Shingles is a viral infection caused by the varicella-zoster virus (VZV), the same virus that causes chickenpox. It typically affects a single sensory nerve ganglion and the skin that the nerve supplies.
Anyone who has had chickenpox can later develop shingles. In fact, according to the Centers for Disease Control and Prevention (CDC), an estimated 1 in 3 people in the United States develop shingles during their lifetime.
People can develop shingles if they have chickenpox in the past. This virus can lie dormant for years and then reactivate as shingles. A person who has not had chickenpox before can get chickenpox through exposure to someone with shingles.
Shingles are most common after the age of 50, but they can appear at any age if a person has previously had chickenpox.
In this article, learn more about shingles, including symptoms, complications, and treatments.
Shingles usually affect one side of the body, most often the waist, chest, abdomen, or back. Symptoms can also appear on the face and in the eyes, mouth, and ears. The virus can also affect some internal organs.
Shingles typically affect a single sensory nerve ganglion near the spinal cord, called a dorsal root ganglion. This is why the symptoms occur in specific areas of the body rather than all over it. The pain results from nerve involvement rather than the rash itself.
Symptoms can vary in nature, depending on where on the body they appear.
Some people have pain but no rash. Others may have a rash with pain accompanied by other symptoms, such as fever, chills, or headache.
Most common symptoms
Some of the most common symptoms of shingles
- a constant dull, burning, or gnawing pain, or a sharp, stabbing pain that comes and goes
- a skin rash that resembles a chickenpox rash but only affects certain areas
- fluid-filled blisters that develop as part of the rash
Symptoms on the body
A blistering skin rash may appear in one or more distinct bands, called dermatomes, that contain sensory nerves of the skin.
Common locations for this include:
- the chest
- the abdomen
- the back
- around the waist
It usually occurs only on one side of the body. The location of the symptoms will depend on which dermatome distribution the virus affects.
Facial symptoms
If the rash affects the face, symptoms usually appear on one side only — usually around one eye and the forehead.
They can include:
- pain over the affected dermatome
- a rash
- muscle weakness
- headache
Eye symptoms
If the virus affects an ophthalmic nerve, it
This can cause pain, swelling in and around the eye, as well as temporary or permanent loss of vision.
Ear symptoms
Shingles can also occur in or around the ear, leading to problems with balance and hearing, as well as muscle weakness on the affected side of the face.
These changes can be long-term or even permanent.
A person who develops symptoms in or around the ears and eyes should seek immediate medical attention to reduce the risk of complications.
Mouth symptoms
If shingles affects the mouth, a person may experience:
- facial tenderness
- pain in the mouth
- toothache
- lesions in hard and soft palate tissues
The pain and discomfort of these symptoms can make it difficult to eat or drink.
Internal shingles
Shingles can also affect the internal organs. There will not be a rash, but other problems can arise.
For example, researchers have found evidence of shingles in the digestive system, which
Other symptoms
There may also be other symptoms,
- fever
- fatigue
- chills
- headache
- upset stomach
Symptom progression
Symptoms typically progress as follows:
- Pain, tingling, numbness, and itching start to affect a specific part of the skin.
- After up to 2 weeks, a rash appears.
- Red blotches and itchy, fluid-filled blisters develop and continue for
3–5 days . - The blisters may merge, forming a solid red band that looks similar to a severe burn. The gentlest touch may be painful.
- Inflammation may affect the soft tissue under and around the rash.
- After 7–10 days, the blisters gradually dry and form scabs or crusts. As the blisters disappear, they may leave minor scarring.
Shingles usually last 2–4 weeks. They are contagious until the blisters dry up and crust over.
Most people will only have an episode of shingles once, but it can recur in some people.
Getting treatment shortly after the onset of symptoms can help decrease the duration and severity of infection.
This is especially important for people
If the rash continues spreading to other parts of the body or other symptoms occur, such as high fever, it is best to consult with a doctor.
Additionally, those who develop a rash near the eye should seek immediate medical attention, as this can be a sign of HZO. If left untreated, the condition can cause scarring, vision loss, and permanent eye damage.
A doctor
Antiviral treatment can help with:
- reducing the severity and duration of symptoms
- preventing complications from developing
- lowering the risk of the rash coming back
In addition to antiviral drugs, there are several other ways to help manage symptoms, including:
- using pain relief medication
- reducing stress as much as possible
- eating regular, nutritious meals
- getting some gentle exercise
- wearing loose-fitting clothes for comfort
- doing relaxing activities that will reduce stress and take a person’s mind off the pain, such as watching television, reading books, socializing, listening to music, or engaging in hobbies
To relieve itching, the
- applying calamine lotion
- taking a lukewarm, oatmeal bath
- placing a cool, damp washcloth on the blisters
Most people will recover with home treatment, but a person should seek medical help if other symptoms appear, such as a fever.
Learn more about home remedies for itching here.
Shingles result from VZV, the same virus that
VZV belongs to a group of herpes viruses, so shingles are also known as “herpes zoster.” All herpes viruses can hide in the nervous system and remain indefinitely in a latent state.
