What Are The Stages Of Shingles?

By carolynne
Reviewed: dr. vanta
Article Sources Article Sources
  • 1. 'Editorial.' Journal of Applied Polymer Science, vol. 6, no. 23, 1962, doi:10.1002/app.1962.070062301.
  • 2. 'Figure 3A: B12 Deficiency Causes.' doi:10.2218/resmedica.v23i1.765.s257.
  • 3. 'Herpes Zoster.' Herpes Zoster | DermNet NZ, dermnetnz.org/topics/herpes-zoster/.
  • 4. 'Conditions.' MyHealth.Alberta.ca Government of Alberta Personal Health Portal, myhealth.alberta.ca/Health/aftercareinformation/pages/conditions.aspx.
  • 5. 'Postherpetic Neuralgia.' Mayo Clinic, Mayo Foundation for Medical Education and Research, 6 Nov. 2020, www.mayoclinic.org/diseases-conditions/postherpetic-neuralgia/symptoms-causes/syc-20376588#:~:text=Postherpetic neuralgia (post-hur-,herpes zoster) virus causes shingles.
  • 6. 'Shingles'. Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 1 July 2019, www.cdc.gov/shingles/about/complications.html.
Medical Expert Medical Expert

Shingles is a painful yet common condition caused by the same virus as chickenpox. This virus remains dormant in the system along a nerve path and can be reactivated years later, presenting as shingles. The disease is characterized by a blistering rash on one side of the body and a general sense of malaise. However, internal shingles may present differently.

Like most viruses, some people experience more severe symptoms. For most individuals, shingles is quite manageable. Those diagnosed with the virus can expect it to last anywhere from three to five weeks. Shingles follows a predictable pattern of symptoms, marked by various stages.

1. Tingling or Burning Feeling

One of the first signs of shingles is a strange tingling or burning feeling on the skin. The sensation can feel a bit like pins and needles. The skin may become sensitive to the touch, and the nerve endings might feel like they're burning. An itching sensation and feeling of numbness might accompany the burning feeling.

This uncomfortable tingling generally appears on one side of the body in a specific area. Common places for the tingling sensation is on one side of the face, waist, trunk and back.1‘Editorial.’ Journal of Applied Polymer Science, vol. 6, no. 23, 1962, doi:10.1002/app.1962.070062301. People frequently report the occurrence of these symptoms before a rash erupts.


2. Pain Concentrated in One Area

The tingling sensation associated with shingles can quickly transition into bouts of pain. The pain is concentrated in the areas where the tingling began, and the severity varies from person to person.

The band of pain can be sensitive to touch, and the skin may become tender. Many individuals complain of either intermittent stabbing pains or a severe ache in the problem area.1‘Editorial.’ Journal of Applied Polymer Science, vol. 6, no. 23, 1962, doi:10.1002/app.1962.070062301. Much like the tingling sensation, the pain is only experienced on one side of the body.

3. Flu-Like Symptoms

Flu-like symptoms might accompany the tingling and pain. In addition to the telltale signs of shingles, some people might experience headaches, light sensitivity and fatigue. This is the body's way of signaling that something is wrong.

The flu-like symptoms normally don't last after the rash appears. Along with the first two stages of shingles, flu symptoms are a pre-cursor to the rash synonymous with shingles. Tingling, burning, pain and flu-like symptoms can last one to five days before the rash.


4. Upset Stomach and Nausea

An isolated incident of an upset stomach is probably not a cause for concern. But add this to a laundry list of typical shingles symptoms and it quickly becomes a sign of the virus being reactivated in the system.

As with the flu-like symptoms, an upset stomach and nausea are more accompanying ailments than defining symptoms. The upset stomach and nausea normally occur prior to the onset of the rash. Individuals should consult a physician to treat these symptoms.

5. Swelling of Lymph Nodes

When the human body is under stress or fighting an infection, it can present in the lymph nodes. Individuals commonly experience inflamed lymph glands in the neck, groin and under the arms.

The lymph nodes in the area where the pain appears drain the site of infection, resulting in a feeling of tenderness.3‘Herpes Zoster.’ Herpes Zoster | DermNet NZ, dermnetnz.org/topics/herpes-zoster/. The nodes might swell slightly, which is a clear indication that the lymphatic system is fighting the virus.


6. A Localized Rash Erupts

As the condition progresses, a localized rash appears at the site of the tingling or burning. The rash is a band of scarlet color papules on one side of the body, frequently occurring in the waist area. Interestingly enough, the word shingles is derived from the Latin word meaning belt.2‘Figure 3A: B12 Deficiency Causes.’ doi:10.2218/resmedica.v23i1.765.s257.

It's normal to experience pain and tingling for up to five days before the rash flares up. There are some people who don't experience a severe rash.

7. Rash Turns Into Fluid-Filled Blisters

The scarlet rash soon becomes a cluster of raised blisters filled with clear fluid. The pustules pop naturally and ooze. Bear in mind that the blisters can easily become infected, so it's important not to pick or scratch them open.

The shingles rash is often mistaken for other skin conditions such as eczema, hives or psoriasis. A telltale sign that it's shingles is the distinct cluster of blisters concentrated on one area of the body, combined with other symptoms of the virus.


8. Blisters Dry and Crust Over

Ten days into the virus the raw blisters dry out and crust over. During this phase, individuals are no longer contagious and can begin to recover from shingles.

During this phase, it's important to continue to monitor symptoms to ensure the virus hasn't spread internally. A great way to speed up the healing process is to smother the sores with cornstarch. To rid the area of oozing liquid, soak the sores under warm tap water.4‘Conditions.’ MyHealth.Alberta.ca Government of Alberta Personal Health Portal, myhealth.alberta.ca/Health/aftercareinformation/pages/conditions.aspx.

9. Scabs Start to Clear

Some people might find they're left with purplish scars after the scabs have cleared. The good news is that the scars tend to disappear quite quickly after recovery. The key to preventing scarring is not to pick at the scabs.

Individuals can expect a full recovery after three to five weeks, and it usually takes a few months for the scars to fade. Topical creams with vitamin E may help scars fade more quickly.

10. Postherpetic Neuralgia and Other Complications

Postherpetic neuralgia is a complication of shingles. However, only 10 to 18 percent of people experience it.6‘Shingles’. Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 1 July 2019, www.cdc.gov/shingles/about/complications.html. Postherpetic neuralgia is a series of lingering after effects that can cause chronic nerve pain in some individuals. The pain is mostly confined to the area where the rash originally broke out. Long-term effects include pain, sensitivity to touch and tingling sensations.

Internal shingles affect internal organs, causing persistent pain, cough, headaches, fever and abdominal pain. It typically affects older individuals with weak immune systems and requires urgent medical attention.


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