Shingles is a viral infection that causes a painful rash. Although shingles can occur anywhere on your body, it most often appears as a band of blisters that wraps from the middle of your back around one side of your chest to your breastbone. Shingles is caused by the varicella-zoster virus - the same virus that causes chickenpox. After you've had chickenpox, the virus lies inactive in nerve tissue near your spinal cord and brain. Years later, the virus may reactivate as shingles. While it isn't a life-threatening condition, shingles can be very painful. Vaccines can help reduce the risk of shingles, while early treatment can help shorten a shingles infection and lessen the chance of complications.

Complications of Shingles

Complications from shingles can range from a mild to severe, ranging from minor skin infections to postherpetic neuralgia.

Postherpetic neuralgia

For some people, shingles pain continues long after the blisters have cleared. This condition is known as postherpetic neuralgia, and it occurs when damaged nerve fibers send confused and exaggerated messages of pain from your skin to your brain. Pain medication, antidepressants or anticonvulsant medications may help provide relief until the pain subsides.

Vision loss

Shingles in or around an eye (ophthalmic shingles) can cause painful eye infections that may result in vision loss.

Neurological problems

Depending upon which nerves are affected, shingles can cause:

• Encephalitis, an inflammation of the brain
• Hearing or balance problems
• Facial paralysis

Skin infections

If shingles blisters aren't properly treated, bacterial skin infections may develop.

Causes of Shingles

• Shingles is caused by the varicella-zoster virus — the same virus that causes chickenpox. Anyone who's had chickenpox may develop shingles. After you recover from chickenpox, the virus can enter your nervous system and lie hidden for years. Eventually, it may reactivate and travel along nerve pathways to your skin — producing shingles.
• The reason for the encore is unclear. But it may be due to lowered immunity to infections as you grow older. Shingles is more common in older adults and in people who have weak immune systems.
• Varicella-zoster is part of a group of viruses called herpes viruses, which includes the viruses that cause cold sores and genital herpes. Because of this, shingles is also known as herpes zoster. But the virus that causes chickenpox and shingles is not the same virus responsible for cold sores or genital herpes, a sexually transmitted disease.

Signs & Symptoms of Shingles

The signs and symptoms of shingles usually affect only a small section of one side of your body. These signs and symptoms may include:

• Pain, burning, numbness or tingling
• A red rash that begins a few days after the pain
• Fluid-filled blisters that break open and crust over
• Itching

Some people also experience:

• Fever and chills
• General achiness
• Headache
• Fatigue

Pain is usually the first symptom of shingles. For some, it can be intense. Depending upon the location of the pain, it can sometimes be mistaken for a symptom of problems affecting the heart, lungs or kidneys. Some people experience shingles pain without ever developing the rash. Most commonly, the shingles rash develops as a band of blisters that wraps around one side of your chest from your spine to your breastbone. Sometimes the shingles rash occurs around one eye or on one side of the neck or face.
Diagnosis of Shingles

Shingles is usually diagnosed based on the history of pain on one side of your body, along with the telltale rash and blisters. Your doctor may also take a tissue scraping or culture of the blisters for examination in the laboratory.

Treatments of Shingles

An episode of shingles usually heals on its own within a few weeks, but prompt treatment can ease pain, speed healing and reduce your risk of complications.

Antiviral drugs

For best results start these medications within 72 hours of the first sign of the shingles rash. Oral antiviral medications include:

• Acyclovir (Zovirax)
• Valacyclovir (Valtrex)
• Famciclovir (Famvir)

Drugs for the pain

Shingles can cause severe pain, so you may need prescription medications for treatment. They may include:

• Narcotics, such as oxycodone
• Tricyclic antidepressants, such as amitriptyline
• Anticonvulsants, such as gabapentin (Neurontin)
• Numbing agents, such as lidocaine, delivered via a cream, gel, spray or skin patch

Prevention of Shingles

Two vaccines may help prevent shingles — the chickenpox (varicella) vaccine and the shingles (varicella-zoster) vaccine.

Chickenpox vaccine

The varicella vaccine (Varivax) has become a routine childhood immunization to prevent chickenpox. The vaccine is also recommended for adults who've never had chickenpox. Though the vaccine doesn't guarantee you won't get chickenpox or shingles, it can reduce your chances of complications and reduce the severity of the disease.

Shingles vaccine

The varicella-zoster vaccine (Zostavax) can help prevent shingles in adults age 60 and older who've had chickenpox. Like the chickenpox vaccine, the shingles vaccine doesn't guarantee you won't get shingles. But this live vaccine will likely reduce the course and severity of the disease and reduce your risk of postherpetic neuralgia. The shingles vaccine is recommended for all adults age 60 and older, whether or not they have had shingles previously. The shingles vaccine is used only as a prevention strategy, however. It's not intended to treat people who currently have the disease.

This shingles vaccine isn't recommended if you:

• Have ever had a life-threatening allergic reaction to gelatin, the antibiotic neomycin or any other component of the shingles vaccine
• Have a weakened immune system from HIV/AIDS or another disease that affects your immune system
• Are receiving medical treatments such as steroids, radiation and chemotherapy
• Have a history of bone marrow or lymphatic cancer

When to seek Medical Advice

Contact your doctor promptly if you suspect shingles, but especially in the following situations:

• The pain and rash occur near your eyes. If left untreated, this infection can lead to permanent eye damage.
• You or someone in your family has a weakened immune system (due to cancer, medications or chronic illness).
• The rash is widespread and painful.