Table of ContentsView AllTable of ContentsTypesSymptomsCausesIs Shingles Contagious?DiagnosisTreatmentPreventionWhen to See a Healthcare ProviderCoping
Table of ContentsView All
View All
Table of Contents
Types
Symptoms
Causes
Is Shingles Contagious?
Diagnosis
Treatment
Prevention
When to See a Healthcare Provider
Coping
This article discusses the symptoms, causes, and treatment of shingles, as well as how to prevent getting shingles.
Fisle / Wikimedia Commons
Types of Shingles
There are over one million cases of shingles in the United States every year. About one in three people in the U.S. will have shingles during their lifetime.
When a person gets chickenpox, their immune system will eliminate VZV from most locations of the body. The virus will, however, remain dormant within a cluster of nerve cells called a spinal ganglion (also called aspinal nerve root).
There are a total of 30 spinal nerve roots with a corresponding dermatome on either side of the body. These are broadly categorized as:
In addition to the cutaneous (skin) herpes zoster, shingles can also cause:
Shingles Symptoms
Herpes zoster causes the formation of a painful, blistering rash. The rash usually appears unilaterally—on one area of the skin on one side of the body.
Symptoms of shingles tend to progress as follows:
For some people, the symptoms of shingles are mild while others experience intense pain from a gentle touch or breeze.
Most cases of shingles last for three to five weeks.
Complications
Shingles usually clears in two to three weeks and rarely return, but sometimes complications can occur.
(PHN)Postherpetic neuralgia:For some people, shingles pain can persist for many months and even years. It occurs when the nerves have been damaged after an outbreak of shingles. Pain ranges from mild to very severe and can significantly affect a person’s quality of life.About 10% to 18% of people with shingles experience PHN, and the risk increases with age.
Herpes zoster ophthalmicus:People who develop this condition commonly experience eye redness, eye pain, light sensitivity, and, in severe cases, vision loss.
Herpes zoster oticus:People with this condition may experiencefacial palsy(weakness of facial muscles), ringing in the ears (tinnitus),vertigo, and hearing loss.
People who are severelyimmunocompromised, such as those with advancedHIV, and the elderly sometimes experience severe complications from shingles, such as:
Occasionally shingles can be fatal, but fortunately, these complications and death are rare.
Signs, Symptoms, and Complication of Shingles
Causes of Shingles
Diminished immunity is largely believed to be the cause. People with a normally functioning immune system can usually keep the virus in check. If the immune system is suppressed, the virus is more likely to reactivate and cause an outbreak.
This may largely explain why people over 50, who often have less robust immune systems than younger people, account for half of all shingles cases in the United States.
The risk of herpes zoster increases with age. By age 85, roughly 50% of people will have had at least one shingles outbreak in their lifetime.
Even so, younger adults and even children are known to experience shingles. While the cause is often related toimmunosuppressionorimmunosuppressive therapies, some outbreaks appear entirely idiopathic (without any known cause).
Causes and Risk Factors of Shingles
Someone with shingles cannot spread shingles to another person, but they can spread chickenpox to someone who hasn’t had chickenpox or the chickenpox vaccine.
The virus is spread through skin-to-skin contact with the fluid from the blisters or breathing in virus particles coming from the blisters. If the person gets infected, they will develop chickenpox, not shingles. They could then develop shingles later in life.
If your shingles rash is in the blister phase, stay away from people who haven’t had chickenpox or the chickenpox vaccine and keep your rash covered. If you have shingles, you’re contagious until the rash is dried and crusted over.
Shingles Diagnosis
With that said,zosteriform herpes simplex(a form ofherpes simplex) can mimic shingles. It can be differentiated with a blood test called anIgM antibody testor a skin test called aTzanck smear. If needed, a scraping of tissue can be sent to the lab for identification usingpolymerase chain reaction (PCR)which amplifies (makes multiple copies) viral DNA.
