Herpes Zoster (Shingles)

Shingles, or herpes zoster, is a viral infection that causes a painful rash and blisters. It usually affects older people, people with immune disorders such as HIV, or people with depressed immune systems because of therapies such as chemotherapy.

The varicella-zoster virus causes chicken pox and shingles. When the virus is reactivated in people who have had chicken pox, it can cause shingles. In fact, 10 to 20 percent of people who have had chicken pox will later develop shingles.

Shingles is contagious. It can spread to people who aren’t immune to the varicella-zoster virus through contact with unscabbed blisters.

Symptoms of shingles

The first sign of shingles may be pain, burning, tingling, numbness or increased sensitivity of an area of skin. This is followed by the development of a red rash and fluid-filled blisters that break open and crust over within several days.

The rash usually occurs only on one side of the body. This is because it follows the path of the nerve where the virus was inactive. In some cases, the virus also affects nerve fibers, causing severe pain to remain after the rash disappears. This is called postherpetic neuralgia.

Shingles also can cause:

• Abdominal pain
• Chills
• Fever
• Headache

Prevention and treatment for shingles

The varicella-zoster vaccine (Zostavax) prevents chicken pox and maintains immunity to prevent a reactivation of the virus.

Treatment for shingles can include:

• Amitriptyline, gabapentin, or topical anesthetics to help manage pain from postherpetic neuralgia.
• Analgesics for pain control
• Astringents to reduce weeping and crusting of blisters
• Corticosteroids to decrease inflammation
• Oral antiviral drugs to decrease the duration and severity of the outbreak

In rare cases of persistent pain, we may refer you to our Pain Center. You also may see our ophthalmology team for shingles cases that involve the eyes.