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Infectious

Shingles

Also known as: Herpes Zoster

Shingles is a painful rash caused by reactivation of the varicella-zoster virus (the same virus that causes chickenpox). It typically appears as a band of blisters on one side of the body.

Understanding Shingles

Approximately 1 in 3 people will develop shingles in their lifetime. Risk increases significantly with age and immune suppression. About 1 million cases occur annually in the United States.

After primary chickenpox infection, the varicella-zoster virus lies dormant in nerve ganglia. When immunity wanes (with age or immunosuppression), the virus reactivates and travels along the nerve to the skin.

Antiviral treatment within 72 hours of rash onset shortens the illness and reduces the risk of postherpetic neuralgia — chronic pain lasting months to years after the rash heals.

Common Symptoms

People with Shingles often experience the following symptoms.

Prodromal Pain

Burning, tingling, or shooting pain in a dermatomal distribution, often 2-3 days before the rash appears.

Dermatomal Rash

Grouped vesicles on an erythematous base, following a single dermatome (nerve distribution), always unilateral.

Acute Neuralgia

Severe pain accompanying the rash, often described as burning, stabbing, or electric shock-like.

Herpes Zoster Ophthalmicus

Shingles affecting the eye (via ophthalmic division of trigeminal nerve), potentially causing vision-threatening complications.

Risk Factors

Certain factors may increase your likelihood of developing Shingles.

Age over 50

Weakened immune system

Previous chickenpox

Stress or illness

Treatment Options

Common approaches to managing shingles. Always consult a healthcare provider for personalized treatment.

Antivirals

Valacyclovir or acyclovir within 72 hours of rash onset. Reduces duration, severity, and postherpetic neuralgia risk.

Pain Management

NSAIDs, gabapentin, or opioids for acute pain. Lidocaine patches for localised relief.

Shingrix Vaccine

Recombinant vaccine, 97% effective at preventing shingles. Recommended for all adults over 50 (2-dose series).

Postherpetic Neuralgia Treatment

Gabapentin, pregabalin, tricyclic antidepressants, or capsaicin for chronic post-shingles pain.

How It's Diagnosed

Clinical diagnosis based on characteristic dermatomal vesicular rash. PCR testing of vesicle fluid confirms diagnosis if atypical. Direct fluorescent antibody testing as alternative.

When to See a Doctor

See a doctor within 72 hours of rash onset for antiviral treatment. Seek urgent care if shingles affects the eye or ear, or if you are immunocompromised.

Prevention Strategies

Steps that may help reduce the risk of developing or worsening shingles.

Shingrix vaccine (adults 50+, 2 doses)

Also recommended for immunocompromised adults 19+

Maintain overall health and immunity

Early antiviral treatment reduces complications

Potential Complications

If left untreated or poorly managed, shingles may lead to:

  • Postherpetic neuralgia (10-18% of cases)
  • Vision loss (herpes zoster ophthalmicus)
  • Hearing loss and facial paralysis (Ramsay Hunt syndrome)
  • Bacterial superinfection of lesions

Frequently Asked Questions

Can you get shingles more than once?

Yes. About 5-6% of people have recurrent shingles. Vaccination reduces recurrence risk.

Is shingles contagious?

You cannot catch shingles from someone. However, the virus can be transmitted to cause chickenpox in someone who has never had it.

Who should get the shingles vaccine?

All adults over 50, and immunocompromised adults 19+. Shingrix is recommended even if you had the older Zostavax vaccine.

Think you might have Shingles?

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This information is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.

Shingles (Herpes Zoster) — Symptoms, Treatment & Vaccine | Symplicured | Symplicured