Shingles - Common Skin Conditions: Skin Health

Content provided by the Faculty of the Harvard Medical School

Shingles

Shingles, also known as herpes zoster, is a viral infection of the nerves that causes a painful, blistering rash. The virus responsible, the varicella-zoster virus, is the same one that causes chickenpox.

Most people born before the chickenpox vaccine became available have been exposed to this virus. After the initial exposure, the virus lies dormant in the spinal nerves and, most of the time, remains inactive throughout life. But sometimes, particularly in people over age 60 or those who have a weakened immune system, the varicella-zoster virus "reawakens" and causes shingles. Initially, shingles causes sharp, burning pain near the surface of the skin. Several days later, a rash of red raised bumps appears. These bumps turn to itchy blisters loaded with viral particles. If your immune system is weakened by other health conditions, the complications from shingles can be life-threatening.

The blisters form distinct patterns along nerve pathways, often appearing in a band over the ribs on one side of the body, or on the face. They usually disappear in two to three weeks, crusting over and occasionally leaving scars. Pain may persist for weeks or, less commonly, for several months. The affected area can become so sensitive that even light bed sheets or clothing cause intense pain, a condition called postherpetic neuralgia. This condition, which results from damage to the nerves, affects about 10%–15% of people who get shingles. For some, antidepressants, corticosteroids, capsaicin cream, or the antiseizure drug carbamazepine have been useful for relieving the pain. Postherpetic neuralgia often disappears on its own over time.

Treating shingles

If you suspect that you have shingles, it's important to see a doctor immediately for treatment to shorten the course of the condition, minimize pain, and reduce the risk for nerve damage. Your doctor may prescribe an oral antiviral drug such as acyclovir, famciclovir, or valacyclovir. Analgesic drugs (pain relievers) may be useful in relieving pain and discomfort. Corticosteroid drugs may help reduce swelling, inflammation, and postherpetic neuralgia. Keeping the skin clean is important to avoid secondary bacterial infection. Applying cool compresses also may help ease the discomfort.

Two vaccines can help prevent shingles. The varicella-zoster vaccine is recommended for children and adults who haven't had chickenpox. This vaccine cannot help people who've already been infected with the virus; that includes the vast majority of today's adults, who had chickenpox before immunization was available.

A newer shingles vaccine was approved in 2006 for adults ages 60 and older. A major clinical trial of more than 38,000 adults found that the vaccine cut the incidence of shingles by half. Vaccinated adults who did get infected had milder cases with fewer complications than people who weren't vaccinated.

Last updated:	July 20, 2007