Yes, scars can occur. Shingles can cause lesions in a dermatonal distributuion, i.e. Along a nerve root. These vesicles can scar. To decrease the risk of poor scars, one should take a course of an antiviral agent (e.g. Zovirax) and a 6 day Medrol (methylprednisolone) dose pack as well as topicals. It is extremely important not to scratch the lesions. For 6 monthes avoid the sun on the scars, use vit e or aloe or Mederma 2 times a day.