how do shingles start

Shingles start when the varicella-zoster virus, which causes chickenpox, reactivates in the body after being dormant. The early symptoms often begin with a tingling, burning, itching, or painful sensation in a specific area on one side of the body or face. This can be accompanied by sensitivity to touch, headache, fever, or feeling generally unwell. A rash then typically develops a few days later in the affected area, usually appearing as red patches that turn into fluid-filled blisters arranged in a band or stripe pattern along a nerve pathway. The blisters eventually burst, dry out, and crust over as the rash heals. This process may be preceded by nerve pain or skin discoloration weeks before the rash appears in some cases. The exact trigger for virus reactivation is often unknown but can be related to factors like aging, a weakened immune system, stress, illness, or trauma. People who have had chickenpox are at risk because the virus remains inactive in nerve cells after the chickenpox infection resolves, only to reactivate years later as shingles.