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What Is Shingles Disease?

Shingles, also known as herpes zoster, is a viral infection that occurs when the varicella-zoster virus, the same virus responsible for chickenpox (varicella), reactivates in the body. After recovering from chickenpox, the virus remains dormant in the nervous system and can resurface years later as shingles1.
This reactivation is more common with age, as the immune system naturally weakens over time. Therefore, older adults are at a higher risk of developing shingles 2,3.

Symptoms of Shingles

Shingles typically causes a painful rash that forms blisters in a stripe along one side of the body, following a nerve path. This rash can appear on the torso, arms, thighs, or head, including sensitive areas like the eyes or ears3. The pain associated with shingles is often described as burning, stabbing, or shock-like4#. The pain can also interfere with daily activities or even sleeping5#.

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Electric shocks

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Piercing nails

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Boiling water burns

How Painful is Shingles?26

Painful Gif

Increased Risk of Shingles with Other Diseases

Diabetes

Diabetes

Diabetes affects blood sugar levels and weakens the immune system, increasing the risk of infections9,10. People with diabetes are more likely to develop shingles compared to those without the condition11.

Cancer

Cancer

People with cancer are almost twice as likely to get shingles6, especially those with blood-related cancers7. Some cancer treatments, like chemotherapy, radiation, and high-dose steroids, can also weaken the immune system, making it easier for the virus to reactivate8.

Asthma/COPD

Asthma/COPD

Research shows that people with asthma and COPD have a higher chance of getting shingles, compared to healthy individuals12.

Complications of Shingles

While most people recover fully from shingles, some may experience complications

Postherpetic Neuralgia (PHN)

Postherpetic Neuralgia (PHN)

PHN can affect up to 25% of people with herpes zoster, causing long-lasting nerve that can persist for months or even years13.

Eye Complications (Ophthalmic Disease)

Eye Complications (Ophthalmic Disease)

Herpes zoster ophthalmicus (HZO) can occur in 50% of people with shingles and affects the eye or nose. About 30% may develop double vision, while rare cases causing serious optic nerve damage14.

Neurological Issues

Neurological Issues

In some rare cases, shingles can lead to neurological problems like encephalitis (brain swelling), which occurs in about 1% of cases15.

Hearing and Balance Problems

Hearing and Balance Problems

In rare cases, shingles can affect the ear, causing herpes zoster oticus. This may lead to hearing loss, vertigo, tinnitus, facial pain, and even facial paralysis (Ramsay Hunt Syndrome). Balance issues can occur in up to 1% of cases16.

This is not a complete list of health complications that can occur after shingles. Consult a doctor for more details.

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Frequently Asked Questions

  • What Causes Shingles?

    Shingles disease is caused by the varicella-zoster virus, which also causes chickenpox. It remains dormant in the body and can reactivate years later 1, usually due to aging 2 or a weakened immune system 17,18, leading to a painful, blistering rash 1.

  • As people age, their immune system weakens, making it harder to keep the varicella-zoster virus inactive. This raises the risk of shingles in those aged 50 or older 2,17. Additionally, they are more likely to have complications like PHN 3.

  • You cannot catch shingles disease from someone who has it. However, if a person has never had chickenpox or the vaccination, the varicella-zoster virus can spread to them, causing chickenpox 19.

  • Shingles usually causes a painful rash that appears on one side of the body or face. It begins as red patches, then forms fluid-filled blisters that scab over within 7-10 days. The rash typically clears up within 2 to 4 weeks 20.

  • Yes, chronic stress can increase your risk of shingles 21. Long-term stress weakens the immune system 22, making it harder to keep the varicella-zoster virus inactive, which can lead to reactivation 21. Consult your doctor for more information

  • What Are the Best Ways to Help Prevent Shingles?

    The shingles vaccination is the best way to protect yourself, as it is over 90% effective in preventing herpes zoster and PHN in adults over 50 with a healthy immune system 23.

    Other precautions include avoiding contact with people who have chickenpox or shingles, especially if you haven’t had chickenpox or the vaccination. Practicing good hand and cough hygiene also helps reduce the risk 19.

    Talk to your doctor for more information on shingles and its prevention.

  • How Does Vaccination Help Prevent Shingles Disease?

    The shingles vaccination strengthens your immune system, helping it fight the shingles virus and prevent it from reactivating 23.

  • Is Shingles Vaccination Safe?

    Yes, the shingles vaccination is safe and recommended for adults 50 and older. It may cause mild side effects like redness, swelling, or soreness that typically last 2-3 days. Consult your doctor if you have concerns 23.

  • How to Manage Shingles?

