Patient education: Shingles (The Basics)

What is shingles? — Shingles is a painful rash that is usually shaped like a band (picture 1). It can affect people of all ages, but it is most common in those older than 50. It is also more common in people whose immune system (the body's infection-fighting system) is weaker than normal. Another name for shingles is "herpes zoster."

Shingles is caused by a virus called varicella-zoster virus. This is the same virus that causes chickenpox. After someone has chickenpox, the virus sometimes hides out, "asleep" in the body. Years later, it can "wake up" and cause shingles. The first time a person is infected with that virus, they get chickenpox, not shingles.

Is shingles contagious? — In a way, yes. It is not possible to "catch" shingles from someone who has the rash. But if you have never had chickenpox or gotten the chickenpox vaccine, it is possible to "catch" the virus and then get sick with chickenpox. Shingles and chickenpox are caused by the same virus.

You probably will not catch the virus (or get chickenpox) if you:

●Had chickenpox or shingles in the past

●Had the chickenpox vaccine

●Were born in the US before 1980 (most people born before 1980 have had chickenpox even if they don't remember it)

If you have never had chickenpox or the chickenpox vaccine, you should avoid contact with anyone who has shingles. It is especially important that you do not touch their rash. If you do, you could get sick with chickenpox. In rare cases, it is possible to get chickenpox from just being near someone with shingles.

Some people have a higher risk than others for getting very sick or having other problems because of chickenpox. People at highest risk include:

●People who are pregnant – Pregnant people can pass the chickenpox virus to their growing baby.

●Premature babies

●People whose immune system (the body's infection-fighting system) is weaker than normal

What are the symptoms of shingles? — At first, shingles causes weird sensations on your skin. You might feel itching, burning, pain, or tingling. Some people get a fever, feel sick, or get a headache. Within 1 to 2 days, a rash with blisters appears. Blisters most often appear in a band across the chest and back (picture 1 and picture 2). But they can show up on other parts of the body, too. The blisters cause pain that can be mild or severe.

Within 3 to 4 days, shingles blisters can become open sores or "ulcers." These ulcers can sometimes get infected. Within 7 to 10 days, the rash should scab over and start to heal.

Can shingles be serious? — Yes. Shingles can be serious, but this is rare. About 1 out of 10 people with shingles will get something called "postherpetic neuralgia," or "PHN." People with PHN keep feeling pain or discomfort even after their rash goes away. This pain can last for months or even years. It can be so bad that it makes it hard to sleep, causes weight loss, and leads to depression.

Shingles can also cause:

●Skin infections

●Eye problems (if the rash is near the eye)

●Ear problems (if the rash is near the ear)

In rare cases, shingles can cause serious problems with the brain or nerves. But this is very uncommon.

Should I see a doctor or nurse? — Yes. If you have a rash that you think might be shingles, call your doctor or nurse right away. They will do an exam and might recommend treatment.

How is shingles treated? — It depends on how long you have had the shingles rash:

●If you have had the rash for less than 3 days, your doctor will prescribe a medicine to help you get rid of the virus. These medicines are called "antivirals." They can speed your recovery and reduce the chances that you will have shingles-related problems such as PHN.

●If you have had the rash for more than 3 days, your doctor might or might not prescribe medicine. Antiviral medicine might help if new blisters are still appearing, or if your immune system is weaker than normal.

Can the pain be treated? — Many people can deal with their pain with non-prescription pain medicines, but some people need prescription medicines.

How should I take care of the rash? — Keep the parts of your skin that have a rash clean and dry. Do not use creams or gels unless your doctor or nurse says you should.

Can shingles be prevented? — People can reduce their chances of getting shingles by getting the shingles vaccine. The vaccine might also make the symptoms of shingles milder if they do occur. Vaccination is typically recommended for adults over 50 years. In some cases, it might also be recommended for younger adults, if their immune system is weaker than normal. Your doctor can tell you if you should get a shingles vaccine.

If you do get shingles, you can prevent spreading it to other people by:

●Keeping your rash covered

●Washing your hands often until your rash has scabbed over

More on this topic

Patient education: Chickenpox (The Basics)
Patient education: What you should know about vaccines (The Basics)

Patient education: Shingles (Beyond the Basics)
Patient education: Chickenpox prevention and treatment (Beyond the Basics)