Shingles (Herpes Zoster)

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What is shingles?

Also known as zoster or herpes zoster, shingles is a disease that causes a rash and often painful blistering on the skin. After the skin clears, some people continue to experience severe pain that can last for months or even years.

What causes shingles?

Shingles is caused by the same virus as chicken pox. After the chicken pox clear, the virus remains dormant (inactive) within certain nerve cells of the body. When the virus reactivates, shingles, which can be quite painful, develops.

Anyone who has had chicken pox can develop shingles. In fact, about 20 percent of people who have had chicken pox develop shingles, usually only once.

It’s not known what triggers shingles, but a weakened immunity, illness, trauma and stress are all likely triggers. It’s also more common in people over 50.

What are symptoms of shingles?

Shingles usually begins with burning, itching, tingling, or extreme sensitivity of the skin for a few days followed by a red rash that turns into painful blisters which generally last for two to three weeks. At first the blisters are clear, but then look yellow or bloody before they scab over and disappear.

A diagnosis of shingles can be confirmed with tests.

How is shingles treated?

Shingles usually clears on its own in a few weeks and seldom recurs. The pain that goes with the blisters sometimes requires painkillers and cool compresses.

When diagnosed within 72 hours, oral anti-viral medication can be prescribed. In addition to treating the shingles, an anti-viral medication can prevent post-herpetic neuralgia (pain, numbness, itching, and tingling that last long after the rash clears

To reduce swelling and pain, a corticosteroid may be prescribed. Oral medications, anti-depressants, anti-seizure and antineuralgia medicines also may be of some benefit.

Complications

Probably the most common problem of shingles is post-herpetic neuralgia, where the pain, numbness, itching, and tingling can last for months or even years.

A bacterial infection can develop in the blisters, which can delay healing and result in scarring.

Shingles in the eye that is not promptly treated can lead to complications such as glaucoma, scarring, and blindness.

Shingles vaccine

In March 2011, the Food and Drug Administration expanded its approval of zoster vaccine to include adults 50-59 years old. (Before then, it was approved for those 60 and older.) This decision was based on results of a clinical trial that followed 22,000 participants for an average of 1.3 years. In this study, the vaccine reduced the risk for zoster by about 70% in adults 50-59 years old.

Other resources

American Academy of Dermatology brochure

Article: CDC recommends shingles vaccine for adults 60+