Shingles: Overview, Symptoms, Causes, and Treatment

What is Shingles?

Shingles is a viral infection caused by the varicella-zoster virus—the same virus responsible for chickenpox. After recovering from chickenpox, the virus remains dormant in the nervous system and can reactivate years later as shingles.

This condition is characterized by a painful rash, typically appearing as a stripe of blisters on one side of the torso, face, or neck. While shingles is not life-threatening, it can cause severe pain and lead to complications if left untreated.

Symptoms of Shingles

Shingles usually affects a small section of one side of the body. Common symptoms include:

• Pain, burning, or tingling (often the first sign)
• Red rash developing a few days after the pain
• Fluid-filled blisters that crust over
• Sensitivity to touch
• Itching

Some people may also experience:

• Fever
• Headache
• Fatigue
• Sensitivity to light

In rare cases, shingles pain occurs without a visible rash.

When to See a Doctor

Seek medical attention if:

• The rash is near the eye (risk of vision damage).
• You are over 50 (higher risk of complications).
• You or a family member has a weakened immune system.
• The rash is widespread and extremely painful.

Causes and Risk Factors

Shingles occurs when the dormant varicella-zoster virus reactivates. The exact trigger is unknown, but risk factors include:

• Age (more common in people over 50)
• Weakened immune system (due to HIV/AIDS, cancer, or medications)
• Cancer treatments (chemotherapy or radiation)
• Certain medications (such as steroids or immunosuppressants)

Is Shingles Contagious?

A person with shingles can spread the varicella-zoster virus to those who have never had chickenpox or the vaccine. Transmission occurs through direct contact with the rash. The infected person will develop chickenpox, not shingles.

To prevent spreading the virus:

• Keep blisters covered.
• Avoid contact with pregnant women, newborns, and immunocompromised individuals until the rash scabs over.

Complications

Possible complications include:

• Postherpetic neuralgia (long-term nerve pain after the rash heals)
• Vision loss (if shingles affects the eye)
• Neurological issues (facial paralysis, hearing problems, or encephalitis)
• Skin infections (if blisters are not properly treated)

Prevention: The Shingles Vaccine

The Shingrix vaccine is recommended for:

• Adults 50+, even if they’ve had shingles before.
• People 19+ with weakened immune systems.

Shingrix is given in two doses, 2–6 months apart, and reduces the risk of severe shingles and complications.

Diagnosis and Treatment

• Diagnosis: Based on symptoms, rash appearance, and sometimes lab tests.
• Treatment:
• Antiviral medications (acyclovir, valacyclovir, famciclovir) to speed healing.
• Pain relief (lidocaine patches, anticonvulsants, or antidepressants).
• Cool compresses and oatmeal baths to soothe itching.

Self-Care Tips

• Keep the rash clean and dry.
• Avoid scratching to prevent infection.
• Manage stress, as it can weaken immunity.