Shingles Symptoms and Signs

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Doctor's View on Shingles Symptoms and Signs

Comment by Melissa Conrad Stöppler, MD

The pain of shingles can be severe, and sometimes it occurs even before the rash develops. When this happens, it can be very difficult to identify shingles as the cause of your pain, especially if this is your first outbreak. The pain is often described as burning or tingling in nature, and tingling or sensitive skin sensations may precede the actual development of blisters by several days to a week. Some people report an itching sensation. In some cases, an outbreak can begin with mild flu-like symptoms like fever and fatigue.

Shingles rash

Like the pain, the rash generally affects the path of one nerve on one side of your body. It begins with small blisters forming on an area of reddened skin. The entire path of the nerve may be involved, or the distribution of blisters can be patchy over the area of the nerve. New blisters continue to form for several days. The blisters eventually burst, and the area appears to ooze. Finally, there is crusting and healing. The time to complete healing can take three to four weeks.

Persistent pain

When the pain persists beyond a month even after the rash has subsided, this can be a sign of a complication called postherpetic neuralgia. It is unclear why some people continue to have pain, but the condition is fairly common, affecting 10%-15% of people who have shingles. Postherpetic neuralgia is the most common complication of shingles.

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Janniger, Camila K. "Herpes Zoster." Feb. 26, 2013. <>.

Last Editorial Review: 8/1/2013 6:11:14 PM