Under the right conditions, the herpes zoster virus can reactivate, like waking up from hibernation, and travel down nerve fibers to cause a new active infection.
What triggers this is not usually clear, but it may happen when something weakens the immune system, prompting the virus to reactivate.
Learn more about chickenpox.
It is not possible to directly transmit shingles to another person. However, a person who has never had chickenpox
If this happens, and the person has not received a vaccination against chickenpox, they would develop chickenpox first, not shingles.
Shingles do not spread through coughing or sneezing. Only direct contact with fluid from the blisters can spread the virus. Therefore, covering the blisters reduces the risk of contagion.
It is important to note that the virus is only active from the time the blisters first appear until they dry up and crust over. Transmission is not possible before the blisters develop or after the crusts form. If a person does not develop blisters, the virus cannot spread in the traditional sense.
Taking the following precautions can help prevent the transmission of the virus:
- covering the rash
- washing the hands often
- avoiding touching or scratching the rash
It is also important for someone with shingles to avoid contact with:
- infants who are preterm or have a low birth weight
- pregnant people who have never had chickenpox or the vaccine for it
- those with a weakened immune system
How long are shingles contagious?
The blisters typically take
Doctors usually diagnose shingles through a physical exam by evaluating the appearance of the rash and blisters on the body.
In some cases, they may collect a tissue sample from the blister fluid and send it to a lab to check for the virus.
They may also conduct a blood test to look for antibodies, which can determine whether a person has ever been exposed to the virus.
Vaccination can offer protection from both chickenpox and shingles.
For children: Chickenpox vaccine
Experts
With two doses of the vaccine, there is at least a 90% chance of preventing chickenpox, which will also prevent shingles.
Children should receive the first dose at
Tests have shown the vaccine to be safe, though some children may experience:
- pain at the injection site
- a fever and a mild rash
- temporary joint pain and stiffness
Since vaccination started in children, the number of shingles cases is
For older adults: Shingles vaccine
A different vaccine, the herpes zoster vaccine, is available for people ages 50 and older who have had chickenpox and, therefore, carry VZV. Experts also recommend this vaccine for those without chickenpox or shingles.
In the U.S.,
The options available are Zostavax and a newer vaccine called Shingrix. According to the CDC, after two doses of Shingrix, a person will have more than 90% protection against shingles, falling to just above 85% after four years.
Who should not have the vaccine?
People who should not have the shingles vaccine without first discussing it with their doctor include those who:
- have an allergy to any component of the shingles vaccine
- have a weakened immune system
- are or might be pregnant
Although anyone who has had chickenpox can develop shingles, some people may be at a higher risk.
Possible risk factors and triggers include:
- older age
- certain cancers or cancer treatment options
- HIV
- treatments that suppress the immune system
- stress or trauma
Complications
Rarely complications can arise — especially in people with an impaired immune system.
Possible complications of shingles
- postherpetic neuralgia (PHN)
- inflammation of the brain or spinal cord, increasing the risk of stroke, encephalitis, and meningitis
- eye and vision problems
- weakness
- problems with balance and hearing
- damage to blood vessels, which could lead to stroke
- pneumonia
According to the CDC, around
It is more likely to occur if a person develops shingles after the age of 40, and the risk continues to increase with age.
In people with weak immune systems
People with a weakened immune system will have a
This includes people who:
- have cancer, especially leukemia or lymphoma
- have HIV
- have undergone an organ transplant
- are taking medications to suppress the immune system, including chemotherapy drugs
These people should seek medical attention as soon as possible if they have concerns about shingles-related symptoms.
Learn more about precautions to take with a weak immune system.
Anyone who has had chickenpox can develop shingles. Most people recover fully from shingles within 3 to 5 weeks, but some experience severe complications. People with weakened immune systems are most at risk.
Getting the varicella vaccination during childhood can prevent chickenpox and shingles. Vaccines against shingles are available for those who did not have the vaccination in childhood.
People age 50 and older should talk with their doctor about the shingles vaccination.
What triggers shingles to flare up?
A weak immune system can trigger shingles to flare up. Health conditions that can trigger a flare-up include cancer, HIV, and taking immunosuppressant medication such as chemotherapy.
Will shingles go away on their own?
Shingles can heal independently, but taking antiviral treatment will quicken recovery.
What should you do if someone in the household has shingles?
If someone in the household has shingles, it is important to cover the blisters up to avoid passing the virus on. They should also avoid scratching the rash and always wash their hands.
Can you get shingles twice?
A person may get shingles twice since the virus lies dormant in the body.
Shingles is a virus that causes symptoms such as painful rashes with fluid-filled blisters. The blisters are contagious and may spread the virus if it comes into contact with another person. Other symptoms include fever, chills, pain, and headache.
Treatment includes antiviral medications and home remedies for itching. Most people will recover fully from shingles within 3 to 5 weeks. If a person experiences any symptoms of shingles, contact a doctor immediately, as those with a weakened immune system are most at risk of complications.