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Shingles usually begins with an unpleasant itching, burning, tingling, or painful sensation in a band-like area. The skin rash of shingles begins to appear 3-4 days after you notice these skin sensations.

Symptoms of the Prodromal Period

The prodromal period is the time about 3-4 days before the rash actually occurs. During this time, you may have the following symptoms:

  • Fever
  • Muscle aches
  • Fatigue
  • Anxiety, nervousness
  • Discomfort in the skin, usually on one side of the face, torso, trunk, back, or buttocks. The discomfort may feel like:
    • Numbness
    • Itching
    • Burning
    • Stinging
    • Tingling
    • Shooting pain
    • Electric shock
    • Sharp pain
    • Extremely sensitive to even light touch

Symptoms of Active Shingles

The period of active shingles begins when you first notice a rash in the same location where you felt the skin sensations:

  • The rash begins as a reddish band or individual bumps in a line.
  • The bumps develop fluid-filled centers.
  • Over the course of 7-10 days, the bumps begin to dry and crust over.
  • You may continue to have pain and/or itching in the area of the rash; the pain may be severe.
  • If the rash develops on the side of your nose or elsewhere on your face, you should contact your doctor right away. This can signal that your eye is affected.

The rash of active shingles should be gone within a week to a month. About 20% of people continue to have pain and discomfort after the rash has healed. This syndrome of pain in the area of the previously infected nerve is called postherpetic neuralgia. It can be severe and debilitating.

References:

NINDS shingles information page. National Institute of Neurological Disorders and Stroke website. Available at: http://www.ninds.nih.gov/disorders/shingles/shingles.htm . Updated January 10, 2013. Accessed May 30, 2013.

Shingles. The American Academy of Dermatology website. Available at: http://www.aad.org/dermatology-a-to-z/diseases-and-treatments/q---t/shingles . Accessed May 30, 2013.

Stankus SJ, Dlugopolski M, Packer D. Management of herpes zoster (shingles) and postherpetic neuralgia. Am Fam Physician . 2000;61(8). Available at: http://www.aafp.org/afp/2000/0415/p2437.html . Accessed May 30, 2013.

Zoster. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/ . Updated May 20, 2013. Accessed May 30, 2013.



Last reviewed May 2013 by Peter Lucas, MD; Michael Woods, MD

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.

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