    Treatment can help reduce the severity and duration of shingles disease 24. If you think you have herpes zoster, see your doctor as soon as possible. They may prescribe medication to weaken the virus and relieve pain.

    Here are some tips to manage symptoms 25:

    • Keep the rash clean and dry to prevent infection
    • Wear loose-fitting clothing
    • Apply a cool compress a few times a day

References

#Individual patient symptoms of Shingles may vary. These statements are based on some patients’ descriptions of their shingles' pain and do not represent every patient’s experience.

  1.  Weaver BA. J Am Osteopath Assoc. 2009;109(6 Suppl 2):S2
  2. Harpaz R et al. MMWR Recomm Rep. 2008 Jun 6;57(RR-5):1-30.
  3. CDC. (2024, September 30). Clinical overview of shingles (herpes zoster). Shingles (Herpes Zoster). https://www.cdc.gov/shingles/hcp/clinical-overview/index.html
  4. eMedicineHealth; 2021; 1-69; Shingles Treatment, Causes, Pictures & Symptoms (REF-143781) #Individual patient symptoms of Shingles may vary. These statements are based on some patients’
    descriptions of their shingles' pain and do not represent every patient’s experience.
  5.  Johnson RW et Al. BMC Med. 2010;8(1):37. #Individual patient symptoms of Shingles may vary. These statements are based on some patients’ descriptions of their shingles' pain and do not represent every patient’s experience.
  6. Marra F et al. Open Forum Infect Dis. 2020;7:1-8.
  7. Qian J, Heywood AE, Karki S, et al. Risk of herpes zoster prior to and following cancer diagnosis and treatment: a population-based prospective cohort study. Journal of Infectious Diseases. 2019;220(1):3-11. doi:10.1093/infdis/jiy625
  8. The immune system and cancer. (2014, October 29). Cancer Research UK. https://www.cancerresearchuk.org/about-cancer/what-is-cancer/body-systems-and-cancer/the-immune-system-and-cancer
  9. Batram M, Witte J, Schwarz M, Hain J, et al. Burden of Herpes Zoster in Adult Patients with Underlying Conditions: Analysis of German Claims Data, 2007-2018. Dermatol Ther (Heidelb). 2021 Jun;11(3):1009-1026.
  10. Nair, P. A., & Patel, B. C. (2023). Herpes Zoster. StatPearls Publishing.
  11. Huang CT, et al. J Clin Endocrinol Metab. 2022 Jan 18;107(2):586-597.
  12. Safonova, E., Yawn, B. P., Welte, T., & Wang, C. (2023). Risk factors for herpes zoster: should people with asthma or COPD be vaccinated? Respiratory Research, 24(1), 35. https://doi.org/10.1186/s12931-022-02305-1
  13. Zoster vaccines for Australian adults. NCIRS.2022;1-17.
  14. Kedar S et al. Journal of Neuro-Opthalmology;2019;39;220-231.
  15. Espiritu R et al. Infectious Disease in Clinical Practice;2007;15;284-288.
  16. Crouch AE. NCBI Bookshelf;2022;1-12- Intro (p.1)
  17. Simon AK et al. Proc Biol Sci 2015;282:20143085.
  18. Al-Jabri M et al. Infect Dis Clin North Am. 2023;37(1):103-121.
  19. CDC. (2025, January 17). About shingles (herpes zoster). Shingles (Herpes Zoster). https://www.cdc.gov/shingles/about/index.html
  20. CDC. (2024a, May 14). Shingles symptoms and complications. Shingles (Herpes Zoster). https://www.cdc.gov/shingles/signs-symptoms/index.html
  21. Schmidt SAJ, et al. Br J Dermatol. 2021;185(1):130-138.
  22. Dhabhar, F. S. (2014). Effects of stress on immune function: the good, the bad, and the beautiful. Immunologic Research, 58(2–3), 193–210. https://doi.org/10.1007/s12026-014-8517-0
  23. CDC. (2024c, October 3). Shingles vaccination. Shingles (Herpes Zoster). https://www.cdc.gov/shingles/vaccines/index.html
  24. Shingles (herpes zoster). (n.d.). Who.int. Retrieved March 7, 2025, from https://www.who.int/news-room/fact-sheets/detail/shingles-(herpes-zoster)
  25. Shingles: Tips for managing. (n.d.). Aad.org. Retrieved March 7, 2025, from https://www.aad.org/public/diseases/a-z/shingles-self-care
  26. Lokeshwar MR;Indian pediatrics;2000;37;714-719
  27. Parikh, R., Spence, O., Giannelos, N., & Kaan, I. (2024). Herpes zoster recurrence: A narrative review of the literature. Dermatology and Therapy, 14(3), 569–592. https://doi.org/10.1007/s13555-024-01101-7