Shingles

Shingles is another name for a condition called "herpes zoster." It is an infection that results from the reactivation of the same virus that causes chickenpox (the varicella-zoster virus). Shingles causes a painful rash.

After you have chickenpox (usually as a child), the virus that causes it stays inactive in your body inside certain nerve cells. Most of the time your immune system keeps the virus in these cells. As you get older, or if your immune system gets weak, the varicella-zoster virus may escape from the nerve cells and cause shingles. If you have had the chickenpox vaccine, you are less likely to get chickenpox and therefore less likely to later develop shingles.

Most people who get shingles are more than 50 years of age or have a weak immune system. For example, you might get shingles if you have cancer, take medicines that weaken your immune system, or have HIV (human immunodeficiency virus) or AIDS (acquired immunodeficiency syndrome).

Shingles usually causes a painful, blistering rash. Sometimes the pain starts a few days before the rash appears. You may also have a fever, chills, nausea, diarrhea and difficulty urinating.

The rash begins with reddish bumps. In a few days, these bumps turn into fluid-filled blisters. You might feel a stinging or burning pain. The rash might also itch. Shingles occurs most often on the trunk of the body, such as a band of blisters around your back and chest.

The blisters usually crust over and fall off after about a week. You may see changes in the color of your skin when the scabs fall off. In more severe cases of shingles, these color changes are permanent.

Even though the rash gets better or goes away in a few weeks, the pain may last longer. This condition is known as postherpetic neuralgia. In most people, however, the pain of shingles goes away in 1 to 2 months.

If shingles occurs on the face, it can also affect your eyes, causing swollen eyelids, redness and pain. Shingles of the eye (called herpes zoster ophthalmicus) can cause scars that damage your vision. It can also lead to glaucoma later in life. Glaucoma is an eye disease that can cause blindness. People who have herpes zoster ophthalmicus should see an eye doctor right away.

Shingles is often treated with an antiviral medicine to reduce the severity and duration of your symptoms. Acyclovir, famciclovir or valacyclovir are commonly prescribed. Your doctor will decide whether one of these medicines is right for you. These medicines work better if you start taking them in the first 3 days after you get the rash.

Your doctor might also have you take a steroid medicine to reduce your pain and swelling. This medicine will also reduce your risk of developing postherpetic neuralgia.

Herpes zoster ophthalmicus is treated with antiviral medicines and steroids.

To help with the pain of shingles, your doctor might have you take an over-the-counter (OTC) pain medicine such as acetaminophen (one brand name: Tylenol) or ibuprofen (two brand names: Motrin, Advil).

Applying a medicated anti-itch lotion (two brand names: Benadryl, Caladryl) to the blisters might reduce the pain and itching. Placing cool compresses soaked in water mixed with white vinegar on the blisters and sores might also ease pain and itching.

If shingles causes severe pain, your doctor might prescribe a stronger pain medicine.

Postherpetic neuralgia is the name used when the pain of shingles lasts for a long time after the rash is gone. About 10 percent of people who have shingles will develop postherpetic neuralgia. It is caused by damaged nerve fibers that send exaggerated pain messages from your skin to your brain.

Like shingles, postherpetic neuralgia causes a stinging or burning pain. Your skin might become very sensitive to temperature changes or a light touch, such as from a bedsheet, your clothing or moving air.

Most people who develop postherpetic neuralgia get better with time. Almost all of them are free of pain within 1 year. However, a few people have chronic pain (pain that doesn't go away).

Postherpetic neuralgia is often treated with OTC pain medicines and capsaicin cream (two brand names: Capzasin-P, Zostrix). If these medicines don't help enough, your doctor might try some other treatments, such as a stronger pain medicine or a patch that contains a numbing medicine called lidocaine.

Some medicines that are used to treat depression and seizures can also help relieve the nerve pain of postherpetic neuralgia. These medicines may take several weeks before they begin to ease your pain.

The shingles vaccine is recommended for adults 60 years and older. The vaccine can prevent shingles, but can not treat active shingles or post-herpetic neuralgia.

Common side effects of the vaccine are headache and redness, swelling, itching and soreness at the injection site. People who have had shingles should get the vaccine to help stop the disease from reoccurring. The vaccine protects for at least 6 years, but may last a lot longer.

The shingles vaccine is not recommended for the following groups:

No one can catch shingles from you. However, they can catch chickenpox if they haven't already had chickenpox or had the chickenpox vaccine. The varicella-zoster virus (which is the virus that causes both chickenpox and shingles) lives in the blisters from shingles. The virus can be spread until the blisters are completely healed. If you have blisters that have not crusted over yet, you should stay away from anyone who has never had chickenpox, babies younger than 12 months of age and pregnant women.