Shingles, also known as herpes zoster, is a painful skin rash caused by the varicella zoster virus, the same virus that causes chickenpox. After a person recovers from chickenpox, the virus stays dormant in the body. Shingles occurs when the virus reactivates later in life, usually due to a weakened immune system. While not everyone with shingles needs to stay home, it is important to take precautions to avoid spreading the infection.
Is shingles contagious?
Yes, shingles is contagious. The varicella zoster virus is spread through direct contact with the fluid from the shingles blisters. A person with shingles can spread the virus when the rash is in the blister phase. Once the blisters crust over, the risk of contagion is lowered.
People who have never had chickenpox are at risk of catching chickenpox if they come into contact with a shingles rash. However, a person who has had chickenpox or the chickenpox vaccine will not develop chickenpox again if exposed to someone with shingles. Instead, the biggest risk is developing shingles themselves in the future.
When is someone with shingles contagious?
A person with shingles can spread the virus when their shingles rash is in the blister phase. This begins with red, inflamed patches of skin that quickly fill with fluid and become blisters. The blisters burst and weep clear fluid that contains high levels of varicella virus. The risk of transmission remains until the blisters have dried out and crusted over.
Once all the blisters are crusted, the risk of spreading the virus is significantly lowered but not completely gone. Some virus can still be shed from the skin lesions for several days after crusting. Scabs may also carry traces of the virus. The risk of transmission ends once all scabs have fallen off and fresh skin has regrown.
How long does a shingles rash last?
The duration of a shingles rash can vary, but it generally follows a predictable course:
- Prodromal phase (1-5 days): Tingling, burning, numbness, and sensitivity in a dermatome (area on one side of the body).
- Active phase (4-14 days): Blisters form, fill with fluid, burst and ooze, then crust over and scab.
- Resolving phase (2-4 weeks): Scabs dry up and eventually fall off, revealing fresh skin.
On average, patients are considered contagious for 7-10 days during the most active and weeping phase of the rash. Some people who have weaker immune systems can remain contagious for longer.
When can I stop isolating with shingles?
The CDC recommends that people with shingles stay home until the blisters have dried and crusted, which typically takes 7-10 days after the rash appears. After this point, the risk of transmission is much lower and isolation may be discontinued if necessary. However, it is ideal to stay home while any blisters or scabs are still present.
People with shingles on areas of the body that cannot be covered, such as the eyes or mouth, may need to isolate for longer. Consult with a doctor about when it is safe to return to work or school.
Should I stay home from work if I have shingles?
Staying home from work is advisable when you have an active shingles rash. The viral shedding is highest and can easily be spread through close proximity with coworkers. Working from home is the best option if you are well enough.
Once the weeping blisters have dried and crusted over, going to work may be possible by covering the rash site with clothing or dressings. However, you may still need time off for shingles pain and post-herpetic neuralgia. Discuss when you can return with your employer and doctor.
Table: Recommendations for Staying Home from Work with Shingles
| Stage of Rash | Recommendation |
|---|---|
| Prodromal stage (tingling, burning) | Can work, monitor for rash |
| Weeping blisters | Stay home |
| Blisters crusted | May return if covered |
| Scabs present | May return if covered |
| After scabs fall off | Can return |
Should I avoid public spaces with shingles?
It is best to avoid crowded public places while you have an active, weeping shingles rash to minimize the risk of transmission. Stay out of public spaces like:
- Schools and daycares
- Offices and workplaces
- Gyms and sports facilities
- Stores and shopping centers
- Movie theaters and restaurants
- Public transit
Once the blisters have crusted over, running essential errands may be possible if the rash site can be completely covered by clothing or bandages. But extended time in crowded areas is still not recommended.
Can I go out in public if I cover my shingles?
Covering shingles may allow you to go out in public briefly, but there are some important considerations:
- Bandages must seal the entire rash area, with no weeping blisters exposed
- Clothing must not rub against uncovered rash areas
- Do not touch dressings and wash hands frequently
- Avoid close contact like hugging, hand-shaking or kissing
- Do not go out if you have facial, mouth or eye shingles
It is still recommended to avoid extended time in crowded spaces if possible while contagious. Work with your doctor to determine if it is an acceptable risk.
Can I spread shingles if I don’t have a rash?
You cannot spread shingles if you do not have an active rash. The varicella-zoster virus is dormant in the nerves and becomes reactivated to cause shingles. It cannot be transmitted from one person to another during dormancy.
About 10-14 days before a shingles rash occurs, some people experience prodromal symptoms like pain, burning and tingling. While this may indicate shingles will develop soon, a person is not contagious during the prodromal phase.
