Shingles Rash: What Each Shingles Stage Looks Like (With Pictures)
Key takeaways:
Shingles is a painful, blistering rash that can happen on one side of the body or the face.
The shingles rash has different stages. It usually starts as red, violet, or brown patches that turn into fluid-filled blisters, which eventually crust over and heal.
Treating shingles early (within 3 days of getting the rash) can help avoid long-term problems, such as chronic pain.
Table of contents
Shingles is a painful, blistering rash that affects one side of the body. It’s caused by the same virus that causes chickenpox. After someone heals from chickenpox, the virus stays inactive in the nerves until it erupts into the typical shingles rash. This usually happens decades later.
Shingles is a common condition. About 1 million people in the U.S. get shingles each year. You’re more likely to develop it the older you get. Catching and treating it early is important to help clear the rash faster and prevent long-term complications, such as scarring and lingering pain.
Let’s review what the shingles rash looks like at each stage (with pictures) to help you identify it as soon as it starts.
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Stages of the shingles rash
Like with other viruses, the shingles rash goes through predictable stages. Each one lasts for a specific amount of time and is associated with different symptoms, including skin changes.
Knowing about the stages helps you identify shingles early and know what to expect. Let’s take a closer look at the three stages of shingles, including what the rash looks and feels like.
Stage 1: Early-stage shingles (prodromal)
The earliest stage of shingles (also called the prodromal or pre-eruptive stage) is not associated with any visible skin changes. It usually lasts 1 to 4 days.
During this phase, you may experience tingling, burning, stabbing, or shooting pain on one side of your body or face. Some people also experience more general symptoms, such as:
Fever
Chills
Tiredness
Headache
Light sensitivity
Stage 2: Shingles rash acute phase
This stage (also called the eruptive phase) is when the rash develops. Symptoms from stage 1, like pain and tingling, typically continue throughout this stage, and can last 2 to 4 weeks.
During this stage, the skin rash starts flat and eventually turns into crusty bumps. Here’s a look at how the shingles rash evolves.
Red, purple, or brown patches and bumps: These are the first sign of the rash. The rash can happen anywhere on the body, but it’s most common on the torso. It usually starts on one side and then wraps around to the back, like a belt.
Fluid-filled blisters (vesicles): Blisters soon form within the discolored patches. They’re usually filled with clear fluid, but are sometimes filled with pus (yellow fluid). These eventually break open to form sores. This is when the rash is most contagious.
Crusting: This is when the shingles rash starts to heal and dry out.
Stage 3: Final stage (chronic shingles)
The final stage is called chronic shingles, and not everyone experiences it. Treating shingles early can help you avoid this stage.
During this phase, people continue to have symptoms, even though the skin rash is starting to heal. Chronic shingles can include pain (called postherpetic neuralgia) and other sensations, like burning, tingling, and numbness. This can last 12 months or longer.
As the rash heals, it can cause scarring and discoloration (like post-inflammatory hyperpigmentation), especially in people with darker skin tones.
How to treat shingles
There’s no cure for shingles. But these prescription antiviral medications can help the rash heal faster and lower the risk of long-term complications:
These medications work best when they’re started within 3 days of developing the rash, so it’s important to notify your healthcare professional as soon as you think you may have shingles.
Preventing shingles
When it comes to shingles, prevention is the best strategy. If you’re 50 years or older, talk with your healthcare professional about getting the shingles vaccine. This can protect you from developing shingles or shingles-related complications.
The bottom line
When shingles develops, it goes through three predictable stages. Before the rash starts, you may experience pain, tingling, or itching on one side of the body or face. A few days later, red, brown, or violet patches of skin develop in the same area. This quickly turns into fluid-filled blisters that can wrap around the side of the body. After 2 to 4 weeks, the rash starts to heal and crust over. In people with darker skin, the rash can leave dark spots, which can take months to heal.
Treating shingles early — ideally within 72 hours of developing the rash — can help prevent long-term complications like persistent pain.
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Images used with permission from VisualDx (www.visualdx.com).
References
Centers for Disease Control and Prevention. (2022). Shingles (herpes zoster).
Nair, P. A., et al. (2023). Herpes zoster. StatPearls.
