Herpes Zoster (Shingles)

Herpes zoster (shingles) is a painful skin rash caused by the varicella-zoster virus (VZV). This is the same virus that causes chickenpox. After a person has chickenpox, the virus may remain inactive in the nerve cells. Years later, the virus can become active again. If it does, a red rash or small blisters occur, usually on one side of the body, spreading along a nerve pathway where the virus has re-activated. On some occasions, even after the rash is gone, the pain may continue for a prolonged time, a complication called postherpetic neuralgia (PHN). People with a weak immune system are at greater risk of getting herpes zoster. Almost half of the cases occur in people older than age 60 years.  People who receive the chickenpox vaccine but never had chickenpox infection can develop herpes zoster.

The incidence of herpes zoster occurring in children is low, but the risk of acquiring this disease increases with age and poor immune status. Children who have weak immune systems may experience the same, or more severe, symptoms as adults.

What are the symptoms of herpes zoster?

Herpes zoster most often occurs on the trunk. However, it may appear on the buttocks, arms, legs, or face. The following are the most common symptoms:

• Pain, burning, tingling, or itching on one part of your face or body
• Rash that first looks like small, red spots which turn into blisters
• Blisters which turn yellow and dry
• Rash is usually localized to one side or part of the body
• Fever, chills, headache, nausea 
• Post Herpetic Neuralgia can cause pain for weeks, months, and rarely even years after the rash resolves 

The symptoms of herpes zoster may resemble other skin conditions. Always consult your health care provider for a diagnosis.

How is herpes zoster diagnosed?

Your health care provider will ask about your medical history and do a physical exam. Diagnosis may also include:

• Skin scrapings. Gently scraping the blisters to determine if the virus is shingles or another virus.

What is the treatment for herpes zoster?

Immediate treatment with antiviral drugs may help lessen the duration and severity of some of the symptoms. These antiviral medications (e.g. acyclovir, valacyclovir) are more effective the sooner they are started. Ask your health care provider about over-the-counter pain relievers.  Use of medication will be determined by your doctor based on factors including duration and severity of the symptoms.