Shingles

ExitCare ImageShingles (herpes zoster) is an infection that is caused by the same virus that causes chickenpox (varicella). The infection causes a painful skin rash and fluid-filled blisters, which eventually break open, crust over, and heal. It may occur in any area of the body, but it usually affects only one side of the body or face. The pain of shingles usually lasts about 1 month. However, some people with shingles may develop long-term (chronic) pain in the affected area of the body.

Shingles often occurs many years after the person had chickenpox. It is more common:

  • In people older than 50 years.

  • In people with weakened immune systems, such as those with HIV, AIDS, or cancer.

  • In people taking medicines that weaken the immune system, such as transplant medicines.

  • In people under great stress.

CAUSES

Shingles is caused by the varicella zoster virus (VZV), which also causes chickenpox. After a person is infected with the virus, it can remain in the person's body for years in an inactive state (dormant). To cause shingles, the virus reactivates and breaks out as an infection in a nerve root.

The virus can be spread from person to person (contagious) through contact with open blisters of the shingles rash. It will only spread to people who have not had chickenpox. When these people are exposed to the virus, they may develop chickenpox. They will not develop shingles. Once the blisters scab over, the person is no longer contagious and cannot spread the virus to others.

SYMPTOMS

Shingles shows up in stages. The initial symptoms may be pain, itching, and tingling in an area of the skin. This pain is usually described as burning, stabbing, or throbbing. In a few days or weeks, a painful red rash will appear in the area where the pain, itching, and tingling were felt. The rash is usually on one side of the body in a band or belt-like pattern. Then, the rash usually turns into fluid-filled blisters. They will scab over and dry up in approximately 2–3 weeks.

Flu-like symptoms may also occur with the initial symptoms, the rash, or the blisters. These may include:

  • Fever.

  • Chills.

  • Headache.

  • Upset stomach.

DIAGNOSIS

Your caregiver will perform a skin exam to diagnose shingles. Skin scrapings or fluid samples may also be taken from the blisters. This sample will be examined under a microscope or sent to a lab for further testing.

TREATMENT

There is no specific cure for shingles. Your caregiver will likely prescribe medicines to help you manage the pain, recover faster, and avoid long-term problems. This may include antiviral drugs, anti-inflammatory drugs, and pain medicines.

HOME CARE INSTRUCTIONS

  • Take a cool bath or apply cool compresses to the area of the rash or blisters as directed. This may help with the pain and itching.  

  • Only take over-the-counter or prescription medicines as directed by your caregiver.  

  • Rest as directed by your caregiver.

  • Keep your rash and blisters clean with mild soap and cool water or as directed by your caregiver. 

  • Do not pick your blisters or scratch your rash. Apply an anti-itch cream or numbing creams to the affected area as directed by your caregiver.

  • Keep your shingles rash covered with a loose bandage (dressing).

  • Avoid skin contact with:

  • Babies.  

  • Pregnant women.  

  • Children with eczema.  

  • Elderly people with transplants.  

  • People with chronic illnesses, such as leukemia or AIDS.  

  • Wear loose-fitting clothing to help ease the pain of material rubbing against the rash.

  • Keep all follow-up appointments with your caregiver. If the area involved is on your face, you may receive a referral for follow-up to a specialist, such as an eye doctor (ophthalmologist) or an ear, nose, and throat (ENT) doctor. Keeping all follow-up appointments will help you avoid eye complications, chronic pain, or disability.  

SEEK IMMEDIATE MEDICAL CARE IF:

  • You have facial pain, pain around the eye area, or loss of feeling on one side of your face.

  • You have ear pain or ringing in your ear.

  • You have loss of taste.

  • Your pain is not relieved with prescribed medicines.  

  • Your redness or swelling spreads.  

  • You have more pain and swelling. 

  • Your condition is worsening or has changed.  

  • You have a fever or persistent symptoms for more than 2–3 days.

  • You have a fever and your symptoms suddenly get worse.

MAKE SURE YOU:

  • Understand these instructions.

  • Will watch your condition.

  • Will get help right away if you are not doing well or get worse.