Shingles is an infection caused by the varicella-zoster virus, which is the same virus that causes chickenpox. Even after the chickenpox infection is over, the virus may live in your nervous system for years before reactivating as shingles.
Shingles may also be referred to as herpes zoster. This type of viral infection is characterized by a red skin rash that can cause pain and burning. Shingles usually appears as a stripe of blisters on one side of the body, typically on the torso, neck, or face.
Most cases of shingles clear up within 2 to 3 weeks. Shingles rarely occurs more than once in the same person, but approximately 1 in 3 people in the United States will have shingles at some point in their life, according to the Centers for Disease Control and Prevention (CDC).
The first symptoms of shingles are usually pain and burning. The pain is usually on one side of the body and occurs in small patches. A red rash typically follows.
Rash characteristics include:
- red patches
- fluid-filled blisters that break easily
- wraps around from the spine to the torso
- on the face and ears
- itching
Some people experience symptoms beyond pain and rash with shingles. These may include:
- fever
- chills
- headache
- fatigue
- muscle weakness
Rare and serious complications of shingles include:
- pain or rash that involves the eye, which should be treated immediately in order to avoid permanent eye damage
- loss of hearing or intense pain in one ear, dizziness, or loss of taste on your tongue, which can be symptoms of Ramsay Hunt syndrome and also requires immediate treatment
- bacterial infections, which you may have if your skin becomes red, swollen, and warm to the touch
Shingles on your face
Shingles usually occurs on one side of your back or chest, but you can also get a rash on one side of your face.
If the rash is close to or in your ear, it can cause an infection that could lead to loss of hearing, issues with your balance, and weakness in your facial muscles.
Shingles inside your mouth can be very painful. It may be difficult to eat, and your sense of taste may be affected.
A shingles rash on your scalp can cause sensitivity when you comb or brush your hair. Without treatment, shingles on the scalp can lead to permanent bald patches.
Shingles of the eye
Shingles in and around the eye, referred to as ophthalmic herpes zoster or herpes zoster ophthalmicus, occurs in about 10 to 20 percent of people with shingles.
A blistering rash may appear on your eyelids, forehead, and sometimes on the tip or side of your nose. You may experience symptoms such as burning or throbbing in your eye, redness and tearing, swelling, and blurred vision.
After the rash disappears, you may still have pain in your eye due to nerve damage. The pain eventually gets better in most people.
Without treatment, shingles of the eye can lead to serious problems including long-term vision loss and permanent scarring due to swelling of the cornea. Get a better understanding of shingles in your eye area.
If you suspect that you have shingles in and around your eye, you should see your doctor right away. Starting treatment within 72 hours will increase your likelihood of not having complications.
Shingles on your back
While shingles rashes usually develop around one side of your waistline, a stripe of blisters may appear along one side of your back or lower back.
Shingles on your buttocks
You can get a shingles rash on your buttocks. Shingles usually only affects one side of your body, so you may have a rash on your right buttock but not on your left.
As with other areas of the body, shingles on your buttocks may cause initial symptoms like tingling, itching, or pain.
After a few days, a red rash or blisters may develop. Some people experience pain but don't develop a rash.
Shingles is not contagious, but the varicella-zoster virus that causes it can be spread to another person who hasn't had chickenpox, and they could develop the disease. You can't get shingles from someone with shingles, but you can get chickenpox.
The varicella-zoster virus is spread when someone comes into contact with an oozing blister. It is not contagious if the blisters are covered or after they have formed scabs.
To prevent spreading the varicella-zoster virus if you have shingles, be sure to keep the rash clean and covered. Don't touch the blisters and wash your hands often.
You should avoid being around at-risk people such as pregnant women and people with weak immune systems.
Two vaccines have been approved by the Food and Drug Administration (FDA) to prevent shingles: Zostavax and Shingrix. These vaccines are recommended for adults 50 and older.