Treatment for Shingles
There is no cure for shingles, but the early use ofantiviral drugs—ideally within the first 72 hours of the appearance of symptoms—may be able to reduce the severity and duration of symptoms.There is some evidence, albeit weak, that it may help reduce the risk of postherpetic neuralgia as well.
The antivirals commonly used to treat shingles include:
Pain can be controlled with medications such as:
How Shingles Is Treated
How to Prevent Shingles
Shingrix is recommended for all adults 50 and older even if they have received the previous shingles vaccine (called Zostavax) or had shingles in the past.
Side effects include injection site pain, redness, and swelling as well as fatigue, headache, body aches, and nausea. Most side effects are relatively mild and tend to resolve within a day or two.
According to the Centers for Disease Control and Prevention (CDC), two doses of Shingrix are 90% effective in preventing shingles.
It is important to contact your healthcare provider right away if you notice symptoms so that antiviral therapy can be prescribed. After 72 hours, the benefits of antiviral therapy drop significantly.
If your healthcare provider is not available, access an urgent care facility or telehealth services. Most providers can authorize and prescribe treatment based on the appearance of the outbreak and a quick review of your medical history.
It is particularly important to contact your healthcare provider if:
Coping With Shingles
Some people find it difficult to cope with the pain of a shingles outbreak. Even the rubbing of clothes against the blistering rash can cause extreme pain, making it difficult to concentrate, sleep, or carry on with daily activities.
These tips can help you deal with the discomfort of shingles:
Home Remedies for Shingles
Summary
13 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Centers for Disease Control and Prevention.Shingles (herpes zoster).Kennedy P, Gershon A.Clinical features of varicella-zoster virus infection.Viruses. 2018;10(11):609. doi:10.3390/v10110609Physiopedia.Dermatomes.Pitton Rissardo J, Fornari Caprara AL.Herpes zoster oticus, ophthalmicus, and cutaneous disseminated: case report and literature review.Neuro-Ophthalmology. 2019;43(6):407-410. doi:10.1080/01658107.2018.1523932National Institute on Aging.Shingles.Hadley GR, Gayle JA, Ripoll J, et al.Post-herpetic neuralgia: a review.Curr Pain Headache Rep. 2016;20(3):17. doi:10.1007/s11916-016-0548-xTuft S.How to manage herpes zoster ophthalmicus.Community Eye Health. 2020;33(108):71-72.National Health Service UK.Shingles.Jianbo W, Koshy E, Mengting L, Kumar H.Epidemiology, treatment and prevention of herpes zoster: a comprehensive review.Inidan J Dermatol Venereol Leprol. 2018;0(0):0. doi:10.4103/ijdvl.ijdvl_1021_16Chen N, Li Q, Yang J, Zhou M, Zhou D, He L.Antiviral treatment for preventing postherpetic neuralgia.Cochrane Database System Rev. 2014;1:1465-858. doi:10.1002/14651858.CD006866.pub3Centers for Disease Control and Prevention.Clinical Overview of Shingles.GlaxoSmithKline.Package insert - Shingrix.Centers for Disease Control and Prevention.What everyone should know about the shingles vaccine (Shingrix).
13 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Centers for Disease Control and Prevention.Shingles (herpes zoster).Kennedy P, Gershon A.Clinical features of varicella-zoster virus infection.Viruses. 2018;10(11):609. doi:10.3390/v10110609Physiopedia.Dermatomes.Pitton Rissardo J, Fornari Caprara AL.Herpes zoster oticus, ophthalmicus, and cutaneous disseminated: case report and literature review.Neuro-Ophthalmology. 2019;43(6):407-410. doi:10.1080/01658107.2018.1523932National Institute on Aging.Shingles.Hadley GR, Gayle JA, Ripoll J, et al.Post-herpetic neuralgia: a review.Curr Pain Headache Rep. 2016;20(3):17. doi:10.1007/s11916-016-0548-xTuft S.How to manage herpes zoster ophthalmicus.Community Eye Health. 2020;33(108):71-72.National Health Service UK.Shingles.Jianbo W, Koshy E, Mengting L, Kumar H.Epidemiology, treatment and prevention of herpes zoster: a comprehensive review.Inidan J Dermatol Venereol Leprol. 2018;0(0):0. doi:10.4103/ijdvl.ijdvl_1021_16Chen N, Li Q, Yang J, Zhou M, Zhou D, He L.Antiviral treatment for preventing postherpetic neuralgia.Cochrane Database System Rev. 2014;1:1465-858. doi:10.1002/14651858.CD006866.pub3Centers for Disease Control and Prevention.Clinical Overview of Shingles.GlaxoSmithKline.Package insert - Shingrix.Centers for Disease Control and Prevention.What everyone should know about the shingles vaccine (Shingrix).
