Shingles During Pregnancy: Causes, Symptoms, and Treatment

Southeast asian pregnant women itching of the skin belly which causes striped. Problems of pregnancy women and Stretch marks or striae concept

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When we hear the word “shingles,” most of us think of a weird illness that only affects older adults (like our grandparents). But the reality is that the shingles virus can affect anyone with a compromised immune system, whether it’s due to age, stress, existing illness, or—yes—pregnancy.

Because expectant moms are more susceptible to all kinds of viruses during pregnancy, their risk of contracting shingles increases, too.

What exactly is shingles, though, and what does it look like in pregnancy? Here’s what you need to know.

Shingles Symptoms

A red rash is a hallmark of the shingles infection; it usually appears in a small area on one side of the body, often on the face, back, or torso. The rash may include fluid-filled blisters, and it may itch, burn, or feel painful. A few days before the rash develops, your skin may feel numb, tingly, itchy, or be sensitive to touch.

While many people think the only symptom of shingles is an irritating rash, other symptoms include:

  • Nerve pain
  • Sensitivity to light
  • Fatigue
  • Headache
  • Chills,
  • Upset stomach
  • Fever

Although these symptoms will be unpleasant to manage during pregnancy, there is no risk to your baby with a shingles infection.

Exposure to chickenpox in pregnancy is potentially more dangerous to the baby if you are unvaccinated and have no immunity to the virus, but those risks don’t apply to shingles (which can only occur when you have already been exposed to chickenpox). 

Causes

Shingles is an infection caused by the varicella-zoster virus (VZV), which is the same virus that causes chickenpox. Once you recover from chickenpox, VZV stays dormant in your body; this means you no longer have any symptoms of chickenpox, but the virus can be reactivated later in life. If it does reactivate, VZV causes shingles.

If you’ve never had chickenpox, then you can’t contract shingles. Shingles itself isn’t contagious, but if someone who had no immunity to chickenpox was exposed to someone with shingles, that person could contract chickenpox (since both illnesses are caused by the same virus). 

The older you get, the more likely you are to get shingles, though the virus can also reactivate in people with lowered immune systems. According to the Centers for Disease Control and Prevention (CDC), about 1 in every 3 people in the U.S. will have shingles.  

Diagnosis

It’s fairly easy for your doctor to identify a case of shingles: if you know you’ve had chickenpox before and you have a painful rash on one side of your body or face, along with any of the other common shingles symptoms, you will probably be diagnosed with shingles.

Most cases of shingles resolve within two to four weeks. A few days after your initial symptoms begin, the rash will likely develop (and so will symptoms like fever and fatigue). It usually takes about 7 to 10 days for the rash blisters to dry up and scab over, but it will take longer for the scabs to disappear and your skin to fully clear.

It’s important to avoid scratching or picking at blisters and scabs, as well as to keep the skin clean and dry, to prevent infection.

After your infection has resolved, you may still experience some nerve pain in the area where you had the rash. If you have sensitive skin, it’s possible to have some scarring where there were larger scabs. 

When to See a Doctor

If you suspect that you have shingles, you should see a doctor right away. While it’s not likely to cause any complications during pregnancy, you might find that you are more uncomfortable from your symptoms than the average person. 

It’s important to note that any rash on your face, especially near your eyes, should be seen immediately by a doctor. Blisters near your eyes or ears can cause permanent damage to your vision and hearing

Seeing a doctor at the start of the infection may also allow you to shorten the duration of your illness. You also need to know how to safely treat your symptoms; not all remedies and OTC products are safe to use during pregnancy (more on that below).

Shingles Treatment

Because shingles is a virus, you can’t cure it with antibiotics or other medications. But you can often use an antiviral medication to shorten the length of your illness and lessen the symptoms.

There are three antivirals usually used to treat shingles:

  1. Acyclovir
  2. Valacyclovir
  3. Famciclovir

For the most part, these antivirals are safe to use during pregnancy, especially if there are possible risks to the mother or baby from not treating the viral infection.

Though shingles itself isn’t dangerous to you or your baby, some of the symptoms—especially when severe or prolonged—could be harmful. Fever or dehydration, for example, can cause pregnancy complications.

You may also need to talk to your doctor about pain relief; acetaminophen is considered safe for use during pregnancy to relieve pain and fever, but your doctor may allow you to use other pain relief options, like lidocaine patches or topical analgesics, as well.

A few common treatments, like anticonvulsants and antidepressants, may not be recommended by your doctor during pregnancy. 

Other home remedies for itching, like antihistamines, colloidal oatmeal, and cool compresses, are generally safe for use during pregnancy, but it’s always a good idea to check with your doctor if you have any questions or concerns. 

Prevention

There aren’t many ways to prevent shingles if you’ve previously had chickenpox since you can’t control whether VZV reactivates in your body or not. However, there is a shingles vaccine available in the U.S., which cuts your risk of infection by about 50 percent.

Many older adults and immunocompromised people choose to get vaccinated to help their chances of preventing infection.  

Your doctor may not recommend a shingles vaccination during pregnancy, but if you’re not yet pregnant (i.e. you’re planning to become pregnant in the near future), you may be able to receive the vaccine before pregnancy if you think you might be vulnerable to infection while expecting a baby.

Otherwise, if you’re immunocompromised you can work with your doctor to manage your condition and keep your immune system functioning as best as possible;. During pregnancy, it’s also important to monitor your stress and anxiety levels.

Lastly, while receiving the chickenpox vaccine as a child doesn’t fully prevent you from ever having shingles, it does help a great deal: a 2019 study in Pediatrics suggests that kids who received the chickenpox vaccine were 78 percent less likely to end up with shingles.

If you were vaccinated against chickenpox as a child, this reduces the likelihood of developing shingles as a pregnant adult. 

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