Shingles is a painful rash caused by the reactivation of the varicella-zoster virus (VZV), the same virus responsible for chickenpox. VZV remains dormant in nerve tissue and can emerge years later, typically as a single stripe of blisters on one side of the body. During an outbreak, many people wonder about resuming normal activities, especially water-based recreation. This article provides guidance regarding the safety of swimming and water exposure during a shingles episode.
Understanding the Risk of Contagion
The primary concern regarding swimming with shingles, particularly in public or shared water, is the risk of transmitting the varicella-zoster virus (VZV). Shingles is not spread through respiratory droplets, but the fluid within active, open blisters is highly infectious. Direct contact with this blister fluid can transmit VZV to people who lack immunity, causing them to develop chickenpox.
Swimming in communal settings, such as a public pool, hot tub, or lake, increases the likelihood of direct contact. Chlorine in swimming pools does not reliably kill VZV, so the water cannot neutralize the infectious fluid. If lesions are weeping or have not yet crusted over, entering shared water poses a risk of exposure to others. Avoiding these environments protects vulnerable individuals, including infants, pregnant women, and those with compromised immune systems.
How Water Affects the Healing Rash
Swimming with an active rash introduces risks to the patient’s own health and recovery. The open, fluid-filled blisters are essentially small wounds, and prolonged soaking in water interferes with the body’s natural healing mechanism. Exposing the rash to water can soften the blister tops, slowing the drying and crusting phase necessary for recovery.
Water in public swimming areas is not sterile and carries bacteria that can enter the open lesions. This exposure increases the chance of developing a secondary bacterial infection in the rash, which complicates healing and may lead to scarring. Chemicals like chlorine or high concentrations of salt can also irritate the sensitive, inflamed skin of the rash. While short, lukewarm baths with colloidal oatmeal can provide symptom relief at home, the general advice is to keep the shingles rash clean and dry to promote faster resolution.
Clear Criteria for Returning to Swimming
Returning to swimming depends entirely on the stage of the rash, as infectivity ceases once the lesions are dry. The standard for safe return to water activities is that all lesions must be fully crusted over, with no new blisters forming. Once a blister has formed a hard scab, the varicella-zoster virus is no longer shed, and the person is no longer considered contagious.
This crusting process typically takes seven to ten days after the rash first appears. While a fully crusted rash means the risk of transmission is negligible, it is still advisable to ensure the scabs are secure before submerging them in water, especially in public pools. Individuals should wait if the rash is still in the painful or blistering stage.