Shingles

Shingles is a painful rash on one side of the body or face, caused by the varicella-zoster virus (VZV) – the same virus that causes chickenpox. If you had chickenpox as a child, the viral infection may reactivate and cause shingles as an adult.

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Shingles: how it's caused, and how it spreads

Shingles is caused by VZV, which is commonly caught in childhood as chickenpox. It is contagious, and can spread from a person with active shingles to anyone who isn’t immune to VZV – for example, someone who has not received the chickenpox vaccine. This typically happens through direct physical contact with the fluid from the open sores of the shingles rash.

The newly infected person will develop chickenpox, not shingles, which can be dangerous for some people.

Until your shingles blisters scab over, you should avoid physical contact, especially with pregnant women. Most people with shingles get it only once, but you can get it multiple times.

Risk factors for developing shingles

  • If you’re age 50 or older. Shingles is most common in people over the age of 50, and it is so common, some experts estimate that half the people age 80 and older will have had shingles.
  • If you have certain diseases. Diseases that weaken your immune system can increase your risk.
  • If you take certain medications. Includes drugs that prevent rejection of transplanted organs, and prolonged use of steroids such as prednisone.
  • If you’re undergoing cancer treatments. They can lower your resistance to diseases like shingles.
  • If you have a weakened immune system. If you have trouble fighting infections, your risk for getting shingles is higher.

Signs and symptoms of shingles

Shingles can present differently

According to the Centers for Disease Control and Prevention (CDC), a shingles rash most commonly occurs in a single stripe of blisters around either the left or the right side of the body.

In some cases, the rash occurs on one side of the face. It can affect the eye and cause vision loss.

In rare cases, the rash is widespread on the body and looks similar to a chickenpox rash.

The virus affects nerve fibers, so some people may experience pain, itching or tingling in the affected area several days before the rash appears.

Other symptoms of shingles can include:

  • Chills
  • Headache
  • Upset stomach

When to see your primary care provider for shingles

We recommend that you see your provider within 3 days of a rash outbreak if you think you might have shingles. If you have blisters on your face, see your doctor immediately or go to urgent care because blisters near or in the eye can cause lasting eye damage or vision loss.

There is no cure for shingles, but your provider will develop a personalized treatment plan that may include drugs to fight the virus and help the blisters dry up faster and limit your pain.

Treating shingles

Steps you can take

If your primary care provider diagnoses you with shingles, they will work with you on a treatment plan to help you heal. It may include at-home treatment steps:

  • Apply calamine lotion or a cool, wet washcloth to your blisters to ease the pain.
  • Avoid stress and rest often.
  • Eat well-balanced meals.
  • Exercise.
  • Take an oatmeal bath to soothe your skin.

Steps to prevent spreading the virus:

  • Do not touch or scratch the rash.
  • Keep the rash covered.
  • Wash your hands often.
  • Wear loose-fitting, natural-fiber clothing.

Prescribed medications

Your provider may also prescribe medicines and antibiotics:

  • Antibiotic ointment. Helps with itching and can prevent scarring. Calamine lotion can also help with blisters.
  • Antiviral medicines. Acyclovir, valacyclovir and famciclovir can treat shingles and shorten the length and severity of the illness.
  • Pain medicine. Over-the-counter (OTC) or prescription pain relievers can help.

The shingles vaccine: safe and easy to get

According to the CDC, about 1 in every 3 people in the U.S. will develop shingles in their lifetime. Even children can get shingles, though your risk increases as you age. The shingles vaccine is safe and easy to get.

We recommend that adults age 50 and older get vaccinated, even if you’ve already had shingles, as you could get another rash and spread the virus.

You may also develop postherpetic neuralgia (PHN) after the shingles rash goes away. PHN causes serious pain in the affected area and can be the longest-lasting and worst part of shingles.

Talk to your primary care provider about the shingles vaccine and how it works.

References

Center for Disease Control and Prevention (CDC). Signs and Symptoms of Shingles (Herpes Zoster) (https://www.cdc.gov/shingles/about/symptoms.html)

National Institute of Aging (NIA). Shingles (https://www.nia.nih.gov/health/shingles)

MedlinePlus: National Library of Medicine. Shingles (https://medlineplus.gov/shingles.html)