Last updated: October 2026
Shingles is a painful rash caused by the chickenpox virus reactivating, usually on one side of the body. It often starts with tingling or burning skin. You can’t catch shingles, but someone who hasn’t had chickenpox can catch chickenpox from the blisters. See a pharmacist within 3 days, and check if you can get the NHS vaccine.
Below: the first signs, how you get it, whether it’s contagious, how long it lasts, what helps and who can get the NHS vaccine from autumn 2026.
The 3-day rule: antiviral medicine works best started within 3 days of the rash appearing, and a pharmacist can give it if you’re 18 or over. If the rash is near your eye or on your nose, get urgent help the same day.
What does the start of shingles look like?
At first, shingles often doesn’t look like anything. The NHS lists these early signs:
- A tingling or painful feeling in one patch of skin. It can burn, stab, throb, itch or feel numb, a bit like pins and needles that stays in one area on one side.
- A headache or feeling generally unwell. NICE says around 1 in 5 people also have a temperature, headache or tiredness.
This stage usually lasts 2 to 3 days, sometimes a week or more. Because the pain comes first, early shingles on the chest or back is easily mistaken for a pulled muscle or upper back pain.
What the shingles rash looks like
The rash is most often on the chest and tummy, but can appear anywhere, including the face, eyes and genitals. The key clue: it’s on one side of the body only, often in a band that follows one nerve. The NHS says a rash on both sides is unlikely to be shingles.
| Stage | What you’ll notice | Typical timing |
|---|---|---|
| Before the rash | Tingling, burning or pain in one area; headache or feeling unwell | Usually 2 to 3 days, sometimes 7 or more |
| Early rash | Blotches or small raised spots in a band on one side | Day 1 of the rash |
| Blisters | Spots turn into itchy, fluid-filled blisters; new ones keep appearing for a few days | Within 1 to 2 days, new blisters for 3 to 4 days |
| Crusting | Blisters dry out and scab over | Around 7 to 10 days after the rash starts |
| Healing | Scabs fall off; skin may stay painful, marked or a different colour | 2 to 4 weeks in total |
On brown and black skin, redness can be harder to see; look for a cluster of blisters on one side. In older people, NICE notes the rash may not blister at all, and with a weakened immune system it can be more severe or widespread.
Is it shingles or something else?
A few common rashes can look like shingles early on. A pharmacist or GP can usually tell by looking.
| Rash | Typical clues | Read more |
|---|---|---|
| Shingles | Pain or tingling first, then blisters in a band on one side only; blisters scab over | This guide |
| Chickenpox | An itchy, spotty rash that can be anywhere on the body, often with a high temperature and feeling unwell; mostly affects children | See Sources |
| Cold sores | Tingling, then small fluid-filled blisters on the face, usually around the lips; heal within about 10 days | Cold sores |
| Hives | Raised, itchy bumps or patches in many shapes and sizes, in one area or across the body | Hives |
| Eczema | Itchy, dry, cracked or scaly skin, common on the elbows, knees and hands, coming and going in flare-ups | Eczema |
Cold sores and shingles both come from herpes viruses, which is why both start with tingling, but they’re different viruses: herpes simplex and varicella zoster.
How do you get shingles?
You don’t catch shingles from anyone. After chickenpox, usually in childhood, the virus stays dormant in your nerve cells for life. Decades later it can wake up and travel down one nerve to the skin, which is why the rash follows a band on one side.
UK vaccine guidance estimates the lifetime risk of shingles at about 1 in 4. Things that make it more likely include:
- Getting older. Both the risk and severity rise with age.
- A weakened immune system, for example from chemotherapy, HIV, some blood cancers, a transplant or long-term steroids.
- Some long-term conditions, including rheumatoid arthritis, lupus, diabetes and asthma.
- Stress. The NHS lists stress as one trigger. The research is mixed: a 2020 meta-analysis linked psychological stress to a modestly higher risk, but a large UK and Danish study found no consistent rise after losing a partner. See stress symptoms.
Many people who get shingles are otherwise healthy, and you can get it more than once.
Is shingles contagious?
Not in the way most people think. You cannot catch shingles from someone with shingles or chickenpox. But the blisters contain the chickenpox virus, so someone who has never had chickenpox (or the vaccine) can catch chickenpox from you.
How is shingles spread?
Through the fluid in the blisters. The NHS says you can only spread it while the rash is oozing. Once the blisters have dried and scabbed, you’re no longer infectious, and you aren’t infectious in the tingling stage before the rash.
Can you catch chickenpox from shingles?
Yes, if you’ve never had chickenpox or the chickenpox vaccine. Children are now offered the MMRV vaccine on the NHS, which protects against chickenpox.
