Shingles, also called herpes zoster, is a painful rash caused by the same virus that causes chickenpox. Once a person has had chickenpox, the virus can live, but remains inactive in certain nerve roots within the body. If it becomes active again, usually later in life, it can cause shingles. In the United States, 98% of adults have been infected with the chickenpox virus. If you are an adult, chances are you are one of many at risk for developing shingles. 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). I remember seeing an unusually high number of cases when I was an oncology nurse.
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. 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 opthalmicus) 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.
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 bed sheet, 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). This condition, along with shingles itself, is often treated with over-the-counter (OTC) pain medicines and cream for itching and burning. Placing cool compresses soaked in water mixed with white vinegar on the blisters and sores might also ease pain and itching. In addition, an antiviral medicine could be used early on to reduce the severity and duration of your symptoms. 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.
No one can catch shingles, or herpes zoster, 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. For most people, the pain from shingles lessens as the rash heals. But for some, shingles can lead to more serious health problems, including scarring, bacterial skin infections, decrease or loss of vision or hearing, paralysis on one side of the face and muscle weakness.