Shingles rates have been increasing in the US for an extended period, but the reasons remain unclear. Almost a third of the US population will develop shingles at some point in life — specifically those that have had chickenpox. Moreover, the risk is high in adults aged 50 and older.¹
Shingles, also known as herpes zoster, causes a cluster of rashes and blisters mostly around one side of the torso, neck, and face. However, the varicella-zoster virus (the virus that causes shingles as well as chickenpox) can affect the penis and surrounding areas, although it's a rare occurrence.
Read on to learn more about the causes, symptoms, and treatment of shingles on the penis.
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Herpes zoster commonly affects the thoracic and facial dermatomes. However, shingles can develop on any part of your body, including around the penis and scrotum. There have been few reported cases of penile herpes zoster.²
So yes, you can get herpes zoster on or around your genital areas, including the scrotum and penis, but it's very rare.
Reported cases of shingles on the penis typically involve S2-S4 dermatomes, including the skin of the scrotum, buttocks, genital area, and back of the legs. A dermatome is the area of your skin that contains sensory information from a particular nerve.
Generally, shingles are caused by the herpes zoster virus — the same virus that causes chickenpox. This is why you're more likely to develop shingles if you've had chickenpox.
When the chickenpox symptoms clear up, normally after two weeks, the varicella-zoster virus remains dormant in the cranial nerves or spine. And when the virus reactivates later in life, it brings about herpes zoster or shingles.
After reactivation, the varicella virus moves down a sensory nerve until it reaches your skin. The disease may affect parts of your body depending on the nerve the virus reactivates in.
For instance, neural information travels from the penis to the brain through the S2 and S3 nerves — located at the level of your sacrum bone. If the herpes zoster virus reactivates in these nerves, shingles may form on your penis, groin, thighs, and buttocks.
Sometimes it can be challenging to diagnose penile shingles based on the physical symptoms, as they can be similar to those of genital herpes.
Moreover, you may experience the symptoms of herpes zoster a few days before the blisters develop. Symptoms include sharp pain or burning, numbness, itchiness, and tingling in the affected area.
A 2020 case report noted the symptoms of penile shingles, including burning and itching of the head of the penis (glans). This was accompanied by red blisters on the glans and severe sharp pain at the shaft.³
Another case report of shingles affecting the S2 and S3 dermatome presented difficulty/painful urination, penile numbness, constipation, and frequent urination.⁴
Other symptoms of shingles include:
Fluid-filled blisters around the affected area
Fever
Chills
Headache
Upset stomach
Furthermore, herpes zoster can affect your sacral nerves and cause bowel or bladder incontinence.
Antiviral medicines like acyclovir, famciclovir, and valacyclovir can treat shingles and shorten the severity of the illness. However, you must take these medicines as soon as you develop a rash on your penis or scrotum to increase their effectiveness.
Antivirals will not only help minimize the length of time you have herpes zoster but also prevent complications like postherpetic neuralgia (PHN).
Moreover, you can take over-the-counter or prescription medication to help ease the pain and discomfort. Antidepressants and anticonvulsants may help manage pain in people with neuralgia — a complication resulting from shingles.
Shingles, or herpes zoster, is not contagious, meaning you can not get the illness from someone else who has it. However, if you've never had chickenpox, someone with the herpes zoster virus can spread it to you, but this will cause chickenpox and not shingles. The infected person may develop shingles later in life.
Moreover, the virus spreads when it's in the blister phase — the blister fluids contain virus particles. The person can no longer spread the virus once the rush crusts.
There are various ways to prevent the spread of the herpes zoster virus. Here's how those with and without shingles can prevent the spread of the virus:
Keep shingles rash clean and covered — this prevents people from coming into contact with the fluid-filled blisters containing the virus.
Avoid touching or scratching the rash.
Wash your hands often.
If infected, avoid being around pregnant women, especially those who have never had chickenpox or the chickenpox vaccine — the varicella-zoster virus can bring severe complications to pregnant women and their babies, including pneumonia.
Children are required to take the chickenpox vaccine, which also reduces the likelihood of getting shingles later in life.
Shingrix is a vaccine used to prevent herpes zoster in adults. According to the CDC, only healthy adults 50 and older should get the Shingrix vaccine.⁵
However, adults who are 19 and older and have a weakened immune system due to therapy or disease can also get the shingles vaccine.
If you currently have shingles, are pregnant, or are allergic to any component of the shingles vaccine, you should not get the Shingrix vaccine.
You should seek immediate treatment from your healthcare provider to prevent complications.
Immunocompromised individuals and older adults are at significant risk of developing shingles complications like postherpetic neuralgia. Therefore, it's always a good idea to see a doctor when you notice a rash on your penis or scrotum.
You should see a doctor when you experience the following:
Blisters spreading to other parts of the body
Extreme pain and discomfort
Fever and chills
It's easier to misdiagnose an unidentified rash on your penis or scrotum. For example, it could be a shingles rash or a sexually transmitted infection like syphilis or genital herpes. However, a doctor can provide clarity on your illness and recommend the best form of treatment.
Shingles is a common illness caused by the herpes zoster virus, the same virus that causes chickenpox. The illness causes fluid-filled blisters around the affected area, among other symptoms.
Herpes zoster can affect any part of your body, but it's more common in some areas.
Shingles may affect your penis and scrotum in rare cases when the herpes zoster virus reactivates in S2 and S3 dermatomes.
You should see a doctor when you experience symptoms of penile shingles or if you have certain complications.
Yes. Shingles can form on any body part, although it's rare on some, like the groin.
Yes, you can get herpes zoster on your penis if the herpes zoster virus reactivates in the S2 and S3 nerves.
Sources
Shingles burden and trends | Centers for Disease Control and Prevention
Herpes zoster with penoscrotal swelling: A rare compilation in a healthy child (2020)
Vaccination | Centers for Disease Control and Prevention
Other sources:
Shingles | National Institute of Neurological Disorders and Stroke
Penile herpes zoster: An unusual location for a common disease (2011)
Signs & symptoms | Centers for Disease Control and Prevention
Complications of shingles | Centers for Disease Control and Prevention
Antidepressants for the treatment of neuropathic pain (2006)
Transmission | Centers for Disease Control and Prevention
Chickenpox during pregnancy | March of Dimes
Shingles vaccination | Centers for Disease Control and Prevention
Shingles (herpes zoster) | New York State
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