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If you or anyone you know has shingles, it’s probably the first question you asked: Is shingles contagious? The answer is: sort of.
In fact, the virus that causes shingles is contagious. In some cases, it can pass from person to person. For that reason, people who have shingles need to take steps to protect other people from the virus.
But while the shingles virus is contagious, someone who catches it won’t develop shingles. At least, not right away.
Confused? Let’s try to clear things up.
What is shingles?
Shingles is a viral infection that tends to cause a blistery, painful rash. The medical term for shingles is herpes zoster. It’s caused by the varicella-zoster virus (VZV). That’s the same virus that causes chickenpox. When you’re exposed to varicella-zoster for the first time, it doesn’t give you shingles. Instead, it gives you chickenpox (Nair, 2021).
Once you’ve had chickenpox, VZV can live quietly inside your body for years or decades. After a period of inactivity, the virus can flare up again. The result is shingles (CDC-a, 2019).
How does shingles spread?
If you have shingles, you’re capable of spreading the varicella-zoster virus to other people. But not everyone is at risk.
If the people you’re around have already had varicella-zoster, or if they’re vaccinated against that virus, they can’t catch it from you. On the other hand, if you’re with people who aren’t vaccinated and have never had chickenpox—such as young children—you can infect them with your virus (Viner, 2012).
How to prevent shingles from spreading
If you have shingles, the virus is most likely to spread from you to other people if they come into direct contact with the fluid in your blisters. You cannot spread the virus before your blisters appear or after they scab over (Albrecht, 2021).
Side effects of acyclovir: a treatment for herpes
It’s also possible that someone could catch the virus by inhaling aerosols released by the fluid in shingles blisters. By covering up your active shingles blisters, you help shut off all these transmission routes (CDC-a, 2019). The best way to cover your blisters is with a new, non-stick bandage. Be sure to wash your hands very well after bandaging (or touching) your blisters (AAD, n.d.).
People with chickenpox are much more contagious than people with shingles. If they spread the virus, anyone who catches it may be at risk for shingles later in life. If you have chickenpox, you’re contagious until you’ve gone 24 hours without developing new chickenpox blisters (CDC-c, 2021).
The symptoms of shingles
The main symptom of shingles is a painful rash. That rash often takes the form of a single band of blisters that appear on one side of your body or face, although it can also be more widespread (Schmader, 2018).
Before your rash is visible, you may feel burning pain, itching, or tingling on or around the area of skin where your blisters will show up (NINDS, 2019). Other symptoms of shingles are headaches, chills, fatigue, an upset stomach, and other fever-like symptoms (CDC-b, 2019).
Once your rash starts to appear, it often takes the form of two or three crops of blisters—again, arranged in a kind of strip or band—that are fully formed within three to five days. Those blisters can be very painful. They will usually break open, leak fluid, and then crust over. This phase usually lasts two-to-four weeks. The shingles rash and blisters typically heal and disappear—along with all their other symptoms—within three to five weeks (NINDS, 2019).
If new lesions are still showing up more than a week after their initial appearance, that may be a sign that your immune system isn’t working right (Dworkin, 2007).
Risk factors for shingles
If you’ve had chickenpox, you’re at high risk for shingles. More than 99% of Americans born before 1980 have had chickenpox, and about 1 in 3 Americans will develop shingles (Harpaz, 2008). Shingles is much more common among older adults—those aged 65 and older—than among younger people (Nair, 2021).
People who have a weak immune system are also at greater risk for shingles. This includes people who have HIV, those who have undergone an organ transplant, and those who are receiving chemotherapy (NINDS, 2019).
Side effects and complications of shingles
Roughly 10 to 15 percent of people who have shingles will develop a chronic condition called postherpetic neuralgia. The older you are, the greater your risk for this complication (Drolet, 2010).
Shingles: symptoms, causes, treatment
For people with postherpetic neuralgia, shingles pain lingers around the site of the skin rash. That pain is often cutting or burning, and it continues for three months or longer after the rash has gone away. Experts aren’t sure why some people with shingles develop postherpetic neuralgia. Out-of-control inflammation may be the cause (Gruver, 2020).
Some other shingles complications include (Nair, 2021) (CDC-e, 2019):
- Scarring at the site of the blisters
- A secondary bacterial infection
- Nerve problems or numbness
- Brain inflammation caused by infection (encephalitis)
- Hearing problems or vision loss
How to prevent shingles
If you’ve had chickenpox, there’s a vaccine that can lower your risk for shingles. This vaccine is called Shingrix. The CDC recommends that healthy people 50 and older get the shingles vaccine. Even if you’ve already had shingles, the vaccine can prevent you from getting it again (CDC-f, 2018).
If you’ve never had chickenpox, there’s a vaccine for that illness too. The CDC recommends it for anyone—kids or adults—who have never had chickenpox. If you’re vaccinated against chickenpox, you’re also greatly protected from shingles (CDC-g, 2021).
