You Should Be More Freaked Out by Shingles

Like a lot of people, Ann Garner thought that shingles was a “mild” illness—until 2024, when she became sick with it herself. If she had known at the time that Norwegians call shingles helvetesild, literally meaning “hell’s fire,” or that the Arabic name for it translates to “belt of fire,” she might have been better prepared.

Shingles (herpes zoster) is a common viral infection that causes a painful skin rash and can trigger post-herpetic neuralgia (PHN), a form of long-term nerve pain that can last for years. The English name derives from the Latin for “girdle,” as the shingles rash most commonly occurs around the torso, although it can affect the face and eyes as well, as Garner discovered.

One in three people will get shingles in their lifetime, but the risk rises sharply after 50 or for anyone with a weakened immune system. The disease is triggered by the reactivation of the varicella zoster virus, the same one that causes chickenpox when it first enters the body. The virus can lie dormant in a person’s nervous system for years until it reactivates—often, but not always, when immunity starts to wane due to factors such as aging, immunosuppressant drugs, or acute stress.

Garner, a 73-year-old retired pharmacy administrator from Wales, in the UK, feels sure stress was a factor in her developing shingles. She had been under intense financial pressure over a large tax bill when, one July afternoon, she felt a strange tingling sensation along one side of her hairline above her forehead.

Within hours, the feeling had intensified—causing her severe pain—and began progressing down her face toward one eye. “It was like hundreds of invisible, tiny hot needles pricking my scalp and face,” she recalls.

Doctors recommended that Garner take acyclovir, an antiviral drug that can help reduce symptoms if taken within a 72-hour window of them appearing, and an acyclovir eye cream to protect her eye, as shingles can cause vision damage and lead to blindness if it affects the eye.

But even with treatment, Garner's face and eyelid were soon covered in a hot red rash with angry blisters. “I couldn’t do anything to stop this sensation of being tortured by burning needles,” she says. “It was like my nerves were electrical wires that had been cut and they were fizzing and sparking.”

Despite shingles being common, it seems public perception has only recently started catching up with the severity of the condition. A 2025 study by researchers at the University of Bristol, UK, points to inadequate public health messaging and a lack of communication regarding patient experiences of the disease: “Limited literature about the experience and understanding of shingles suggests that people tend to think of it as minor until they experience it themselves,” researchers concluded.

Many people also fail to realize shingles can have a significant and long-lasting impact on their lives, says Martin Sollie, a consultant plastic surgeon at Oslo University Hospital in Norway. Sollie conducts research into the surgical management of chronic pain, including exploring whether grafting fat onto the skin could help reduce PHN. In 2022, he led a systematic review examining how shingles affects patients’ quality of life.

His meta-analysis of five studies, involving 2,519 patients in the US, Europe, and China, found those with an acute case of shingles had quality-of-life scores 15 percent below the norm for physical health and 13 percent below for mental health. “We were quite surprised that it did affect quality of life so much,” he says. “We know that if you have chronic pain, your quality of life is affected, but it’s very uncommon for a disease that is temporary—and not deadly—to have such an effect.”

Garner describes the pain she experienced from shingles as “perpetual”—far worse, even, than the time she broke her back some years previously, because “there was no respite at all.” “I took sleeping pills so I could get to sleep, and I begged God to help me,” she says. Over-the-counter remedies failed to bring relief; a nerve suppressant (pregabalin) calmed her symptoms only slightly, until she began to recover and the pain gradually reduced six weeks later.

Garner was fortunate that her shingles never penetrated her eyes or central nervous system, which, in rare cases, can cause encephalitis—a serious inflammation of the brain requiring urgent care. She was shocked to discover that people who have shingles are also at significantly increased risk of stroke in the 12 months afterwards.

For a year, Garner had a red mark across her face (“like I’d been branded with a hot poker”). She still has PHN. “My forehead and eyelid still feel abnormal. The skin is very oversensitive, and it tingles; it feels raw to the touch.”

Marian Nicholson, director of the UK’s Shingles Support Society, says while antiviral treatment can be very effective at reducing shingles and preventing PHN, she has heard of patients who ended their lives because of ongoing pain. “The older you are, the more grueling it is,” she says. “PHN can leave patients in unendurable misery in the final years of their lives.” This is particularly the case in older people with cognitive impairment or dementia, who may struggle to understand or contextualize their pain.

She also highlights another rarer side effect: pseudohernia. This occurs when muscle control is lost due to nerve damage, causing tissues to sag or bulge like a hernia.

With limited treatment options to alleviate shingles or PHN, the best way for patients to protect themselves is to be vaccinated against shingles, she says. In the US, the shingles vaccine is available to all adults 50 and older and anyone 19 and older with a weakened immune system. In the UK, it is offered routinely either at age 65 or between the ages of 70 and 79, and to immunocompromised adults over 18.

But uptake is low. In the US, around 34 percent of eligible adults had at least one dose of the vaccine in 2022. In the UK, vaccine coverage ranged from 33 percent to 45 percent in late 2024, with higher uptake among older patients.

Garner, who had chickenpox as a child, was 70 when she developed shingles. She doesn’t recall whether or not her doctor recommended the vaccine, but she never sought it out. “I completely dismissed it because shingles didn’t seem to me like a serious illness. I thought it was [just] a mild rash.” Now, she wishes she had. “I would have done anything to avoid going through this,” she says.

Sollie also believes both patients and governments need to start taking protection against shingles more seriously. “Everyone thinks, ‘It’s a month of pain, I'll manage,’ but if it turns into a lifetime of chronic pain, that’s something different.”