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Physical Exam
Once the rash appears, thesigns and symptoms of shingles—also called herpes zoster—are pretty distinctive and are often enough on their own for a healthcare provider to make a diagnosis and recommend treatment.
During a physical exam, healthcare providers will ask you about your medical history, including whether you’ve hadchickenpoxor received the chickenpox vaccine. They’ll also take a look at the rash (if one is present) to see if it has all the telltale signs of a shingles rash, including being concentrated on one side or one area of the body, tingling, itching, or burning, or whether the rash is starting to or already has blistered.
Though it’s not common, in some cases you can have pain or stinging associated with shingleswithoutthe rash—a condition called zoster sine herpete.
Shingles Doctor Discussion GuideGet our printable guide for your next doctor’s appointment to help you ask the right questions.Download PDFEmail AddressSign UpThank you, {{form.email}}, for signing up.There was an error. Please try again.
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Labs and Tests
If you don’t have a rash, or if the rash stretches across the body or looks like it could be some other type of rash—like herpes simplexor contact dermatitis—your healthcare provider might need lab tests in order to diagnose shingles.
Polymerase Chain Reaction (PCR)
Polymerase chain reaction (PCR)is alab techniqueused for a wide variety of purposes, including to spot the DNA of varicella-zoster virus, the pathogen thatcauses shingles.
Commonly referred to as “molecular photocopying,” PCR uses swabs typically taken from the shingles blisters or scabs and then copies (amplifies) the virus DNA for easy detection. In some instances, a saliva swab can also be used, but it’s not as reliable as samples taken from blisters.
Other diagnostic methods, such as direct fluorescent antibody (DFA) or Tzanck smear testing, are not recommended because they aren’t as sensitive as PCR.
Serologic Methods
When you’re exposed to varicella-zoster virus, your body makes antibodies to defend itself. Serological testing can detect two types of these antibodies: IgM and IgG. IgM antibodies are short-term antibodies the body makes to immediately fight off a varicella infection—typically spiking within a week or two of getting chickenpox and then again when/if the virus is reactivated as herpes zoster.Over time, these antibodies can wane until they are undetectable but can resurface during shingles episodes.
IgG antibodies, on the other hand, are made a couple of weeksafterfirst getting infected and remain in the body long-term. Levels are often detectable for many years.If test results detect both IgMandIgG, it could be an indication that you have shingles.
It’s important to note, however, that these tests aren’t foolproof.
Individuals with weakened immune systems, for example, might not launch a very strong immune response to either chickenpox or shingle—in which case, serological testing could give a negative result even if they really do have shingles.
Similarly, even with a positive test result, in the absence of typical symptoms or a complete medical history, it can be difficult to know whether you have shingles or if it’s really a primary infection of chickenpox. Your healthcare provider will do their best to diagnose and choosean appropriate treatment.
Frequently Asked QuestionsIt may start out as a group of small pimples or spots clustered together on one area of the body or face. The clusters may be in the shape of a band or belt. Later, the pimples will change to pus-filled blisters.In some cases, the rash may looksimilar to other conditionsincludingpsoriasis,eczema,allergic reactions,ringworm, andmeasles. Your healthcare provider can diagnose the rash through examination and possibly lab tests. If you have a rash that appears suddenly, check with your healthcare provider.
Frequently Asked Questions
It may start out as a group of small pimples or spots clustered together on one area of the body or face. The clusters may be in the shape of a band or belt. Later, the pimples will change to pus-filled blisters.
In some cases, the rash may looksimilar to other conditionsincludingpsoriasis,eczema,allergic reactions,ringworm, andmeasles. Your healthcare provider can diagnose the rash through examination and possibly lab tests. If you have a rash that appears suddenly, check with your healthcare provider.
4 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Cohen JI.Clinical practice: Herpes zoster. N Engl J Med. 2013;369(3):255-63. doi:10.1056/NEJMcp1302674Centers for Disease Control and Prevention.Shingles | Diagnosis, Testing, Lab Methods | Herpes Zoster.Min SW, Kim YS, Nahm FS, et al.The positive duration of varicella zoster immunoglobulin M antibody test in herpes zoster. Medicine (Baltimore). 2016;95(33):e4616. doi:10.1097/MD.0000000000004616Nemours Foundation. KidsHealth.Shingles.Additional ReadingCenters for Disease Control and Prevention.Shingles: Diagnosis & Testing.Centers for Disease Control and Prevention.Shingles: Clinical Overview.National Human Genome Research Institute.Polymerase Chain Reaction (PCR). National Institutes of Health.
4 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Cohen JI.Clinical practice: Herpes zoster. N Engl J Med. 2013;369(3):255-63. doi:10.1056/NEJMcp1302674Centers for Disease Control and Prevention.Shingles | Diagnosis, Testing, Lab Methods | Herpes Zoster.Min SW, Kim YS, Nahm FS, et al.The positive duration of varicella zoster immunoglobulin M antibody test in herpes zoster. Medicine (Baltimore). 2016;95(33):e4616. doi:10.1097/MD.0000000000004616Nemours Foundation. KidsHealth.Shingles.Additional ReadingCenters for Disease Control and Prevention.Shingles: Diagnosis & Testing.Centers for Disease Control and Prevention.Shingles: Clinical Overview.National Human Genome Research Institute.Polymerase Chain Reaction (PCR). National Institutes of Health.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Cohen JI.Clinical practice: Herpes zoster. N Engl J Med. 2013;369(3):255-63. doi:10.1056/NEJMcp1302674Centers for Disease Control and Prevention.Shingles | Diagnosis, Testing, Lab Methods | Herpes Zoster.Min SW, Kim YS, Nahm FS, et al.The positive duration of varicella zoster immunoglobulin M antibody test in herpes zoster. Medicine (Baltimore). 2016;95(33):e4616. doi:10.1097/MD.0000000000004616Nemours Foundation. KidsHealth.Shingles.
Cohen JI.Clinical practice: Herpes zoster. N Engl J Med. 2013;369(3):255-63. doi:10.1056/NEJMcp1302674
Centers for Disease Control and Prevention.Shingles | Diagnosis, Testing, Lab Methods | Herpes Zoster.
Min SW, Kim YS, Nahm FS, et al.The positive duration of varicella zoster immunoglobulin M antibody test in herpes zoster. Medicine (Baltimore). 2016;95(33):e4616. doi:10.1097/MD.0000000000004616
Nemours Foundation. KidsHealth.Shingles.
Centers for Disease Control and Prevention.Shingles: Diagnosis & Testing.Centers for Disease Control and Prevention.Shingles: Clinical Overview.National Human Genome Research Institute.Polymerase Chain Reaction (PCR). National Institutes of Health.
Centers for Disease Control and Prevention.Shingles: Diagnosis & Testing.
Centers for Disease Control and Prevention.Shingles: Clinical Overview.
National Human Genome Research Institute.Polymerase Chain Reaction (PCR). National Institutes of Health.
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