Shingles (Herpes Zoster)

Man talking to healthcare provider in exam room.
Talk to your healthcare provider about the shingles vaccine.
Shingles is also called herpes zoster. It is a painful skin rash caused by the herpes zoster virus. This is the same virus that causes chickenpox. After a person has chickenpox, the virus remains inactive in the nerve cells. Years later, the virus can become active again and travel to the skin. Most people have shingles only once, but it is possible to have it more than once.

What are the risk factors for shingles?

Anyone who has ever had chickenpox can develop shingles. But your risk is greater if you:

  • Are 50 years of age or older

  • Have an illness that weakens your immune system, such as HIV/AIDS

  • Have cancer, especially Hodgkin disease or lymphoma

  • Take medicines that weaken your immune system

What are the symptoms of shingles?

  • The first sign of shingles is usually pain, burning, tingling, or itching on one part of your face or body. You may also feel as if you have the flu, with fever and chills.

  • A red rash with small blisters appears within a few days. The rash may appear as follows: 

    • The blisters can occur anywhere, but they’re most common on the back, chest, or abdomen.

    • They usually appear on only one side of the body, spreading along the nerve pathway where the virus was inactive. 

    • The rash can also form around an eye, along one side of the face or neck, or in the mouth.

    • In a few people, usually those with weakened immune systems, shingles appear on more than one part of the body at once.

  • After a few days, the blisters become dry and form a crust. The crust falls off in days to weeks. The blisters generally do not leave scars.

How is shingles treated?

For most people, shingles heals on its own in a few weeks. But treatment is recommended to help relieve pain, speed healing, and reduce the risk of complications. Antiviral medicines are prescribed within the first 72 hours of the appearance of the rash. To lessen symptoms:

  • Apply ice packs (wrapped in a thin towel) or cool compresses, or soak in a cool bath.

  • Use calamine lotion to calm itchy skin.

  • Ask your healthcare provider about over-the-counter pain relievers. If your pain is severe, your healthcare provider may prescribe stronger pain medicines.

What are the complications of shingles?

Shingles often goes away with no lasting effects. But some people have serious problems long after the blisters have healed:

  • Postherpetic neuralgia. This is the most common complication. It is severe nerve pain at the place where the rash used to be. It can last for months, or even years after you have had shingles. Medicines can be prescribed to help relieve the pain and improve quality of life.

  • Bacterial infection. Shingles blisters may become infected with bacteria. Antibiotic medicine is used to treat the infection.

  • Eye problems. A person with shingles on the face should see his or her healthcare provider right away. Shingles can cause serious problems with vision, and even blindness.

Very rarely shingles can also lead to pneumonia, hearing problems, brain inflammation, or even death. 

When to seek medical care

Contact your healthcare provider if you experience any of the following:

  • Symptoms that don’t go away with treatment

  • A rash or blisters near your eye

  • Increased drainage, fever, or rash after treatment, or severe pain that doesn’t go away

How can shingles be prevented?

You can only get shingles if you have had chickenpox in the past. Those who have never had chickenpox can get the virus from you. Although instead of developing shingles, the person may get chickenpox. Until your blisters form scabs, avoid contact with others, especially the following:

  • Pregnant women who have never had chickenpox or the vaccine

  • Infants who were born early (prematurely) or who had low weight at birth

  • People with weak immune system (for example, people receiving chemotherapy for cancer, people who have had organ transplants, or people with HIV infections)


The shingles vaccine

Shingles vaccines are available to help prevent shingles or make it less painful. Vaccination is recommended for adults 50 and older, even if you've had shingles in the past. Talk with your healthcare provider about the most appropriate time for you to get vaccinated, and which vaccine is best for you.

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