(Herpes Zoster; Post-herpetic Neuralgia)
by Editorial Staff and Contributors
Shingles is a painful infection of the nerves and skin.
Shingles is caused by the varicella zoster virus. This is the same virus that causes chickenpox. Shingles occurs in people who have had chickenpox in their lifetime. After causing the first chickenpox infection, the virus is not totally eliminated from the body. Some of the remaining virus settles in nerve roots near the spinal cord. When reactivated, the virus travels along nerve paths to the skin where it causes pain and a rash.
Risk Factors TOP
Shingles is more common in women, and in people aged 50 years and older. Other factors that may increase the chances of shingles include:
Shingles can occur in those with no known risk factors.
Shingles is not usually transmitted from one person to another, but a person who has never had chickenpox and never received the varicella vaccine is likely to get chickenpox if contact occurs with a person who has shingles. Covering shingles sores with a bandage reduces the risk of transmitting shingles to others.
Shingles may cause:
The rash usually disappears within 3 weeks. In some cases, though, post-herpetic neuralgia (PHN) develops. With PHN, the pain continues for months or even years after the rash has healed. PHN can be severe and difficult to treat.
You will be asked about your symptoms and medical history. A physical exam will be done. The rash can be diagnosed by its appearance. Fluids may be drawn from the blisters for testing, but this is not done often.
Shingles cannot be cured. Treatment focuses on:
Home Remedies and Over-the-Counter Products
The following will help relieve pain and ease symptoms:
Antiviral medications may control shingles. Antiviral therapy may shorten a shingles episode, but you must start it within 48-72 hours after symptoms first develop. They are especially used in people with suppressed immune systems.
Treatment for Post-herpetic Neuralgia TOP
If you develop PHN, your doctor may recommend:
Treatment for Shingles of the Eye TOP
If you develop shingles on your face, contact your doctor right away. You may be prescribed medications, such as steroids, to treat this condition. Without treatment, permanent eye damage can result, including glaucoma, scarring, and blindness.
There are now 2 vaccines that are used to reduce the risk of shingles and the severity of PHN if shingles occurs. The live HSV is advised for people 60 years and older. It is a single dose vaccine used in adults with healthy immune systems. The dead virus is a 2-shot series, which may be given 2-6 months apart starting at age 50 years old. Talk to your insurance company and doctor about your options.
If you do have shingles, take these steps to prevent giving chickenpox to others:
National Institute of Neurological Disorders and Stroke
National Shingles Foundation
The College of Family Physicians of Canada
Herpes zoster. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T113997/Herpes-zoster . Updated March 13, 2018. Accessed March 13, 2018.
Ocular shingles. Wills Eye Institute website. Available at: https://www.willseye.org/disease_condition/ocular-shingles. Accessed March 13, 2018.
Shingles. Family Doctor—American Academy of Family Physicians website. Available at: https://familydoctor.org/condition/shingles. Updated September 2017. Accessed March 13, 2018.
Shingles: overview. American Academy of Dermatology website. Available at: https://www.aad.org/public/diseases/contagious-skin-diseases/shingles. Accessed March 13, 2018.
Shingles (herpes zoster). Centers for Disease Control and Prevention website. Available at:
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Updated January 30, 2018. Accessed March 13, 2018.
Tseng HF, Smith N, Harpaz R, Bialek SR, Sy LS, Jacobsen SJ. Herpes zoster vaccine in older adults and the risk of subsequent herpes zoster disease. JAMA. 2011;305(2):160-166.
6/9/2014 DynaMed Plus Systematic Literature Surveillance http://www.dynamed.com/topics/dmp~AN~T113997/Herpes-zoster : Forbes H, Bhaskaran K, Thomas SL, et al. Quantification of risk factors for herpes zoster: population based case-control study. BMJ. 2014;348:g2911.
Last reviewed March 2018 by EBSCO Medical Review Board Marcie L. Sidman, MD
Last Updated: 3/13/2018
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