Shingles (Herpes Zoster) Learning Center

Definition

Shingles (herpes zoster) is a painful, blistering skin rash due to the varicella-zoster virus, the virus that causes chickenpox.

See also: Ramsay Hunt syndrome

Alternative Names

Herpes zoster

Causes, incidence, and risk factors

After you get chickenpox, the virus remains inactive (becomes dormant) in certain nerves in the body. Shingles occurs after the virus becomes active again in these nerves years later.

The reason the virus suddenly become active again is not clear. Often only one attack occurs.

Shingles may develop in any age group, but you are more likely to develop the condition if:

• You are older than 60
• You had chickenpox before age 1
• Your immune system is weakened by medications or disease

If an adult or child has direct contact with the shingles rash on someone and has not had chickenpox as a child or a chickenpox vaccine, they can develop chickenpox, rather than shingles.

Symptoms

The first symptom is usually one-sided pain, tingling, or burning. The pain and burning may be severe and is usually present before any rash appears.

Red patches on the skin, followed by small blisters, form in most people.

• The blisters break, forming small ulcers that begin to dry and form crusts. The crusts fall off in 2 to 3 weeks. Scarring is rare.
• The rash usually involves a narrow area from the spine around to the front of the belly area or chest.
• The rash may involve face, eyes, mouth, and ears.

Additional symptoms may include:

• Abdominal pain
• Chills
• Difficulty moving some of the muscles in the face
• Drooping eyelid (ptosis)
• Fever and chills
• General ill-feeling
• Genital lesions
• Headache
• Hearing loss
• Joint pain
• Loss of eye motion
• Swollen glands (lymph nodes)
• Taste problems
• Vision problems

You may also have have pain, muscle weakness, and a rash involving different parts of your face if shingles affects a nerve in your face. See: Ramsay Hunt syndrome

Signs and tests

Your doctor can make the diagnosis by looking at your skin and asking questions about your medical history.

Tests are rarely needed, but may include taking a skin sample to see if the skin is infected with the virus that causes shingles.

Blood tests may show an increase in white blood cells and antibodies to the chickenpox virus but cannot confirm that the rash is due to shingles.