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Centers for Disease Control and Prevention.Shingles (herpes zoster).Kennedy P, Gershon A.Clinical features of varicella-zoster virus infection.Viruses. 2018;10(11):609. doi:10.3390/v10110609Physiopedia.Dermatomes.Pitton Rissardo J, Fornari Caprara AL.Herpes zoster oticus, ophthalmicus, and cutaneous disseminated: case report and literature review.Neuro-Ophthalmology. 2019;43(6):407-410. doi:10.1080/01658107.2018.1523932National Institute on Aging.Shingles.Hadley GR, Gayle JA, Ripoll J, et al.Post-herpetic neuralgia: a review.Curr Pain Headache Rep. 2016;20(3):17. doi:10.1007/s11916-016-0548-xTuft S.How to manage herpes zoster ophthalmicus.Community Eye Health. 2020;33(108):71-72.National Health Service UK.Shingles.Jianbo W, Koshy E, Mengting L, Kumar H.Epidemiology, treatment and prevention of herpes zoster: a comprehensive review.Inidan J Dermatol Venereol Leprol. 2018;0(0):0. doi:10.4103/ijdvl.ijdvl_1021_16Chen N, Li Q, Yang J, Zhou M, Zhou D, He L.Antiviral treatment for preventing postherpetic neuralgia.Cochrane Database System Rev. 2014;1:1465-858. doi:10.1002/14651858.CD006866.pub3Centers for Disease Control and Prevention.Clinical Overview of Shingles.GlaxoSmithKline.Package insert - Shingrix.Centers for Disease Control and Prevention.What everyone should know about the shingles vaccine (Shingrix).
Centers for Disease Control and Prevention.Shingles (herpes zoster).
Kennedy P, Gershon A.Clinical features of varicella-zoster virus infection.Viruses. 2018;10(11):609. doi:10.3390/v10110609
Physiopedia.Dermatomes.
Pitton Rissardo J, Fornari Caprara AL.Herpes zoster oticus, ophthalmicus, and cutaneous disseminated: case report and literature review.Neuro-Ophthalmology. 2019;43(6):407-410. doi:10.1080/01658107.2018.1523932
National Institute on Aging.Shingles.
Hadley GR, Gayle JA, Ripoll J, et al.Post-herpetic neuralgia: a review.Curr Pain Headache Rep. 2016;20(3):17. doi:10.1007/s11916-016-0548-x
Tuft S.How to manage herpes zoster ophthalmicus.Community Eye Health. 2020;33(108):71-72.
National Health Service UK.Shingles.
Jianbo W, Koshy E, Mengting L, Kumar H.Epidemiology, treatment and prevention of herpes zoster: a comprehensive review.Inidan J Dermatol Venereol Leprol. 2018;0(0):0. doi:10.4103/ijdvl.ijdvl_1021_16
Chen N, Li Q, Yang J, Zhou M, Zhou D, He L.Antiviral treatment for preventing postherpetic neuralgia.Cochrane Database System Rev. 2014;1:1465-858. doi:10.1002/14651858.CD006866.pub3
Centers for Disease Control and Prevention.Clinical Overview of Shingles.
GlaxoSmithKline.Package insert - Shingrix.
Centers for Disease Control and Prevention.What everyone should know about the shingles vaccine (Shingrix).
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