Quick answer. Shingles (herpes zoster) is a painful blistering rash caused by reactivation of the chickenpox virus (varicella-zoster virus) that has stayed dormant in the body. It typically causes burning or tingling pain, then a one-sided rash with blisters along a single band of skin, often on the trunk or face. Starting antivirals such as aciclovir, valaciclovir or famciclovir early, within 72 hours of the rash, reduces severity and the risk of lasting nerve pain (postherpetic neuralgia). In Singapore, the Shingrix vaccine (two doses) is HSA-registered and recommended for adults aged 60 and above, and is part of the National Adult Immunisation Schedule. See a doctor urgently if the rash involves the eye or face.
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Shingles, or herpes zoster, is a painful rash caused by the reactivation of the varicella-zoster virus, the same virus that causes chickenpox. After chickenpox, the virus lies dormant in nerve tissue and can wake up years later, usually when immunity dips with age, illness or stress.
The most important things to know are that early antiviral treatment works best within 72 hours, and that the Shingrix vaccine can help prevent shingles and its most common complication, long-lasting nerve pain.
At a glance
| Stage | What happens | What to do |
|---|---|---|
| Early (prodrome) | Burning, tingling, numbness or itch in one area, 1-3 days before rash | See a doctor early, even before the rash |
| Rash | One-sided blistering rash in a band; blisters last 2-3 weeks | Start antivirals within 72 hours; keep rash clean and covered |
| Complication | Postherpetic neuralgia: nerve pain lasting over 3 months | More common in older adults; needs ongoing pain management |
| Prevention | Shingrix vaccine, 2 doses 2-6 months apart | Recommended for adults 60+ and immunocompromised 18-59 |
What causes shingles and who is at risk
Shingles is caused by reactivation of the varicella-zoster virus that remains dormant after a past chickenpox infection. You cannot get shingles unless you have previously had chickenpox (or, rarely, the chickenpox vaccine).
Risk increases with:
- Older age, with risk rising notably from around 60 years
- A weakened immune system (cancer, HIV, chemotherapy, radiotherapy or immunosuppressive medicines)
- Physical or emotional stress and illness
Symptoms and how shingles develops
Shingles often begins with a prodrome: burning, tingling, numbness, itching or unusual skin sensitivity in one area, typically 1 to 3 days before the rash appears.
The rash then develops as:
- Groups of blisters on a red base, classically forming a single stripe or band on one side of the body only (following a nerve)
- Common sites include the chest or trunk, the buttock area, or the face
- It may come with fever, headache, chills and fatigue
Blisters usually crust over and heal within 2 to 3 weeks.
Postherpetic neuralgia and other complications
The most common complication is postherpetic neuralgia (PHN): burning, aching or stabbing nerve pain that persists for more than three months after the rash heals. PHN is more common and more severe in older adults, and the risk is higher with severe outbreaks, weakened immunity and delayed antiviral treatment.
Other complications include:
- Eye involvement (herpes zoster ophthalmicus), which can threaten vision
- Ramsay Hunt syndrome (facial-nerve involvement affecting the ear and face)
- Bacterial skin infection of the blisters
- Widespread (disseminated) shingles in immunocompromised people
Treatment: start antivirals early
Antiviral medicines are the mainstay of treatment and work best when started within 72 hours (3 days) of the rash appearing. The options are:
- Aciclovir, valaciclovir or famciclovir to reduce the severity and duration of the attack and lower the risk of PHN
Supportive care includes:
- Pain relief, from simple analgesics to nerve-pain medicines (such as gabapentin or pregabalin) for PHN
- Keeping the rash clean, dry and covered; cool compresses and calamine lotion can soothe
Because the 72-hour window matters, see a doctor as soon as you suspect shingles.
The Shingrix vaccine in Singapore
Shingrix (recombinant zoster vaccine) is the only shingles vaccine currently registered with the HSA in Singapore. It is given as two doses, 2 to 6 months apart, and was added to the National Adult Immunisation Schedule from 1 September 2025.
- Recommended for adults aged 60 and above, and for immunocompromised adults aged 18-59.
- The older Zostavax vaccine is no longer the preferred option; people who previously had Zostavax can still benefit from Shingrix.
- Cost (varies by clinic and eligibility): After subsidies from September 2025, the full two-dose course costs roughly S$75 to S$300 for eligible Singapore Citizens and about S$450 for Permanent Residents. Means-tested CHAS subsidies of up to 75% apply at CHAS GP clinics and polyclinics, with extra subsidies for Pioneer and Merdeka Generation seniors.
- MediSave can be used to pay the remaining cost after subsidies from 2026, including Flexi-MediSave for those aged 60 and above.
Is shingles contagious, and when to seek urgent care
You cannot catch shingles from someone else. However, a person with active, weeping shingles blisters can pass the varicella-zoster virus to someone who has never had chickenpox or the chickenpox vaccine through contact with the blister fluid. That person would develop chickenpox, not shingles. Risk falls once the blisters crust over, and keeping the rash covered helps.
See a doctor urgently if you have:
- A rash on or near the eye, or on the face, forehead or nose
- A widespread rash or one that crosses to both sides of the body
- A weakened immune system
- Severe pain, new blisters spreading, high fever, confusion, or facial weakness or hearing changes
Related guides
- Best GP & Family Clinics in Singapore — our editorial shortlist
- GP & family clinics directory
- Dengue fever
- Hand, foot & mouth disease
- Influenza (flu)
Sources
- HealthHub (MOH) – Herpes Zoster (Shingles)
- Communicable Diseases Agency (CDA) – Shingles (Herpes Zoster)
- MOH – Subsidies and MediSave Coverage for Shingles Vaccine
- MOH – Shingles and Pneumococcal Vaccines Added to NAIS
- SingHealth – Postherpetic Neuralgia: A Primary Care Approach
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