Shingles (Herpes Zoster)
What is shingles?
Shingles (herpes zoster) is a painful skin rash caused by the varicella-zoster virus
(VZV). 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. If it does, a red rash or small blisters occur, usually on one side of the
body, spreading along a nerve pathway where the virus was inactive. Sometimes, even
after the rash is gone, the pain may continue for a prolonged time. This is a complication
called postherpetic neuralgia (PHN). People who get the chickenpox vaccine still have
a small risk of herpes zoster, although it appears to be less than the risk after
an actual chickenpox infection. People with a weak immune system are at greater risk
of getting shingles. Almost half of the cases of shingles occur in people older than
The incidence of herpes zoster occurring in children is low, but the risk of getting
this disease increases with age. Children who have weak immune systems may have the
same, or more severe, symptoms as adults. Children most at risk for herpes zoster
are those who had chickenpox during the first year of life or whose mothers had chickenpox
very late during pregnancy.
What are the symptoms of shingles?
Shingles most often occurs on the trunk and buttocks. It may also appear on the arms,
legs, or face. These are the most common symptoms:
Pain, burning, tingling, or itching on one part of your face or body
Rash, which can appear up to 5 days after and first looks like small, red spots that
turn into blisters
Blisters which turn yellow and dry
Rash which usually goes away in 2 to 4 weeks
Rash is usually localized to one side or part of the body
Fever, chills, headache, nausea
PHN can cause pain for weeks, months, and rarely even years after the rash resolves
The symptoms of herpes zoster may look like other skin conditions. Always see your
healthcare provider for a diagnosis.
How is shingles diagnosed?
Your healthcare provider will ask about your medical history and do a physical exam.
Diagnosis may also include:
What is the treatment for shingles?
Immediate treatment with antiviral medicines may help lessen the duration and severity
of some of the symptoms. These antiviral medicines (acyclovir, famcyclovir and valacyclovir)
are more effective the sooner they are started. Ask your healthcare provider about
over-the-counter pain relievers. If your pain is severe, your provider may prescribe
stronger pain medicine. You and your healthcare provider will decide on the best treatment
based on factors including duration and severity of the symptoms.
How can I prevent shingles?
The CDC recommends vaccination at age 60 or older for everyone. If you have questions
about shingles or if you should get the shingles vaccine, talk with your healthcare
provider. The vaccine is approved for use at age 50 as well, but current CDC guidelines
do not recommend routine vaccination between 50 and 59 years old. The herpes zoster
vaccine has been shown in clinical trials to reduce infections by one half, and to
reduce PHN by two thirds. Even if you have had shingles, you can still get the vaccine
to help prevent future occurrences of the disease. The vaccine is effective for at
least 6 years, but may last longer. The vaccine is made of a live but weakened virus.
It should not be given to those who have a weak immune system. Check with your healthcare