While your rash is weeping, try to avoid:
- anyone who is pregnant and hasn’t had chickenpox
- people with a weakened immune system, such as someone having chemotherapy
- babies less than 1 month old
Should you stay off work or school?
The NHS says stay off if the rash is oozing and can’t be covered, until it has dried out. Loose clothing or a non-stick dressing can cover it. As chickenpox also spreads from things with blister fluid on them, don’t share towels until the blisters have crusted.
Can you have shingles without a rash?
Yes, but it’s rare. The NHS and NICE both say shingles can occasionally cause pain without a rash. Doctors call this zoster sine herpete, which simply means “shingles without the rash”.
You get the same one-sided burning or stabbing nerve pain, but no blisters. A 2020 review notes this makes it hard to diagnose, and most evidence comes from case reports; tests for the virus can help. If you have new, unexplained one-sided pain, see a GP rather than waiting for a rash.
How long does shingles last?
Usually 2 to 4 weeks. The NHS says the rash can take up to 4 weeks to heal, and the skin can stay painful for weeks afterwards, usually improving over time. If you feel run down for longer, see why am I always tired?
Post-herpetic neuralgia: when the pain lasts
The most common complication is post-herpetic neuralgia (PHN): nerve pain lasting more than 90 days after the rash started. On average it lasts 3 to 6 months, and can be set off by light touch or even wind on the face. It becomes much more likely with age (UK estimates from before the vaccine):
| Age | Chance of pain lasting over 90 days |
|---|---|
| 60 to 64 | 9% |
| 65 to 69 | 11% |
| 70 to 74 | 15% |
| 75 to 79 | 20% |
| 80 to 84 | 27% |
| 85 and over | 52% |
Other complications include infection of the rash, scarring, muscle weakness, eye problems and Ramsay Hunt syndrome (facial weakness). Prompt treatment lowers the risk.
What helps shingles
Antiviral medicine: the first 3 days matter
If you’re 18 or over, the NHS advises seeing a pharmacist within 3 days of the rash appearing; in England they can give the same antivirals as a GP. The antivirals used in the UK are aciclovir, valaciclovir and famciclovir.
A mild rash may need no treatment. Antivirals may be offered if you have a weakened immune system, moderate or severe pain or rash, or a rash beyond your chest, tummy and back. You may also be offered painkillers, steroid tablets or nerve pain medicines. If you take other medicines, tell the pharmacist or GP.
Things you can do at home
The NHS recommends:
- taking paracetamol for the pain
- keeping the rash clean and dry to lower the risk of infection
- wearing loose-fitting clothing
- using a cool compress a few times a day, such as a wet cloth, or ice cubes or frozen vegetables wrapped in a towel
And avoiding:
- dressings or plasters that stick to the rash
- clothes with rough fibres that rub and irritate the skin
Shingles pain can disturb sleep; see sleep deprivation for ways to recover. No diet or supplement treats shingles; see how to support your immune system for what the evidence says.
Who can get the NHS shingles vaccine?
The NHS uses a vaccine called Shingrix, given as 2 injections. It isn’t a live vaccine. In England it’s offered free to:
- People who turned 65 on or after 1 September 2023. You become eligible on your 65th birthday.
- Everyone aged 70 to 79. If you turned 65 before 1 September 2023, you become eligible when you turn 70.
- People aged 18 and over with a severely weakened immune system, with no upper age limit.
Age-based eligibility lasts until your 80th birthday (second dose up to your 81st).
| Your situation (England) | Can you get it? | Doses |
|---|---|---|
| Turned 65 on or after 1 September 2023 | Yes, until your 80th birthday | 2 doses, 6 to 12 months apart |
| Under 70 and turned 65 before 1 September 2023 | Not yet: you’ll be offered it at 70 | 2 doses, 6 to 12 months apart |
| Aged 70 to 79 | Yes, until your 80th birthday | 2 doses, 6 to 12 months apart |
| 18 or over with a severely weakened immune system | Yes, at any age | 2 doses, 8 weeks to 6 months apart |
| Aged 80 or over | Only if you have a severely weakened immune system, or to finish a course before your 81st birthday | As above |
Who becomes eligible in autumn 2026?
According to the UKHSA eligibility chart, from 1 September 2026 the new groups are people born 1 September 1961 to 31 August 1962 (turning 65) and 1 September 1956 to 31 August 1957 (turning 70).
Is the shingles vaccine age changing to 60?
Gradually. The UKHSA chart shows people turning 60 and 65 being offered it from 1 September 2028, with routine vaccination at 60 from 2033. NHS England calls the 2028 stage subject to confirmation, so nothing changes for people in their early 60s yet.
