Shingles
(Herpes Zoster)
Medical Author: Frederick Hecht, MD, FAAP, FACMG
Revising Medical Author: Melissa Conrad Stöppler, MD
Medical Editor: William C. Shiel Jr., MD, FACP, FACR
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A Painful Rash -- Is It Shingles?
Medical Author:
Melissa Conrad Stöppler, MD
Medical Editor: William C. Shiel Jr., MD, FACP, FACR
 Shingles (Herpes zoster)
is an extremely painful skin rash caused by the Varicella zoster virus, the same virus that
causes chickenpox. In people who have had chickenpox, the virus is never fully
cleared from the body; instead, it remains dormant in the nerve tissues. When physical or emotional
stresses to the body weaken the
immune system, the virus re-activates and
spreads along the nerve fibers to the particular area of skin supplied by the
involved nerve (called a dermatome). The virus
responsible for chickenpox and shingles is a member of the Herpesviruses,
although it is not the same as the Herpes simplex 1 and 2 viruses that cause
cold sores and
genital herpes,
respectively.
Pain,
itching, tingling, or burning of the skin are symptoms of shingles that often precede the rash in an
outbreak. The blisters that develop resemble the lesions of
chickenpox but are concentrated in the area supplied by the involved nerve.
Rarely, more than one nerve is involved. Blisters may occur along the entire
path of the nerve or only in certain areas supplied by the nerve. As with the
blisters of chickenpox, the blisters in shingles eventually burst and begin to
crust over and heal. The entire outbreak can last for three to four weeks.
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What is shingles? What causes shingles?
Shingles is a skin rash caused by the same virus that causes chickenpox. The
virus responsible for these conditions is called the Varicella zoster virus (VZV).
After an individual has chickenpox, this virus lives in the nervous system
and is never fully cleared from the body. Under certain circumstances, such
as emotional stress, immune deficiency (from AIDS or chemotherapy), or with
cancer, the virus reactivates causing shingles. In most cases, however, a
cause for the reactivation of the virus is never found. Anyone who has ever
had chickenpox is at risk for the development of shingles, although it
occurs most commonly in people over the age of 60. It has been estimated
that up to 500,000 cases of shingles occur each year in the U.S.
The herpes virus that causes shingles and
chickenpox is not the same as the herpes virus that causes genital herpes (which can be sexually transmitted) and herpes mouth sores. Shingles is medically termed Herpes zoster.
What are symptoms of shingles? How long does shingles last?
Before a rash is visible, the patient may notice several days to a week of
burning pain and sensitive skin. Before the rash is visible, it may be difficult
to determine the cause of the often severe pain. Shingles start as small
blisters on a red base, with new blisters continuing to form for three to five
days. The blisters follow the path of individual nerves that comes out of the
spinal cord (called a dermatomal pattern). The entire path of the nerve may be
involved or there may be areas with blisters and areas without blisters.
Generally, only one nerve level is involved. In a rare case, more than one nerve
will be involved. Eventually, the blisters pop, and the area starts to ooze. The
affected areas will then crust over and heal. The whole process may take three
to four weeks from start to finish. On occasion, the pain will be present but
the blisters may never appear. This can be a very confusing cause of local pain.
Is shingles contagious?
Yes, shingles is contagious. Shingles can be spread from an affected person to children or adults who have not had chickenpox.
But instead of developing shingles, these people develop chickenpox. Once they have had chickenpox, people cannot catch shingles (or contract the virus) from someone else. Once infected, however,
people have the potential to develop shingles later in life.
Shingles is contagious to people that have not previously had chickenpox, as long as there are new blisters forming and old blisters healing. Once all of the blisters are crusted over,
the virus can no longer be spread.
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| Pictures of shingles |
Next: What is the treatment for shingles? Should I visit my health-care professional? »
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