What is shingles?

Monday, February 17, 2020

By Abbigail Sampson, Extension Educator

Shingles (herpes zoster) is a painful, blistering skin rash. It is caused by the varicella-zoster virus. This is the same virus that causes chickenpox. One-in-three adults will get shingles in their lifetime, but less than 30 percent of those eligible get vaccinated.

After you get chickenpox, your body does not get rid of the virus. Instead, the virus remains in the body, but is inactive (becomes dormant) in certain nerves in the body. Shingles occurs after the virus becomes active again in these nerves after many years. Many people had such a mild case of chickenpox that they do not realize they have had the infection. The reason the virus suddenly becomes active again is not clear. Often only one attack occurs. Shingles can develop in any age group. You are more likely to develop the condition if you are older than 60, you had chickenpox before age 1 and your immune system is weakened by medicines or disease. If an adult or child has direct contact with the shingles rash and did not have chickenpox as a child or get the chickenpox vaccine, they can develop chickenpox, not shingles.

What are the symptoms? The first symptom is usually pain, tingling or burning that occurs on one side of the body. The pain and burning may be severe and are usually present before any rash appears. Red patches on the skin, followed by small blisters, form in most people. The blisters break, forming small sores that begin to dry and form crusts. The crusts fall off in two-to-three weeks. Scarring is rare. The rash usually involves a narrow area from the spine around to the front of the abdomen or chest. The rash may involve the face, eyes, mouth and ears.

What are exams and tests associated with it? Your health care provider can make the diagnosis by looking at your skin and asking about your medical history. Tests are rarely needed.

What is the treatment? Your provider may prescribe a medicine that fights the virus called an antiviral drug. This drug helps reduce pain, prevent complications and shorten the course of the disease. The medicines are most effective when started within 72 hours of when you first feel pain or burning. It is best to start taking them before the blisters appear. Follow your provider’s instructions about how to care for yourself at home. Other measures may include caring for your skin by applying cool, wet compresses to reduce pain, taking soothing baths and resting in bed until the fever goes down. Stay away from people while your sores are oozing to avoid infecting those who have never had chickenpox – especially pregnant women.

What is the outlook? Herpes zoster usually clears in two-to-three weeks and rarely returns. If the virus affects the nerves that control movement (the motor nerves), you may have temporary or permanent weakness or paralysis. Sometimes the pain in the area where the shingles occurred may last from months to years. This pain is called postherpetic neuralgia. It occurs when the nerves have been damaged after an outbreak of shingles. Pain ranges from mild to very severe. Postherpetic neuralgia is more likely to occur in people over age 60.

What are possible complications? Complications may include another attack of shingles, bacterial skin infections, blindness (if shingles occurs in the eye), deafness, infection - including encephalitis of sepsis (blood infection) in people with a weakened immune system - and Ramsay Hunt syndrome if shingles affects the nerves of the face or ear.

When should you contact a medical professional? Call your provider if you have symptoms of shingles, particularly if you have a weakened immune system or if your symptoms persist or worsen. Shingles that affects the eye may lead to permanent blindness if you do not receive emergency medical care.

How can it be prevented? Do not touch the rash and blisters on people with shingles or chickenpox if you have never had chickenpox or the chickenpox vaccine. Two shingles vaccines are available in a live vaccine or a recombinant. The shingles vaccine is different than the chickenpox vaccine. Older adults who receive the shingles vaccine are less likely to have complications from the condition. This information was found through the University of Florida Health website.

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