Shingles can be hard to diagnose, especially if you’re younger—in part because people don’t expect younger adults to get it. That said, being told you have the viral infection and not a random rash like you thought can make your head spin. This is especially true when you’re figuring out what to do next. Do you need to shut yourself away from the world because you’re contagious, or are you okay going about your life if you’re feeling up to it? It turns out that the answer isn’t exactly straightforward.
“Shingles is an unusual infection,” William Schaffner, MD, an infectious disease specialist and professor at the Vanderbilt University School of Medicine, tells SELF. While doctors usually warn that the infection is contagious, you can’t actually give someone shingles, he explains. Confused yet? Let’s break it down.
Let’s review some shingles basics first.
Shingles is caused by the reactivation of the varicella-zoster virus, the same virus that causes chicken pox, according to the Centers for Disease Control and Prevention (CDC). You can only get shingles if you’ve had chicken pox in the past, Thomas Russo, MD, professor and chief of the Division of Infectious Diseases at the University at Buffalo’s medical school, tells SELF. “When you recover from chicken pox, the virus is not completely cleared from your body,” he explains. “It lives in a dormant state [in your nerve cells], and the virus can ‘wake up’ [later in life], causing shingles.” This usually happens when the immune system is compromised, often due to factors like another illness or stress.
A case of shingles can cause a range of uncomfortable symptoms, including burning or shooting pain and a rash that usually appears on one side of the body or face, according to the National Library of Medicine. During a shingles infection an individual may also experience a fever, headaches, chills, or an upset stomach, and they can develop complications—even after the rash clears—such as postherpetic neuralgia (severe, long-lasting pain in the areas where the rash appeared), vision loss, or issues with hearing or balance. In very rare cases shingles can cause pneumonia, brain inflammation, or even death.
Approximately one in three Americans will develop shingles in their lifetime, according to the CDC. Most people only have shingles once, although it’s possible to get it multiple times.
So is shingles contagious or not?
This is where things get slightly confusing. Technically, shingles itself is not contagious. But it is possible to spread the virus that causes the infection. “People who have not had chicken pox and have been exposed to the varicella-zoster virus can become infected and develop chicken pox,” Alfred F. Tallia, MD, MPH, professor and chair of the Department of Family Medicine and Community Health at the Rutgers University Robert Wood Johnson Medical School, tells SELF.
So if you’re diagnosed with shingles, your health care provider will usually recommend covering your rash to reduce the risk of spreading the varicella-zoster virus to others. It’s particularly important to avoid contact with pregnant people who’ve never had chicken pox or the chicken pox vaccine, along with infants and people with weakened immune systems, until your rash scabs over, according to Dr. Tallia. (You can’t spread the virus before blisters appear or after your rash scabs over, according to the CDC.)