There’s no cure for shingles, but treating it as soon as possible can help prevent complications and speed your recovery. Ideally, you should be treated within 72 hours of developing symptoms. Your doctor may prescribe medications to ease symptoms and shorten the length of the infection.
Medication
The medications prescribed to treat shingles vary, but may include the following:
Type
|
Purpose
|
Drug frequency
|
Method
|
antiviral medications, including acyclovir, valacyclovir, and famciclovir
|
to reduce pain and speed recovery
|
2 to 5 times daily, as prescribed by your doctor
|
oral
|
anti-inflammation drugs, including ibuprofen
|
to ease pain and swelling
|
every 6 to 8 hours
|
oral
|
narcotic medications or analgesics
|
to reduce pain
|
likely to be prescribed once or twice daily
|
oral
|
anticonvulsants or tricyclic antidepressants
|
to treat prolonged pain
|
once or twice daily
|
oral
|
antihistamines, such as diphenhydramine (Benadryl)
|
to treat itching
|
every 8 hours
|
oral
|
numbing creams, gels, or patches, such as lidocaine
|
to reduce pain
|
applied as needed
|
topical
|
capsaicin (Zostrix)
|
to help reduce the risk of a nerve pain called postherpetic neuralgia, which occurs after recovery from shingles
|
applied as needed
|
topical
|
Shingles typically clears up within a few weeks and rarely recurs. If your symptoms haven’t lessened within 10 days, you should call your doctor for follow-up and re-evaluation.
Shingles is caused by the varicella-zoster virus, which also causes chickenpox. If you've already had chickenpox, you can develop shingles when this virus reactivates in your body.
The reason why shingles may develop in some people is not clear. It is more common in older adults because of lower immunity to infections.
Possible risk factors for shingles include:
- a weakened immune system
- emotional stress
- aging
- undergoing cancer treatments or major surgery
Some people with shingles only experience mild symptoms, such as tingling or itchy skin. But for others, it can be very painful. Even a gentle breeze can cause pain. Some people experience intense pain without developing a rash.
The pain from shingles usually occurs in the nerves of the chest or the neck, face, or lower back. To help relieve the pain, your doctor may prescribe antiviral, anti-inflammation, and other medications.
Home treatment can help ease your shingles symptoms. These remedies include:
- taking cool baths or showers to clean and soothe your skin
- applying cold, wet compresses to the rash to reduce pain and itching
- applying calamine lotion, or a paste made of baking soda or cornstarch and water, to reduce itching
- taking colloidal oatmeal baths to ease pain and itching
- eating foods with vitamins A, B-12, C, and E, as well as the amino acid lysine to strengthen your immune system
While getting shingles during pregnancy is unusual, it is possible. If you come into contact with someone who has chickenpox or an active shingles infection, you can develop chickenpox if you have not been vaccinated or if you have never had it before.
Depending on what trimester you’re in, having chickenpox during pregnancy can result in congenital disabilities. Getting a chickenpox vaccine before pregnancy can be an important step in protecting your child.
Shingles is less likely to cause complications, but it can still be unpleasant. See your doctor right away if you develop any rash during pregnancy. Find out more about shingles and pregnancy.
Anti-viral medications used to treat shingles can be used safely during your pregnancy. Antihistamines can also help reduce itching, and acetaminophen (Tylenol) can reduce pain.
While shingles can be painful and bothersome on its own, it’s important to monitor your symptoms for potential complications. These complications include:
- eye damage, which can occur if you have a rash or blister too close to your eye (the cornea is particularly susceptible)
- bacterial skin infections, which can easily occur from open blisters and can be severe
- Ramsay Hunt syndrome, which can occur if shingles affects the nerves in your head and can result in partial facial paralysis or hearing loss if left untreated; if treated within 72 hours, most patients make a full recovery
- pneumonia
- brain or spinal cord inflammation, such as encephalitis or meningitis, which is serious and life-threatening
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