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Shingles is a painful skin rash. It's caused by the varicella zoster virus. Shingles usually appears in a band, a strip, or a small area on one side of the face or body. It's also called herpes zoster.
Shingles is most common in older adults and people who have weak immune systems because of stress, injury, certain medicines, or other reasons. Most people who get shingles will get better and won't get it again. But it's possible to get shingles more than once.
Shingles occurs when the virus that causes chickenpox starts up again in your body. After you've had chickenpox, the virus "sleeps" (is dormant) in your nerve roots. In some people, the virus "wakes up" when disease, stress, or aging weakens the immune system. Some medicines may trigger the virus.
Shingles symptoms happen in stages. First you may have a headache, sensitivity to light, and flu-like symptoms. Later you may feel tingling or pain in the area where a rash may occur a few days later. The rash then turns into blisters.
Doctors can usually diagnose shingles when they see an area of rash around the left or right side of your body. If the diagnosis isn't clear, your doctor may order tests on cells from a blister. If your doctor thinks that you have shingles, your doctor may not wait for tests before treating you.
Shingles is treated with medicines. These medicines include antiviral medicines and medicines for pain. Treatment may shorten the illness and prevent complications.
See your doctor right away if you think you may have shingles. Starting antiviral medicine right away can help your rash heal faster and be less painful. And you may need prescription pain medicine if your case of shingles is very painful. It's important to see your doctor right away if you have shingles near your eye or nose. Treatment can help prevent permanent eye damage.
Other treatments may help with intense pain. Getting pain under control right away may prevent nerve damage that may cause pain that lasts for months or years.
Good home care also can help you feel better faster. Avoid scratching blisters. Apply baking soda to help dry the sores. Soak crusted sores with tap water to clean away crusts and soothe the skin.
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Shingles occurs when the virus that causes chickenpox starts up again in your body.
After you've had chickenpox, the virus "sleeps" (is dormant) in your nerve roots. In some people, it stays dormant forever. In others, the virus "wakes up." In this case, you may get a rash that occurs only in the area of the affected nerve.
The virus can become active again when disease, stress, or aging weakens the immune system. Some medicines may trigger the virus. It's not clear why this happens.
After the virus becomes active again, it can cause only shingles, not chickenpox. Anyone who has had even a mild case of chickenpox can get shingles. This includes children.
You can't catch shingles from someone who has shingles. But if you haven't had chickenpox or haven't gotten the chickenpox vaccine, you can get chickenpox if you come into contact with the fluid in the shingles blisters.
Things that increase your risk for getting shingles include:
If a pregnant woman gets chickenpox, her baby has a high risk for shingles during his or her first 2 years of life. And if a baby gets chickenpox in the first year of life, he or she has a higher risk for shingles during childhood.footnote 1
Anyone who has had chickenpox may get shingles later in life. If you've never had chickenpox or the chickenpox vaccine, avoid contact with people who have shingles or chickenpox. Fluid from shingles blisters is contagious. It can cause chickenpox (but not shingles).
A shingles vaccine may help prevent shingles. It is recommended for adults ages 50 and older and adults 19 and older who have a weakened immune system.
If you have shingles, avoid close contact with people until after the rash blisters heal. It's most important to avoid contact with people who are at special risk from chickenpox. This includes pregnant people, infants, and anyone who has never had chickenpox, is currently ill, or has a weak immune system. Also cover any fluid-filled blisters that are on a part of your body that isn't covered with clothes. Choose a type of bandage that absorbs fluid and protects the sores.
Shingles symptoms happen in stages. At first you may have a headache or be sensitive to light. You may also have flu-like symptoms without a fever.
Later you may feel itching, tingling, or pain in a certain area. That's where a small area of rash may occur a few days later. It can appear anywhere on the body, but on only the left or the right side of the body. Piercing pain may occur along with the skin rash.
The rash turns into clusters of blisters. The blisters fill with fluid and then crust over. It takes 2 to 4 weeks for the blisters to heal, and they may leave scars. Some people get no rash at all.
Sometimes postherpetic neuralgia (PHN) develops. Symptoms can include a painful rash or sensitivity to touch. PHN may last for months or years.
Some people will have other problems from shingles. These can include:
Delaying or not getting medical treatment may increase your risk for problems.
Call your doctor now if you:
If you still feel intense pain for more than 1 month after the skin heals, see your doctor to find out if you have PHN. Getting your pain under control right away may prevent nerve damage that may cause pain that lasts for months or years.
Shingles is treated with medicines. See your doctor right away if you think you may have shingles. There is no cure for shingles. But treatment can help your rash heal faster and be less painful. It may shorten the length of illness and prevent complications.
It's important to see your doctor right away if you have shingles near your eye or nose. Treatment can help prevent permanent eye damage.
As soon as you are diagnosed with shingles, your doctor probably will start treatment with antiviral medicines. If you start taking medicines within the first 3 days of seeing the shingles rash, you have a lower chance of having later problems, such as postherpetic neuralgia (PHN).
The most common treatments for shingles include:
For severe cases of shingles, some doctors may have their patients use corticosteroids along with antiviral medicines. But steroids aren't used very often for shingles. This is because studies show that taking a steroid medicine along with an antiviral medicine doesn't help any more than just taking an antiviral medicine by itself.footnote 2
If you have pain that lasts longer than a month after your shingles rash heals, your doctor may diagnose postherpetic neuralgia (PHN). It's the most common complication of shingles. PHN can cause pain for months or years. It affects 10 to 15 out of 100 people who have had shingles.footnote 3 Treatment to reduce the pain of PHN includes:
Creams that contain capsaicin may provide some relief from pain. You put them on your skin. There is also a high-dose skin patch available by prescription (Qutenza) for PHN. Capsaicin may irritate or burn the skin of some people. It should be used with caution.
In some cases, shingles causes long-term problems. Treatment depends on the specific complication.
Gershon AA (2009). Varicella zoster virus. In RD Feigin et al., eds., Feigin and Cherry's Textbook of Pediatric Infectious Diseases, 6th ed., vol. 2, pp. 2077–2088. Philadelphia: Saunders Elsevier.
Chen N, et al. (2010). Corticosteroids for preventing postherpetic neuralgia (Review). Cochrane Database of Systematic Reviews (12).
Dubinsky RM, et al. (2004, reaffirmed 2008). Practice parameter: Treatment of postherpetic neuralgia. An evidence-based report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology, 63(6): 959–965.
Current as of:
July 1, 2021
Author: Healthwise StaffMedical Review: E. Gregory Thompson MD - Internal MedicineAdam Husney MD - Family MedicineMartin J. Gabica MD - Family Medicine
Current as of: July 1, 2021
Author: Healthwise Staff
Medical Review:E. Gregory Thompson MD - Internal Medicine & Adam Husney MD - Family Medicine & Martin J. Gabica MD - Family Medicine
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