Is it safe to be around certain groups if I have shingles?
It is recommended to avoid contact with people at high-risk for complications if you have active shingles. These include:
- Pregnant women – Shingles can cause chickenpox in newborns
- Infants – Higher risk of severe infection
- Immunocompromised – Increased susceptibility to infection
- Unvaccinated – More likely to catch chickenpox if exposed
Do not visit or receive visitors from these groups until all shingles scabs have fallen off and fresh skin is present. Their doctor may recommend preventive treatment.
Can I infect my family if I isolate at home?
There is a risk of infecting susceptible household members if you isolate at home with active shingles. To reduce transmission:
- Cover rash sites with gauze dressings
- Avoid skin-to-skin contact
- Do not share towels, bedding or utensils
- Disinfect surfaces, clothing and towels
- Isolate yourself in a private room if possible
At-risk household members may need to stay elsewhere until you are no longer contagious. Discuss with their doctor.
When can I be around children if I had shingles?
Children are at high risk for developing chickenpox if exposed to shingles. Avoid contact with children until all shingles scabs have fallen off and fresh skin has regrown. This may take 2-4 weeks after the initial onset of the rash.
It is also recommended that adults with direct contact with children receive the shingles vaccine to lower their risk. This includes school employees, childcare workers, parents and grandparents.
Can I spread shingles through my clothes?
The varicella zoster virus can survive on surfaces and contaminate objects. Direct skin contact with shingles blisters is the main route of transmission, but clothes do pose a risk:
- Do not shake or handle clothing with uncovered shingles
- Avoid contact between exposed rash and fabrics
- Wash clothing in hot water and dry thoroughly after use
- Clean hampers after use and do not share with others
Contaminated laundry should be avoided until all scabs have fallen off. Have someone handle laundry for you if possible.
Is it safe for me to handle food if I have shingles?
It is not recommended to handle, prepare, serve or share food while you have weeping shingles blisters. The varicella virus can be transmitted through contact, including from hands into food and beverages. Wait until all blisters have crusted over before resuming food handling and preparation.
Even once scabbed, it is ideal to avoid food handling if shingles is on the hands, arms, face or neck. Coordinate with your workplace about when it is safe to return if you are a food worker.
Can my pets get shingles from me?
Pets do not get shingles, which only occurs in humans infected with the varicella zoster virus. However, pets can develop a zoonotic infection called feline herpesvirus or pseudorabies from exposure to a shingles rash.
Avoid contact between your pets and active shingles lesions. Do not handle pets with uncovered rash on your hands. Limit petting and snuggling until the rash has fully healed over.
Is shingles contagious through the air?
Airborne transmission of shingles is very unlikely. Unlike the measles or tuberculosis, the varicella virus spreads through direct contact with fluid from shingles blisters. It does not stay suspended in the air for long periods.
A person generally needs to touch a shingles rash or something contaminated by the fluid to become infected. Just being in proximity is low risk as long as contact is avoided.
Can I get shingles from my spouse?
You cannot directly “catch” shingles from another person since it is caused by reactivation of dormant varicella virus. However, exposure to someone with active shingles can trigger the virus to reactivate in someone else who has had chickenpox before.
Spouses and partners are at increased risk due to close physical contact. While not a guarantee, try to minimize contact with shingles lesions. See a doctor right away if you develop symptoms.
Can you get shingles twice?
It is possible but uncommon to have shingles more than once. About 5% of people will get the condition a second or third time at some point in their lives. Reasons it may recur:
- Older age and weakened immunity
- Underlying medical conditions
- Immunosuppressing treatments
- Failure of the first shingles episode to boost immunity
Getting vaccinated can lower the odds of repeat occurrences. If you do get shingles again, it may be milder and shorter duration.
Can I get shingles after the vaccine?
Yes, it is possible to develop shingles even after being vaccinated, but the chances are significantly lower. Studies show the vaccines reduce risk by about 51% with Shingrix and 38% with Zostavax compared to unvaccinated adults.
If shingles does occur after vaccination, the symptoms are often milder with a shorter duration. The rash may involve fewer blisters confined to a smaller area. Postherpetic neuralgia is also less common.
Conclusion
Shingles can be contagious when blisters are actively weeping and contain high levels of varicella virus. It is advisable to stay home during this phase to avoid spreading it to vulnerable individuals. Once blisters crust over, the risk decreases but isolation may still be needed if scabs are present.
Work with your doctor to determine when it is safe to return to work, school and other public activities after having shingles. Keep the rash covered, avoid close contact, and disinfect any contaminated surfaces or items. Be vigilant for recurrent signs and symptoms if you are at higher risk for repeat episodes of shingles.