Shingles (Herpes Zoster): Symptoms, Causes, and Ways to Relieve the Itch

Originally published last August 31, 2025. Updated March 5, 2026.

Shingles, also known as herpes zoster, is a viral infection that affects the nerves and causes a painful skin rash. The rash usually appears on one side of the body or face and often forms a band or stripe of blisters.

Many people are surprised to learn that shingles is caused by the same virus that causes chickenpox, called the varicella-zoster virus. After someone recovers from chickenpox, the virus does not completely leave the body. Instead, it stays inactive in the nervous system and may reactivate years later.

Shingles can affect anyone who has had chickenpox. However, it is much more common in adults over 50 or people with weakened immune systems.

Although shingles cannot be completely cured, early treatment and proper skin care can reduce symptoms, shorten recovery time, and help prevent complications.

What Shingles Looks and Feels Like

Shingles typically begins with unusual skin sensations before the rash appears. Many people first notice pain, tingling, itching, or burning in a specific area of the body.

Within a few days, a rash develops. The rash often forms clusters of small fluid-filled blisters that follow the path of a nerve.

Early signs of shingles

Common early symptoms include:

• Burning, tingling, or itching on one side of the body

• Sensitivity or pain in a specific area of skin

• Headache

• Fever

• Fatigue

• Sensitivity to light

These symptoms may appear several days before the rash.

When the rash appears

The shingles rash usually develops in stages:

1. Red patches appear on the skin

2. Small blisters form and fill with fluid

3. Blisters break open and crust over

4. Scabs gradually heal over several weeks

The rash typically lasts 2 to 4 weeks.

Some people experience lingering nerve pain after the rash heals. This condition is called postherpetic neuralgia, and it can last for months in severe cases.

What Causes Shingles to Develop

Shingles occurs when the varicella-zoster virus reactivates inside the body.

After a person recovers from chickenpox, the virus remains dormant in nerve cells near the spinal cord and brain. For reasons that are not always clear, the virus can reactivate years later and travel along the nerves to the skin, causing the shingles rash.

Factors that increase the risk of shingles

Researchers believe the virus may reactivate more easily when the immune system is weakened. Risk factors include:

• Age over 50

• Stress or exhaustion

• Illness such as cold or flu

• Chronic health conditions

• Cancer treatments or immunosuppressive medications

For example, someone recovering from a stressful illness may notice pain on one side of their back or chest. A few days later, the classic blistering rash may appear.

Treatments That Help Manage Shingles Symptoms

While shingles has no permanent cure, medical treatment can greatly reduce discomfort and complications.

The sooner treatment begins, the better the outcome. Doctors often recommend starting medication within 72 hours of the first symptoms.

Antiviral medications

Antiviral drugs help stop the virus from multiplying and can shorten the duration of shingles.

Common antiviral medications include:

• Acyclovir (Zovirax)

• Famciclovir (Famvir)

• Valacyclovir (Valtrex)

These medications can also help reduce the risk of postherpetic neuralgia, especially when started early.

Pain relief options

Shingles pain can range from mild discomfort to severe nerve pain. Doctors may recommend:

• Over-the-counter pain relievers such as ibuprofen or acetaminophen

• Prescription pain medication for severe cases

• Cool compresses to calm irritated skin

Keeping the affected area clean and dry can also help prevent secondary infection.

Anti-itch relief for shingles rash

Itching is one of the most frustrating symptoms of shingles. Scratching can worsen irritation and may even damage healing skin.

A steroid-free anti-itch cream such as Dermeleve® can help calm irritated skin while protecting the skin barrier.

Dermeleve contains soothing ingredients such as:

• Shea butter

• Hyaluronic acid

• Vitamins C and E

• Ceramides

These ingredients help hydrate the skin, reduce itching, and support the natural healing process.

Using a steroid-free formula is often recommended for long-term skin comfort because prolonged use of topical corticosteroids may lead to unwanted side effects.

The Shingles Vaccine and Prevention

Vaccination is the most effective way to reduce the risk of shingles.

The CDC recommends the Shingrix vaccine for:

• Adults 50 years and older

• Adults 19 years and older with weakened immune systems

The vaccine is given in two doses.

Benefits of the shingles vaccine

Clinical studies show that Shingrix can:

• Reduce the risk of shingles by more than 90 percent

• Significantly lower the chance of developing postherpetic neuralgia

• Provide protection that lasts at least seven years

Even people who have had shingles before can benefit from vaccination because it helps prevent future outbreaks.

When to See a Doctor

Prompt medical care is important if shingles is suspected.

Contact a healthcare provider if you notice:

• Pain or burning followed by a rash on one side of the body

• Blisters near the eyes or face

• Severe pain or spreading rash

• Symptoms that do not improve within a few days

Early treatment with antiviral medication can speed healing and reduce complications.

Supporting the skin with soothing care, including a gentle anti-itch cream like Dermeleve®, can also help keep skin comfortable while the rash heals.

Most cases of shingles resolve within three to five weeks, and many people only experience it once. With the right treatment and preventive care, the discomfort and long-term effects can often be minimized.

Frequently Asked Questions About Shingles

How long does shingles usually last?

Most shingles cases last 3 to 5 weeks from the first symptoms to complete healing. The rash usually forms blisters within a few days, then crusts over and gradually clears. Some people may experience nerve pain after the rash heals, a condition known as postherpetic neuralgia.

What triggers shingles to reactivate?

Doctors do not always know exactly why the virus reactivates. However, shingles is more likely to develop when the immune system is weakened. Common triggers may include:

• Aging

• Stress

• Illness such as cold or flu

• Cancer treatments or immunosuppressing medications

• Chronic health conditions

Adults over 50 years old have the highest risk.

Can you get shingles more than once?

Yes. Although most people only develop shingles once, it is possible to have shingles more than once. This is why vaccination is recommended for adults over 50, even if they have already had shingles.

What helps relieve shingles itching?

Shingles itching can be intense and uncomfortable. Relief options include:

• Cool compresses

• Loose clothing to reduce irritation

• Over-the-counter pain relievers

• A steroid-free anti-itch cream like Dermeleve®

Keeping the skin moisturised and avoiding scratching can also help prevent further irritation or infection.

When should you see a doctor for shingles?

You should see a doctor as soon as shingles symptoms appear, especially if you notice:

• Pain followed by a rash on one side of the body

• Blisters near the eyes or face

• Severe pain or spreading rash

• Fever or worsening symptoms

Early treatment with antiviral medication can speed recovery and lower the risk of complications.

Medically reviewed by Dr. Neal Bhatia

Dr. Neal Bhatia is a board-certified dermatologist based in San Diego, California. He serves as the Director of Clinical Dermatology at Therapeutics Clinical Research and is the Chief Medical Editor for Practical Dermatology. Additionally, he is an Associate Clinical Professor at Harbor-UCLA Medical Center in Los Angeles, CA. With a background in immunology, Dr. Bhatia has a special interest in mechanisms of therapy, skin cancer, and medical dermatology.

Learn more about Dr. Bhatia and our Medical Advisory Board