Shingles

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

After you have chickenpox (usually as a child), the virus that causes it stays in your body in 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 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 old 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 the virus that causes AIDS (acquired immunodeficiency syndrome).

Shingles 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 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 7 to 10 days. You may see changes in the color of your skin when the scabs fall off. In more severe cases of shingles, these color changes last forever.

Even though the rash gets better or goes away in a few weeks, the pain may last longer (a condition known as postherpetic neuralgia). About 1 in 5 people who get shingles develop postherpetic neuralgia. In most people, the pain goes away in 1 to 3 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 (brand name: Zovirax), famciclovir (brand name: Famvir) or valacyclovir (brand name: Valtrex) are commonly prescribed. Your doctor will decide which of these medicines might work 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 and 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 pain medicine such as acetaminophen (one brand name: Tylenol) or ibuprofen (one brand name: Motrin).

Putting a medicated lotion (two brand names: Benadryl, Caladryl) on the blisters might reduce the pain and itching. Putting cool compresses soaked in an astringent liquid (two brand names: Bluboro, Domeboro) on the blisters and sores might ease pain and itching.

If shingles causes severe pain, your doctor might have you take a prescription pain medicine.

Postherpetic neuralgia is the name used when the pain of shingles lasts for a long time after the rash is gone. About 1 in 5 people with shingles will get postherpetic neuralgia.

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. A few people have chronic pain (pain that doesn't go away).

Postherpetic neuralgia is often treated with over-the-counter pain medicines and capsaicin cream (two brand names: Capsin, Zostrix). If these medicines don't help enough, your doctor might try some other treatments, such as a patch that contains lidocaine (brand name: Lidoderm).

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

No one can catch shingles from you, but they can catch chickenpox if they haven't already had chickenpox or had the chickenpox vaccine. The varicella virus (which is the virus that causes both chickenpox and shingles) lives in the blisters from shingles, and the virus can be spread until the blisters are completely healed. If you have shingles, you should stay away from babies younger than 12 months and pregnant women.