Kevin Lutz, MD, FACP
Sep 1 2020

Shingles is caused by the chickenpox virus. Once you have had chickenpox, the virus stays inactive in nerve tissue near your spinal cord and brain. Years later, this same virus can reappear as shingles.


Nervous SystemViruses

What is shingles (Herpes Zoster)?

Shingles is caused by the chickenpox virus. Once you have had chickenpox, the virus stays inactive in nerve tissue near your spinal cord and brain. Years later, this same virus can reappear as shingles. Shingles leads to a rash most often appearing as a stripe of fluid-filled blisters wrapping around the left or right side of your body. Sometimes the rash can develop around one eye, or on one side of the neck or face. Because the nerves along the path become inflamed, shingles can also be very painful. Pain that lasts for months after the rash has healed is called post herpetic neuralgia or PHN. For some people, this pain can be severe and chronic.

If I am perfectly healthy, am I really at risk for shingles?

If you are one of the 99% of adults over 50 years old who has had chickenpox, the virus that causes shingles is inside your body and can reactivate at any time. 1 in every 3 people in the U.S. will get shingles in their lifetime. No matter how healthy you feel, your immune system declines as you age, and that puts you at an increased risk for shingles.

Can you have a shingles outbreak more than once?

Unfortunately, yes you can. One of the biggest myths about shingles is that it can only happen once. This is not true -- you can have more than one episode. If you get shingles again, you usually don’t get the rash in the same place.

Is shingles contagious like chickenpox?

The virus is released from the oozing lesions of the rash. If you have a rash with open sores, you should stay away from those who have not had chickenpox and wait until the lesions scab over.

How long does shingles last?

From the time you begin to feel symptoms until the rash has totally disappeared can take three to five weeks.

  • First, a few days before the rash appears, you may feel pain in an area on your skin. The pain is described as itching, burning, stabbing, or shooting and can be quite severe.
  • Next, the raised rash appears as a band or a patch, usually on only one side of the body. The rash usually appears around the trunk or on one side of the face or neck but can occur in other areas including the arms and legs. 
  • Within three to four days, the rash develops into red, fluid-filled, round, painful, blisters. 
  • Usually, these blisters begin to dry out and crust over within about 10 days. The scabs clear up two to three weeks later.
  • For some unfortunate patients, the severe pain associated with the rash never goes away.

How is shingles treated?

Shingles is not curable, but there are several antiviral medications that can treat the blisters, and shorten the length and severity of the illness. If you suspect you have shingles, contact your doctor right away. The medicines are most effective if you start taking them as soon as possible after the rash appears. Over-the-counter pain medicines may help alleviate shingles discomfort. Wet compresses, calamine lotion and colloidal oatmeal baths may help reduce itching.

How do I prevent Shingles?

That is a great question! There is a Shingles vaccine called Shingrix. It is the only shingles vaccine proven to be greater than 90% effective in adults 50 years and older in clinical trials. Shingrix is given as a 2-dose series, with the second shot administered 2 to 6 months after the first shot. It is important to receive both shots of Shingrix.

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