How common is scarring after herpes zoster, and what do these scars look like?

The research indicates that post-herpes zoster scarring occurs in approximately 9.7% of patients. These scars can present in various forms, including hypopigmented, hyperpigmented, atrophic, and hypertrophic scars. The formation of these scars is influenced by several factors, as identified by the study conducted over three years, which included 113 herpes zoster patients.

What are the main risk factors that increase the likelihood of scarring after a shingles outbreak?

Several factors increase the risk of scarring after a herpes zoster outbreak. Extensive and severe herpes zoster infections significantly elevate the likelihood of scarring. Immunosuppression is another critical factor; individuals with weakened immune systems are more susceptible. Additionally, a prior history of hypertrophic or keloid scarring also increases the risk of developing scars after herpes zoster.

How can antiviral treatment help prevent scarring associated with herpes zoster?

The study highlights the importance of prompt antiviral treatment for herpes zoster. Early initiation of antiviral medication can effectively reduce the severity of the infection. By mitigating the intensity of the outbreak, antiviral treatments decrease the probability of developing scars. This proactive approach is a key strategy in preventing lasting skin damage.

What role does the herpes zoster vaccine play in reducing the risk of scarring?

The herpes zoster vaccine plays a crucial role in preventing scars. Vaccination is shown to reduce both the severity and incidence of herpes zoster. By decreasing the frequency and intensity of shingles outbreaks, the vaccine minimizes the potential for scarring. Consulting a doctor to determine if the herpes zoster vaccine is suitable, especially for those over 50 or with weakened immune systems, is highly recommended.

Where on the body are scars from herpes zoster most likely to appear?

The most frequent locations for scarring after herpes zoster are the trunk, cervical region, and face. The study observed that these areas are more prone to scar formation, possibly due to the higher concentration of nerve endings or the skin's natural healing processes in these regions. Understanding the common locations helps in targeted prevention and early intervention strategies.

Protective skin barrier representing herpes zoster vaccination.

Herpes Zoster Scars: Why They Happen and How to Prevent Them

Kai Mendoza in Health & Wellness December 2025 • 4 min read.

"Uncover the surprising link between shingles and skin scarring, and learn how early treatment can make a difference."

Chickenpox, caused by the varicella-zoster virus (VZV), often leaves behind cutaneous scars, affecting about 20% of children. But what about herpes zoster, also known as shingles, which is caused by the same virus reactivating later in life? Surprisingly, skin scars from shingles aren't as widely discussed, and the risk factors for post-herpes zoster scarring remain unclear.

A recent study aimed to change that by prospectively investigating the incidence and risk factors for scarring after herpes zoster. The study followed patients with herpes zoster at a tertiary university hospital over three years, collecting data on age, sex, immune status, prior scarring history, severity and extent of the herpes zoster infection, affected dermatome (the area of skin supplied by a single spinal nerve), and antiviral treatment received.

The findings shed light on why some people develop scars after shingles and, more importantly, how to potentially prevent them. This article delves into the study's results, offering insights and actionable advice to help you protect your skin after a shingles outbreak.

What the Research Reveals About Scarring After Shingles

Protective skin barrier representing herpes zoster vaccination.

The study, conducted over three years, included 113 herpes zoster patients who were monitored for scar formation six months after their skin lesions healed. The results indicated that 9.7% of these patients developed post-herpes zoster scarring. These scars varied in appearance, including hypopigmented (lighter than the surrounding skin), hyperpigmented (darker than the surrounding skin), atrophic (sunken), and hypertrophic (raised) scars.

Researchers identified several key factors that appeared to increase the risk of scarring:

Severity of Herpes Zoster: Extensive and severe herpes zoster infections were more likely to result in scarring.
Immunosuppression: A significant number of patients who developed scars were immunocompromised, suggesting a weakened immune system increases the risk.
Previous Scarring History: Patients with a history of hypertrophic or keloid scarring were more prone to developing scars after herpes zoster, although they did not have prior varicella scars.

Interestingly, the most frequent locations for scarring were the trunk, cervical region, and face. While the study provides valuable insights, the researchers acknowledged that the setting—a tertiary university hospital—might have led to an overrepresentation of immunocompromised patients with severe herpes zoster.

Taking Action: Preventing Scars After Herpes Zoster

The study underscores that scarring after herpes zoster is likely more common than previously thought. The good news is that there are steps you can take to minimize your risk. Prompt initiation of antiviral treatment for herpes zoster is crucial to reduce the severity of the infection and, consequently, the likelihood of scarring. Furthermore, herpes zoster vaccination can significantly decrease the severity and incidence of herpes zoster, thus reducing the potential for scarring. Talk to your doctor about whether the herpes zoster vaccine is right for you, especially if you are over 50 or have a weakened immune system.