected skin, cellulitis is highly curable and unlikely to leave permanent damage.

Facial Pain and Eye Damage

In about 10% of cases, shingles will affect the trigeminal ganglion—a triple-branched nerve that provides sensation to structures in the face. This leads to herpes zoster ophthalmicus (HZO).

Specifically, the trigeminal ganglion involves the eye (the ophthalmic branch); the cheek (the maxillary branch); and the mandibular branch (the jaw). Of these, the ophthalmic branch is the one most commonly affected by herpes zoster. 

HZO can affect any part of the eye, from the optic nerve to the conjunctiva (the membrane that covers the front of the eye and lines the eyelid). Without antiviral treatment, almost half of people who have shingles near the eye will experience eye pain and damage, so it's vital to see an ophthalmologist immediately.

Uncommon Complications

What shingles will feel like may also depend on other potential, though uncommon, health problems caused by shingles.

Ramsay Hunt Syndrome 

Otherwise known as herpes zoster oticus, this is inflammation of a facial nerve near one of the ears. The symptoms include:

  • Facial paralysis
  • Ear pain
  • Small, fluid-filled blisters (called vesicles) inside the ear canal

People with Ramsay Hunt often experience dizziness or lack of balance. The condition also can cause permanent hearing loss if not treated promptly.

Meningitis

This is an infection of the meninges, the protective membranes that surround the brain and spinal cord. Symptoms of meningitis include:

  • Fever
  • Severe headache
  • Sensitivity to light
  • Achy muscles

Because this type of meningitis is caused by the shingles virus, it is treated with antiviral medications such as intravenous (IV) acyclovir.

Encephalitis

Like meningitis, this is a secondary viral infection. Encephalitis affects the brain and can cause symptoms such as a headache, memory loss, fever, and changes in personality.

Motor Neuropathy

Normally the varicella virus affects only sensation in the skin, but, in rare cases, it can go deeper into muscle tissue, causing weakness or atrophy. Most patients experiencing motor neuropathy will regain motor function.

When to See a Healthcare Provider

If you suspect you have shingles, you should see a healthcare provider right away—within three days of finding the rash. You can then begin appropriate treatment that will help to relieve your symptoms, speed your recovery, and lower your risk of complications. This is especially important if you:

  • Are over age 60
  • Have a condition that has caused you to have a weakened immune system, such as HIV
  • Take medication that may diminish your body's immune response (e.g. chemotherapy drugs, steroids, or immunosuppressants after an organ transplant)
  • Share a home with someone who has a weakened immune system
  • Have a rash on your face. Blisters near your eye could lead to serious eye damage or even cause you to lose sight in that eye.

Shingles Doctor Discussion Guide

Get our printable guide for your next doctor's appointment to help you ask the right questions.

Doctor Discussion Guide Old Man

If while you're dealing with shingles you experience any of the following, let your healthcare provider know right away if:

  • The rash shows signs of infection, such as swelling or pus.
  • Your pain continues or you feel unwell even after the rash clears.

Also, contact your provider if you begin to have symptoms of a secondary infection, such as a very high fever, chills, and severe headache.​

Your healthcare provider will help you determine the right treatment for you. This may include antiviral drugs, antidepressant medications, and pain medications.

Summary

Shingles (herpes zoster) infections can occur many years after exposure to the varicella virus that causes chicken pox. The first symptoms of what shingles feels like include fever, headache, and an upset stomach common to many types of infection. You also may experience pain at a specific site on your body.

The pain can be significant. People often describe it as sharp, stabbing, or burning. A rash typically follows and lasts for three to five days. Symptoms overall may last two to four weeks, but pain may last longer. Complications can occur as well, some of them serious.

It's important to see a healthcare provider right away if you suspect shingles and its symptoms. And consider the highly effective Shingrix vaccine to prevent shingles in people over 50.

Frequently Asked Questions

  • Will shingles go away if left untreated?

    It can, but there's a risk of developing severe pain without treatment. It's important to see your healthcare provider within three days of developing a rash. Early treatment with antiviral medicine can help the rash heal faster and prevent severe pain.

  • What is the most common early treatment for shingles?

    Antiviral medications can help prevent severe pain and shorten the length of the illness. These include acyclovir, valacyclovir, and famciclovir.