To sum all this up, shingles is caused by a contagious virus. But there are steps you and others can take to stop the virus’s spread or protect yourself from shingles.
- Albrecht, M, & Levin, M. (2021). Vaccinations for the prevention of shingles (herpes zoster). In UpToDate. Hirsch, M., and Mitty, J. (Eds.) Retrieved on July 15, 2021 from https://www.uptodate.com/contents/vaccination-for-the-prevention-of-shingles-herpes-zoster
- American Academy of Dermatology (AAD). (n.d.) Shingles: tips for managing. American Academy of Dermatology. Retrieved July 14, 2021 from https://www.aad.org/public/diseases/a-z/shingles-self-care
- Centers for Disease Control and Prevention (CDC)-a. (2019). Shingles (herpes zoster): transmission. Centers for Disease Control and Prevention. Retrieved July 14, 2021 from https://www.cdc.gov/shingles/about/transmission.html
- Centers for Disease Control and Prevention (CDC)-b. (2019). Shingles (herpes zoster): signs & symptoms. Centers for Disease Control and Prevention. Retrieved July 14, 2021 from https://www.cdc.gov/shingles/about/symptoms.html
- Centers for Disease Control and Prevention (CDC)-c. (2021). Chickenpox (varicella): transmission. Centers for Disease Control and Prevention. Retrieved July 14, 2021 from https://www.cdc.gov/chickenpox/about/transmission.html
- Centers for Disease Control and Prevention (CDC)-d. (2019). Shingles (herpes zoster): about shingles (herpes zoster). Centers for Disease Control and Prevention. Retrieved July 14, 2021 from https://www.cdc.gov/shingles/about/index.html
- Centers for Disease Control and Prevention (CDC)-e. (2019). Shingles (herpes zoster): complications of shingles. Centers for Disease Control and Prevention. Retrieved July 14, 2021 from https://www.cdc.gov/shingles/about/complications.html
- Centers for Disease Control and Prevention (CDC)-f. (2018). Vaccines and preventable diseases: shingles vaccination. Centers for Disease Control and Prevention. Retrieved July 14, 2021 from https://www.cdc.gov/vaccines/vpd/shingles/public/shingrix/index.html
- Centers for Disease Control and Prevention (CDC)-g. (2021). Chickenpox (varicella): vaccination. Centers for Disease Control and Prevention. Retrieved July 14, 2021 from https://www.cdc.gov/chickenpox/vaccination.html
- Drolet, M., Brisson, M., Levin, M. J., Schmader, K. E., Oxman, M. N., Johnson, R. W., et al. (2010). A prospective study of the herpes zoster severity of illness. The Clinical Journal of Pain, 26(8), 656–666. doi: 10.1097/AJP.0b013e3181eef686. Retrieved from https://pubmed.ncbi.nlm.nih.gov/20842005/
- Dworkin, R. H., Johnson, R. W., Breuer, J., Gnann, J. W., Levin, M. J., Backonja, M., et al. (2007). Recommendations for the management of herpes zoster. Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America, 44 Suppl 1, S1–S26. doi: 10.1086/510206. Retrieved from https://pubmed.ncbi.nlm.nih.gov/17143845/
- Gruver, C., & Guthmiller, K. B. (2020). Postherpetic neuralgia. In StatPearls [Internet]. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK493198/
- Harpaz, R., Ortega-Sanchez, I. R., Seward, J. F., & Advisory Committee on Immunization Practices (ACIP) Centers for Disease Control and Prevention (CDC) (2008). Prevention of herpes zoster: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR. Recommendations and Reports: Morbidity and Mortality Weekly Report 57(RR-5), 1–CE4. Retrieved from https://pubmed.ncbi.nlm.nih.gov/18528318/
- Nair, P. A., & Patel, B. C. (2021). Herpes zoster. In StatPearls. StatPearls Publishing. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK441824/.
- National Institute of Neurological Disorders and Stroke (NINDS). (2019) Shingles information page. National Institute of Neurological Disorders and Stroke. Retrieved July 14, 2021 from https://www.ninds.nih.gov/Disorders/All-Disorders/Shingles-Information-Page
- Schmader K. (2018). Herpes zoster. Annals of Internal Medicine, 169(3), ITC19–ITC31. doi: 10.7326/AITC201808070. Retrieved from https://pubmed.ncbi.nlm.nih.gov/30083718/
- Viner, K., Perella, D., Lopez, A., Bialek, S., Newbern, C., Pierre, R., et al. (2012). Transmission of varicella zoster virus from individuals with herpes zoster or varicella in school and day care settings. The Journal of Infectious Diseases, 205(9), 1336–1341. doi: 10.1093/infdis/jis207. Retrieved from https://pubmed.ncbi.nlm.nih.gov/22454467/
Felix Gussone is a physician, health journalist and a Manager, Medical Content & Education at Ro.