Shingles is a disease characterized by a painful, blistering skin rash that affects one side of the body, typically the face or torso. This condition may also be referred to as herpes zoster, or simply zoster. There are approximately 1 million estimated cases per year in the U.S.. Shingles is more common in older individuals and in those with weakened immune systems.
The characteristic rash of shingles typically appears after an initial period of burning, tingling, itching, or stinging in the affected area. After a few days, the rash then appears in a stripe or band-like pattern along a nerve path, affecting only one side of the body without crossing the midline (to the other side). The rash erupts as clusters of small red patches that develop into blisters, which may appear similar to chickenpox.
What causes Shingles?
Shingles is caused by the same virus that causes chickenpox (varicella). Only those who have previously had chickenpox and those who have received the varicella vaccine can develop shingles later in life. After the episode of chickenpox has resolved, the virus remains in a dormant state in the nervous system in certain nerve cells of the body located in the spine. While in this inactive state, you will not experience any symptoms from the varicella zoster virus. However, in certain individuals and for reasons that are not completely clear, the varicella zoster virus may reactivate years later and travel along nerve paths to cause shingles.
Though similar in name, herpes zoster is not the same disease as herpes simplex (which is caused by the herpes simplex virus causing cold sores, fever blisters, or genital herpes)
Who can get Shingles?
Shingles can only occur in individuals who have previously been exposed to the varicella zoster virus. Risk factors for the development of shingles include the following:
- Increasing age: Though shingles can rarely occur in children, it is much more common in older adults, increasing with age.
- Weakened immune system: Individuals with impaired immune systems have a higher probability of developing shingles.
The virus that causes shingles, the varicella zoster virus, can be transmitted from person to person by direct contact with the fluid from the active blistering rash. Therefore, susceptible individuals should avoid contact with people who have active shingles, especially pregnant women who have never had chickenpox and immunocompromised individuals. It cannot be transmitted by coughing or sneezing, and it is not contagious before the blisters appear. Once the shingles rash has dried and developed crusting, it is not considered to be contagious.
Shingles usually starts with burning, tingling, itching, or stinging in the region where the rash will ultimately develop. Sometimes, this pain can be severe and individuals may complain of extremely sensitive skin. This discomfort typically occurs a few days before the rash develops. In rare instances, the characteristic shingles rash will not appear (a condition called zoster sine herpete).
Often, individuals may also experience other associated symptoms such as headache, fever and chills, malaise, nausea,body aches, and swollen lymph glands.
A few days after the skin discomfort begins (or rarely, several weeks afterward), the characteristic rash of shingles will appear. It typically begins as clusters of small red patches that eventually develop into small blisters. These fluid-filled blisters eventually break open, and the small sores begin to slowly dry and scab over. The crusts usually fall off after several weeks, and the shingles rash typically clears up after approximately four weeks.
The location of the shingles rash can vary. Though shingles can appear almost anywhere on the body, it most commonly affects the torso and the face (including the eyes, ears, and mouth). It is often present in the area of the ribcage or the waist. This characteristic rash is in a stripe or band-like pattern that affects only one side of the body (the right or the left), and it usually does not cross over the midline.
What are medical treatments for shingles?
The treatment for shingles is aimed at diminishing the effects of the virus, as well as pain management. There are several medications that can be used. Your doctor will discuss the best treatment options for your particular situation.
The duration of an acute shingles outbreak may vary, but typically it will last anywhere between two to four weeks. In some individuals, it may last longer.