A severely weakened immune system includes some people with blood cancer or HIV, some people after a stem cell or organ transplant, chemotherapy or radiotherapy, and people on certain immune-suppressing medicines. If unsure, ask your GP or specialist team.
How to get it and what to expect
- Your GP surgery should contact you. If you think you’re eligible and haven’t heard, contact them.
- Still have it if you’ve had shingles before, once your symptoms have gone.
- It can usually be given with the flu, COVID-19 and pneumococcal vaccines (see flu jab side effects).
- Side effects are usually mild and settle in 2 or 3 days: a sore arm, headache, aching, tiredness, a temperature or shivering.
- Only people who’ve had anaphylaxis to a previous dose or an ingredient can’t have it.
In trials, two doses cut the risk of shingles by 97% in adults aged 50 and over, with protection still high 11 years on. A 2025 study of Welsh health records also linked the older shingles vaccine to fewer dementia diagnoses, though the NHS offers it to prevent shingles.
Scotland, Wales and Northern Ireland run their own programmes (in Scotland the doses are 2 to 6 months apart), so check with your GP surgery.
Shingles in pregnancy
The NHS says shingles in pregnancy is mostly mild, with usually no risk to you or your baby. But ask for an urgent GP appointment or call 111, and tell your midwife; a specialist should advise on treatment. If you’re pregnant, have never had chickenpox and have been near someone with shingles or chickenpox, speak to your GP or midwife promptly, as protective treatment is available after an exposure.
When to get urgent help
Ask for an urgent GP appointment or get help from NHS 111 if you have symptoms of shingles and:
- the rash is on or around your eye, or on your nose (including the tip)
- you have any changes to your vision
- you’re pregnant
- you’re breastfeeding and the rash is on your breasts
- you have a severely weakened immune system, for example from chemotherapy
- you’re 17 or younger
Shingles near the eye (10% to 20% of cases) can damage sight, so get help the same day. Facial weakness or hearing changes also need prompt advice. Call 999 if someone with shingles is very drowsy, confused, struggling to breathe or has a fit; rarely, the virus spreads to the lungs or brain.
Most people recover without problems. For looking after yourself through the colder months, see our winter wellness guide.
FAQs
What does the start of shingles look like?
It often starts with tingling, burning or pain in one patch of skin, sometimes with a headache. A few days later a rash appears on one side of the body and turns into itchy blisters that scab over.
Is shingles contagious?
You cannot catch shingles from someone, but a person who has never had chickenpox can catch chickenpox from the blister fluid. You’re only infectious while the rash is oozing.
Can you catch chickenpox from shingles?
Yes, if you have never had chickenpox or the vaccine. Until the blisters crust, avoid pregnant people who haven’t had chickenpox, people with weakened immune systems and babies under 1 month.
Can you have shingles without a rash?
Rarely. Zoster sine herpete is one-sided nerve pain without blisters. See a GP if you have new, unexplained one-sided burning pain.
How long does shingles last?
Usually 2 to 4 weeks. Pain lasting more than 90 days is called post-herpetic neuralgia and is more common in older people.
Who can get the shingles vaccine on the NHS?
In England: people who turned 65 on or after 1 September 2023, everyone aged 70 to 79, and people 18 and over with a severely weakened immune system.
Can you get shingles more than once?
Yes, which is why the NHS advises the vaccine even if you have had shingles before.
Sources
- NHS. Shingles.
- NHS. Shingles vaccine.
- NHS. Chickenpox.
- UKHSA. Shingles (herpes zoster): the Green Book, chapter 28a (updated August 2025).
- UKHSA. Eligibility for shingles vaccine (chart), September 2025.
- NHS England. General practice shingles vaccination programme: technical guidance.
- NICE Clinical Knowledge Summaries. Shingles (revised January 2026).
- Marra F, et al. Risk factors for herpes zoster infection: a meta-analysis. Open Forum Infect Dis, 2020. PMID 32010734.
- Schmidt SAJ, et al. Partner bereavement and risk of herpes zoster. Clin Infect Dis, 2017. PMID 27986685.
- Zhou J, et al. Zoster sine herpete: a review. Korean J Pain, 2020. PMID 32606265.
- Lal H, et al. Efficacy of an adjuvanted herpes zoster subunit vaccine in older adults. N Engl J Med, 2015. PMID 25916341.
- Strezova A, et al. Final analysis of the ZOE-LTFU trial to 11 years post-vaccination. eClinicalMedicine, 2025. PMID 40630610.
- Eyting M, et al. A natural experiment on the effect of herpes zoster vaccination on dementia. Nature, 2025. PMID 40175543.
This guide is general information, not medical advice. If you think you have shingles, speak to a pharmacist, your GP or NHS 111.
