Symptoms and Diagnosis

Burning, Itching, Tingling, Then a Rash

An outbreak of shingles usually begins with a burning, itching, or tingling sensation on the back, chest, or around the rib cage or waist. It is also common for the face or eye area to be affected.

(Watch the video to learn more about one woman's experience with shingles. To enlarge the video, click the brackets in the lower right-hand corner. To reduce the video, press the Escape (Esc) button on your keyboard.)

Some people report feeling feverish and weak during the early stages. Usually within 48 to 72 hours, a red, blotchy rash develops on the affected area. The rash erupts into small blisters that look like chickenpox. The blisters seem to arrive in waves over a period of three to five days.


The blisters tend to be clustered in one specific area, rather than being scattered all over the body like chickenpox. The torso or face are the parts most likely to be affected, but on occasion, shingles breaks out in the lower body. The burning sensation in the rash area is often accompanied by shooting pains.

After the blisters erupt, the open sores take a week or two to crust over. The sores are usually gone within another two weeks. The pain may diminish somewhat, but it often continues for months -- and can go on for years.


Shingles can be quite painful. Many shingles patients say that it was the intense pain that ultimately sent them to their healthcare provider. They often report that the sensation of anything brushing across the inflamed nerve endings on the skin is almost unbearable.

Diagnosis is Usually Easy for Healthcare Providers

A typical shingles case is easy to diagnose. A healthcare provider might suspect shingles if

  • the rash is only on one side of the body
  • the rash erupts along one of the many nerve paths, called dermatomes, that stem from the spine.

A healthcare provider usually confirms a diagnosis of shingles if the person also

  • reports a sharp, burning pain
  • has had chickenpox
  • has blisters that look like chickenpox
  • is elderly.

If the Diagnosis Is Unclear

Some people go to their healthcare provider because of burning, painful, itchy sensations on one area of skin, but they don't get a rash. If there is no rash, the symptoms can be difficult to diagnose because they can be mistaken for numerous other diseases.

In cases where there is no rash or the diagnosis is questionable, healthcare providers can do a blood test. If there is a rash, but it does not resemble the usual shingles outbreak, a healthcare provider can examine skin scrapings from the sores.