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The idea that you can “catch” shingles is one of the more common misconceptions I hear from patients who arrive worried they’ve got it. Often, they’ve recently been near a child with chickenpox or someone else with shingles, and are understandably anxious they’ve picked it up.

As a GP, I encounter this misunderstanding all the time. In fact, a study from my own University of Bristol found that while most patients had heard of shingles, few actually understood what it is.

Shingles isn’t something you catch from someone else. It’s the reactivation of a virus already inside your body: the varicella zoster virus, the same one that causes chickenpox. After you recover from chickenpox, the virus doesn’t leave; it hides in the nerve cells that supply sensation to your skin, lying dormant for years, sometimes decades. Shingles is what happens when that virus “wakes up”.

Read more: Chickenpox vaccine recommended for NHS – here’s why a jab is better than getting the disease

When it reactivates, it causes clusters of small, fluid-filled blisters known as vesicles. Before the rash appears, people can feel tingling, burning or pain in one area of the body – sometimes two or three days beforehand. The skin can become unusually sensitive, and you might feel generally tired, feverish or unwell.

Shingles is common, affecting about one in 25 people. It tends to follow a characteristic pattern. The rash usually appears in a strip or band on one side of the body, corresponding to a dermatome (an area of skin served by one spinal nerve). It’s rare for shingles to appear on both sides of the body.

The blisters eventually burst, scab over and heal within three to four weeks, sometimes leaving small scars. Until each blister has crusted, a person with shingles is considered infectious, meaning they can transmit the virus to others – but not in the way most people think.

1. You can catch chickenpox from someone with shingles

To develop shingles, you must already have had chickenpox. For some patients though, chickenpox can be mild or have happened so long ago that they may struggle to recall having it.

When the shingles blisters burst, the fluid inside them contains the same, live varicella zoster virus. If someone who has never had chickenpox (or hasn’t been vaccinated against it) comes into direct contact with that fluid, they can become infected and develop chickenpox – but not shingles. Shingles only occurs when the dormant virus reawakens inside someone who has already had chickenpox.

For that reason, people with shingles should keep their rash covered (with clothing or a non-adherent dressing) until all the blisters have crusted over and healed.

It’s important to avoid contact with anyone for whom chickenpox could be particularly dangerous. That includes pregnant women - as varicella can sometimes cause complications for the mother and may harm the unborn baby. Newborn infants, whose immune systems are not yet strong enough to fight the infection are also at risk. Other patients with weakened immune systems (such as the elderly, those undergoing chemotherapy or living with conditions like HIV) may also struggle to fight the virus. Chickenpox can become a severe illness in these people, leading to complications like pneumonia.

2. Shingles can occur at any age

Although shingles becomes more likely as we age, it can occur at any time after you’ve had chickenpox – even in young adults or children. It’s more common when the immune system is weakened, which can happen with age, and in people receiving chemotherapy or other immunosuppressive treatments.

3. It can affect more than just your torso

Most cases appear on the chest or back, but shingles can occur anywhere on the body, including the face, limbs and even the genitals. When it affects the face, it can involve the eyes through nerve branches that extend there. This form, known as ophthalmic herpes, can threaten vision and cause blindness if not treated promptly. It can also affect the facial nerve which controls your facial muscles - otherwise known as Ramsay Hunt syndrome.

Some people develop pain, tingling, or sensitivity without a visible rash. The appearance of shingles can also vary by skin tone, making it harder to spot in darker skin.

4. Early treatment helps

If you suspect shingles, see a clinician promptly. Antiviral medications can help shorten recovery time and reduce complications, but they work best when started within 48-72 hours of the rash appearing.

Certain groups, including young, pregnant and breastfeeding patients, people with weakened immune systems and anyone with shingles affecting the face, nose, eyes (including the eye’s surface) or any visual changes, should definitely seek medical attention urgently.

5. The story doesn’t always end when the rash heals

For some, shingles can cause problems even after the visible rash clears. Open blisters can become infected with bacteria, sometimes requiring antibiotics. The virus can also damage nearby nerves, leading to post-herpetic neuralgia – persistent nerve pain that can last for months or even years after the skin has healed. It can feel like burning, stabbing or throbbing pain in the same area where the rash appeared.

Unfortunately, shingles can return again, sometimes in a different part of the body. The shingles vaccine significantly reduces both the risk of developing shingles and the chance of long-term nerve pain like post-herpetic neuralgia, though it doesn’t remove the risk entirely.

Think of shingles not as something you “catch”, but as something that can wake up again within your own body. It’s a reminder that viruses don’t always leave when we think they do. And that protecting yourself and others means recognising the signs early, covering the rash, and getting prompt medical advice.

This article is republished from The Conversation, a nonprofit, independent news organization bringing you facts and trustworthy analysis to help you make sense of our complex world. It was written by: Dan Baumgardt, University of Bristol

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Dan Baumgardt does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.