From the moment you experience the first symptoms of shingles—a skin-tingling sensation followed by a rash on one side of your body—you’ll want to know: How long does shingles last?
Shingles is caused by the varicella-zoster virus, also known as the herpes zoster virus. It’s the same viral infection that causes chicken pox in children—if you had that malady as a kid, you’re at risk for a case of shingles, most common in older adults.
“After the initial infection, varicella-zoster virus remains in nerve cells and can later reemerge, traveling along the nerves to the skin, where it causes a painful rash and blisters,” explains board-certified dermatologist Shoshana Marmon, MD, PhD, FAAD, an assistant professor in the department of dermatology at New York Medical College.
Here’s everything you need to know about how the chickenpox virus can reactivate years later as a shingles rash, how long shingles pain will last, and how complications of shingles infection might prolong your symptoms. Plus, what to know about the shingles vaccine.
Who is at risk for shingles?
To be at risk for shingles, you have to have been previously infected with the chicken pox virus. Aging, illness, stress, and certain immunosuppressing medical treatments can cause the virus to reactivate. For these reasons, shingles is most common in adults over 50 but younger adults can find themselves facing a shingles outbreak, particularly after a period of stress or another illness.
People with a weakened immune system are also at risk for reactivation of the virus. “This includes people with diseases such as rheumatoid arthritis, ulcerative colitis, and eczema and who those are on immunomodulatory medication,” says Elisabeth J. Cohen, MD, professor in the Department of Ophthalmology and vice chair for academic affairs at NYU Grossman School of Medicine.
What are the symptoms of shingles?
The herpes zoster virus can lay dormant in nerve cells for decades. When it reactivates, it spreads down the nerve pathway where it causes skin sensitivity, nerve pain, itching, or an “electric sensation,” according to the American Academy of Dermatology Association.
Next, a painful rash develops with fluid-filled blisters in the area of skin connected to the infected nerve. You may also develop a fever, headache, chills, or upset stomach, according to the Centers for Disease Control and Prevention. (Though these systemic symptoms are less common in otherwise healthy individuals, Dr. Marmon says.)
Typically, the rash appears on just one side of the body—usually in a stripe on the torso. A shingles rash can also show up on the head, neck, and face where it can cause a complication called herpes zoster opthalmicus (HZO), characterized by vision problems, and potentially vision loss. HZO occurs in “about 8 percent of the more than 1 million new shingles cases in the United States each year,” says Dr. Cohen. If you develop a rash near your eye or experience any vision problems, you should contact a specialist immediately to see if you are a candidate for antiviral treatment. “HZO is also a risk factor for potentially life-threatening strokes and other serious neurological complications,” says Dr. Cohen.
Other complications of shingles include bacterial infection and long-term nerve pain, or postherpetic neuralgia (PHN). PHN is relatively rare, according to the CDC—it affects between 10% and 18% of adults with shingles and the risk increases with age—but can be quite serious, according to Dr. Cohen. “It’s a chronic debilitating pain condition that has a very negative impact on quality of life, especially in people over age 65.”
How long does shingles last?
So, how long does shingles last? The virus will run its course in about 3-5 weeks, according to the National Institute on Aging.
One to five days after you first notice the tingling or burning sensation, the oozing rash appears. After that, it takes a week to 10 days for the fluid-filled blisters to scab over. It will likely take another week to two weeks for the scabs to disappear completely.
Nerve pain caused by postherpetic neuralgia may last longer, notes Dr. Marmon.
If you experience a rash on your face or neck, severe pain, a widespread rash, or if you are immunocompromised, ask your healthcare provider for a referral to the appropriate specialist, such as a dermatologist or ophthalmologist.
Should I get the shingles vaccine?
Yes. Shingles rates are on the rise, particularly in people in their 50s. “We are seeing a decrease in shingles in the age groups older than 60, and we believe it is due to higher vaccination rates in those groups,” Dr. Cohen says.
The CDC recommends two doses of a recombinant zoster vaccine (RZV), also known as the Shingrix vaccine, for adults 50 and older. “Those with a weakened immune system should get vaccinated starting at age 19,” says Dr. Cohen.
Getting the vaccine will not only lower your risk of developing ongoing complications like PHN, it may protect against other neurological side effects. “There are recent preliminary publications that report that shingles may be associated with cognitive decline, and vaccination against shingles may be protective,” says Dr. Cohen.
What if I’ve already had shingles?
The Shingrix vaccine recommendation applies to everyone—even if you’ve already had shingles or the chickenpox vaccine. (Or the older zostavax vaccine.)
If you contract a case of shingles, it will give you natural immunity to ward off reinfection—but not forever. “Immunity after infection lasts for decades but weakens with age, increasing the risk of reactivation,” says Dr. Marmon.
Ask your healthcare professional about the best time to get vaccinated after a case of shingles. You’re eligible for the vaccine following infection as soon as the shingles rash clears, according to the CDC.
