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Shingles (Herpes Zoster)

Shingles is also called herpes zoster. It is a painful skin rash caused by the herpes zoster virus. This is the same virus that causes chickenpox. After a person has chickenpox, the virus remains inactive in the nerve cells. Years later, the virus can become active again and travel to the skin. Most people have shingles only once, but it is possible to have it more than once.

What are the risk factors for shingles?

Anyone who has had chickenpox can develop shingles. But your risk is greater if you:

  • Are 50 years of age or older.

  • Have an illness that weakens your immune system, such as HIV/AIDS.

  • Have cancer, especially Hodgkin disease or lymphoma.

  • Take medications that weaken your immune system.

What are the symptoms of shingles?
Man sitting on exam table. Health care provider is putting on gloves to examine rash on man's side.
The shingles rash usually appears on just one side of the body.

  • The first sign of shingles is usually pain, burning, tingling, or itching on one part of your face or body. You may also feel as if you have the flu, with fever and chills.

  • A red rash with small blisters appears within a few days. The rash may appear as follows: 

    •  The blisters can occur anywhere, but they’re most common on the back, chest, or abdomen.

    • They usually appear on only one side of the body, spreading along the nerve pathway where the virus was inactive. 

    • The rash can also form around an eye, along one side of the face or neck, or in the mouth.

    • In a few people, usually those with weakened immune systems, shingles appear on more than one part of the body at once.

  • After a few days, the blisters become dry and form a crust. The crust falls off in days to weeks. The blisters generally do not leave scars.

How is shingles treated?

For most people, shingles heals on its own in a few weeks. But treatment is recommended to help relieve pain, speed healing, and reduce the risk of complications. Antiviral medications are prescribed within the first 72 hours of the appearance of the rash. To lessen symptoms:

  • Apply ice packs (wrapped in a thin towel), cool compresses,  or soak in a cool bath.

  • Use calamine lotion to calm itchy skin.

  • Ask your health care provider about over-the-counter pain relievers. If your pain is severe, your provider may prescribe stronger pain medications.

What are the complications of shingles?

Shingles often goes away with no lasting effects. But some people have serious problems long after the blisters have healed:

  • Postherpetic neuralgia. This is severe nerve pain that lasts for months, or even years after you have shingles. Medications can be prescribed to help relieve the pain and improve quality of life.

  • Bacterial infection. Shingles blisters may become infected with bacteria. Antibiotic medication is used to treat the infection.

  • Eye problems. A person with shingles on the face should see his or her health care provider right away. Shingles can cause serious problems with vision, and even blindness.

When to seek medical care

Contact your health care provider if you experience any of the following:

  • Symptoms that don’t go away with treatment.

  • A rash or blisters near your eye.

  • Increased drainage, fever, or rash after treatment, or severe pain that doesn’t go away.

How can shingles be prevented?

You can only get shingles if you have had chicken pox in the past. Those who have never had chickenpox can get the virus from you. Although instead of developing shingles, the person may get chickenpox. Until your blisters form scabs, avoid contact with others, especially the following:

  • Pregnant women who have never had chickenpox or the vaccine

  • Infants who were born early (prematurely) or who had low weight at birth

  • People with weak immune system (for example, people receiving chemotherapy for cancer, people who have had organ transplants, or people with HIV infections)

 

The shingles vaccine

If you’re 60 years of age or older , ask your health care provider if you should receive the shingles vaccine. The vaccine makes it less likely that you will develop shingles. If you do develop shingles, your symptoms will likely be milder than if you hadn’t been vaccinated. Note: Although the vaccine is licensed for people 50 years of age or older, the CDC does not recommend the vaccine for those who are 50 to 59 years old.

Online Medical Reviewer: Holloway, Beth, RN, M.Ed.
Online Medical Reviewer: MMI board-certified, academically affiliated clinician
Last Review Date: 8/7/2014
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