Shingles (Herpes Zoster): Symptoms & Treatment

Overview

What is shingles?

Shingles is a viral infection that results from the varicella-zoster virus, the same virus that causes chickenpox. After a person recovers from chickenpox, the virus remains dormant in the body and can reactivate years later, causing shingles.

Where does shingles come from?

The origin of shingles is closely tied to the initial infection of chickenpox. The varicella-zoster virus is responsible for both conditions, with shingles occurring due to the reactivation of the virus that has lain dormant within the nerve tissues.

How common is shingles?

Who is at risk for getting shingles?

Can you get shingles more than once?

Shingles is relatively common, especially among older adults. Individuals with weakened immune systems, whether from stress, injury, certain medications, or other reasons, are at a higher risk. While it is uncommon to get shingles more than once, it is indeed possible.

Symptoms and Causes

What causes shingles?

The activation of the dormant varicella-zoster virus within the body’s nerve tissues causes shingles. This reactivation is promoted by a weakened immune system but the exact trigger is often unknown.

What are the symptoms of shingles?

Symptoms of shingles include a painful rash that can occur anywhere on your body but often appears as a single stripe of blisters wrapped around the left or right side of your torso.

How long does a shingles outbreak last?

Do you always get the typical rash if you have shingles?

A shingles outbreak typically lasts 2 to 4 weeks. While the rash is a common symptom, it’s possible to experience shingles without developing the typical rash.

Why does shingles appear mostly on one side or in one area of your body?

Shingles rash tends to appear on one side of the body because the virus affects nerve pathways, leading to localized infection and symptoms in the area served by those nerves.

Is shingles contagious?

How long are you contagious if you have shingles?

Shingles itself is not contagious, but the virus can be spread from an active shingles rash to another person who has never had chickenpox or been vaccinated against it, potentially causing chickenpox. You are contagious until all the blisters have crusted over.

Diagnosis and Tests

How is shingles diagnosed?

Shingles is primarily diagnosed based on the appearance of the characteristic rash and your symptoms. In some cases, a doctor may collect a tissue sample or swab from the blisters to test for the varicella-zoster virus.

Management and Treatment

How is shingles treated?

• Antiviral medications
• Over-the-counter pain medications
• Prescription pain medication and topical creams

Treatment for shingles aims to shorten the length of the infection, reduce pain and discomfort, and minimize complications. Antiviral medications are most effective when started within 72 hours after the rash appears.

Topical Solutions and Home Care

Alongside prescribed treatments, certain lotions or oatmeal baths can provide relief from itching. Cool compresses can also help alleviate the pain associated with shingles blisters.

If you have more than one area of blisters, what can you expect if you go to the hospital?

If you have shingles in only one area of your body that can’t be kept covered, what can you expect for your hospital stay?

Hospitalization may be necessary for severe cases, especially for those with immune systems complications. Treatment could include antiviral drugs, pain management, and monitoring for complications.

What are the complications of shingles?

Postherpetic neuralgia is the most common complication; it involves chronic pain in the area where the shingles rash was present, even after the rash has cleared up. Other potential complications include bacterial infections of the rash, vision loss if the rash occurs around the eye, and neurological problems such as encephalitis or paralysis.

How is postherpetic neuralgia treated?

Treatment may involve medications, nerve blocks, or other methods to manage pain. Antidepressants or anticonvulsant medications can also be used to alleviate pain from postherpetic neuralgia.

Prevention

Is a vaccine available to prevent shingles?

Who should be vaccinated with Shingrix?

Who should not be vaccinated with Shingrix?

What serious side effects should you watch for after getting the Shingrix vaccine?

If you’ve had shingles recently, how long should you wait before getting the Shingrix vaccine?

Is the Zostavax vaccine still being used?

Do you need to stay away from children, people who are pregnant, have cancer or anyone with a weak immune system after you get the Zostavax vaccine?

If you have previously received the Zostavax vaccine, how long should you wait before getting the Shingrix vaccine?

If you get the shingles vaccine, does this mean you’re 100% protected from getting shingles?

If you have a medical condition that suppresses your immune system, should you get the shingles vaccine?

The Shingrix vaccine is recommended to prevent shingles and complications associated with the disease. It is advised for healthy adults aged 50 and older, including those who’ve had shingles before, received the Zostavax vaccine, or aren’t sure if they’ve had chickenpox. Some individuals with weakened immune systems or certain medical conditions may also be eligible after consulting with a healthcare provider. Vaccination provides strong protection, although not 100%, and is considered the best defense against shingles.

Outlook / Prognosis

What should you expect if you get shingles?

Most people can expect a full recovery from shingles, especially if treated promptly. However, some may experience postherpetic neuralgia or other complications.

Is shingles dangerous or even fatal?

While shingles can be very painful, it is rarely fatal. The risk of complications is higher in older adults and those with weakened immune systems.

When is it safe to return to work if you have shingles?

You can return to work or other activities as long as you feel up to it and you can effectively keep the rash covered. It’s important to maintain good hygiene practices and avoid close contact with those who have not had chickenpox, are pregnant, or have weakened immune systems.

Additional Common Questions

Why doesn’t having chickenpox earlier in life provide immunity against having shingles later?

Can you still develop shingles if you’ve been vaccinated for chickenpox?

Can you get shingles if you haven’t had chickenpox?

Can you get chickenpox more than once?

Are there natural ways to boost your immune system to help lessen the chances of developing shingles?

What is the difference between herpes zoster and varicella-zoster?

Are measles and shingles related since they both produce a rash?

Can you get shingles from the COVID-19 vaccine?

Having chickenpox does provide immunity, but the virus can reactivate as shingles later in life. Vaccination for chickenpox can lower this risk but not eliminate it. Shingles can develop in anyone who has had chickenpox, and in rare cases, chickenpox can occur more than once. Natural immune boosters may help reduce the risk. Herpes zoster and varicella-zoster refer to the same virus at different stages (chickenpox and shingles, respectively). Shingles is not related to measles or triggered by the COVID-19 vaccine.