26 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Centers for Disease Control and Prevention. Shingles (Herpes Zoster) Signs & Symptoms

  2. John AR, Canaday DH. Herpes Zoster in the Older Adult. Infect Dis Clin North Am. 2017;31(4):811-826. doi: 10.1016/j.idc.2017.07.016

  3. Centers for Disease Control and Prevention. Signs and Symptoms.

  4. Yun H, Xie F, Baddley JW, Winthrop K, Saag KG, Curtis JR. Longterm Effectiveness of Herpes Zoster Vaccine among Patients with Autoimmune and Inflammatory Diseases. J Rheumatol. 2017;44(7):1083-1087. doi: 10.3899/jrheum.160685

  5. U.S. National Library of Medicine. MedlinePlus. Neuralgia.

  6. Cohen KR, Salbu RL, Frank J, Israel I. Presentation and Management of Herpes Zoster (Shingles) in the Geriatric Population. P T. 2013;38(4): 217-224, 227.

  7. Galetta KM, Gilden D. Zeroing in on zoster: A tale of many disorders produced by one virus. J Neurol Sci. 2015;358(1-2):38-45. doi: 10.1016/j.jns.2015.10.004

  8. Harvard Health Publishing. Shingles: What triggers this painful, burning rash?

  9. Poloni A, Cossu MV, Antinori S. A HIV-positive subject with dermatomal and generalized vesicular skin lesions. Eur J Intern Med. 2022 Aug;102:112-113. doi:10.1016/j.ejim.2022.05.011.

  10. National Health Service Scotland. Shingles.

  11. Mallick-searle T, Snodgrass B, Brant JM. Postherpetic neuralgia: epidemiology, pathophysiology, and pain management pharmacology. J Multidiscip Healthc. 2016;9:447-454. doi: 10.2147/JMDH.S106340

  12. Centers for Disease Control and Prevention. Complications of Shingles.

  13. Aggarwal A, Suresh V, Gupta B, Sonthalia S. Post-herpetic Neuralgia: A Systematic Review of Current Interventional Pain Management Strategies. J Cutan Aesthet Surg. 2020 Oct-Dec;13(4):265-274. doi:10.4103/JCAS.JCAS_45_20. 

  14. Centers for Disease Control and Prevention. Clinical Overview of Shingles (Herpes Zoster).

  15. Pereira LB. Impetigo - review. An Bras Dermatol. 2014;89(2):293-9. doi: 10.1590/abd1806-4841.20142283

  16. American Academy of Dermatology. Cellulitis: Overview.

  17.  American Academy of Ophthalmology. Herpes zoster ophthalmicus.

  18. Jeon Y, Lee H. Ramsay Hunt syndrome. J Dent Anesth Pain Med. 2018;18(6):333-337. doi: 10.17245/jdapm.2018.18.6.333

  19. Kim SH, Choi SM, Kim BC, et al. Risk Factors for Aseptic Meningitis in Herpes Zoster Patients. Ann Dermatol. 2017;29(3):283-287. doi: 10.5021/ad.2017.29.3.283

  20. Alvarez JC, Alvarez J, Tinoco J, Mellado P, Miranda H, Ferrés M, et al. Varicella-Zoster Virus Meningitis and Encephalitis: An Understated Cause of Central Nervous System Infections. Cureus. 2020 Nov 20;12(11):e11583. doi:10.7759/cureus.

  21. Saxena A, Khiangte B, Tiewsoh I, Jajoo UN. Herpes zoster encephalitis presenting as multiple cerebral hemorrhages - a rare presentation: a case report. J Med Case Rep. 2013;7:155. doi: 10.1186/1752-1947-7-155

  22. Teo HK, Chawla M, Kaushik M. A Rare Complication of Herpes Zoster: Segmental Zoster Paresis. Case Rep Med. 2016;2016:7827140. doi: 10.1155/2016/7827140

  23. American Academy of Dermatology. Shingles: Diagnosis and Treatment.

  24. American Academy of Dermatology. Shingles Tips for Managing.

  25. National Institute on Aging. Shingles.

  26. Centers for Disease Control and Prevention. Treating shingles.

Additional Reading

By James Myhre & Dennis Sifris, MD
Dennis Sifris, MD, is an HIV specialist and Medical Director of LifeSense Disease Management. James Myhre is an American journalist and HIV educator.