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Shingles (Herpes Zoster)

Shingles is a painful skin rash caused by the varicella-zoster virus. This is the same virus (germ) that causes chickenpox. After you have chickenpox, the virus often remains in your 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 a second or even a third time. When shingles does recur, it may affect a different part of the body.

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 suppress 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 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 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 that held the virus. 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 with medications can help relieve pain, speed healing, and reduce the risk of complications. These medications include antiviral medications and steroids. To care for your symptoms:

  • Apply cool compresses to your skin or soak in a cool bath.

  • Use calamine lotion to calm itchy skin.

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

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 pain that lasts for months or even years after you have shingles. Medications and skin ointments can be prescribed to help relieve the pain.

  • Bacterial infection. Instead of healing normally, shingles blisters become infected with bacteria. The infection can cause scars or loss of skin tissue.

  • Blindness. Shingles that occurs near the eye can lead to blindness.

  • Nerve damage. Shingles that affects nerves in the face can cause hearing loss and paralysis (loss of movement) of certain facial muscles.

When to Call Your Doctor

Contact your doctor if you experience any of the following:

  • Symptoms that don’t go away with treatment.

  • A rash near your eye. Immediate care can help prevent blindness.

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

Preventing the Spread of the Virus

You can’t catch shingles or spread it to another person. But you can spread the virus to someone who hasn’t had chickenpox. Until your blisters fully heal, avoid contact with others, especially the following:

  • Pregnant women who have never had chickenpox (the chickenpox virus can harm a developing baby)

  • Newborns

  • Adults and children who have never had chickenpox

  • People with a weakened immune system

The Shingles Vaccine

If you’re 60 years of age or older and have had chickenpox, ask your doctor 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.


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