Diseases & Conditions


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Zoster (Shingles Disease)


What is shingles (herpes zoster)? Shingles, also called herpes zoster or zoster, is a painful skin rash caused by the varicella zoster virus (VZV). VZV is the same virus that causes chickenpox. After a person recovers from chickenpox, the virus stays in the body. Usually the virus does not cause any problems; however, the virus can reappear years later, causing shingles. Herpes zoster is not caused by the same virus that causes genital herpes, a sexually transmitted disease. What does shingles look like? Shingles usually starts as a rash on one side of the face or body. The rash starts as blisters that scab after 3 to 5 days. The rash usually clears within 2 to 4 weeks. Before the rash develops, there is often pain, itching, or tingling in the area where the rash will develop. Other symptoms of shingles can include fever, headache, chills, and upset stomach. Are there any long-term effects from shingles? Very rarely, shingles can lead to pneumonia, hearing problems, blindness, brain inflammation (encephalitis) or death. For about 1 person in 5, severe pain can continue even after the rash clears up. This pain is called post-herpetic neuralgia. As people get older, they are more likely to develop post-herpetic neuralgia, and it is more likely to be severe. How common is shingles in the United States? In the United States, there are an estimated 1 million cases of shingles each year. Who gets shingles? Anyone who has recovered from chickenpox may develop shingles, including children. However, shingles most commonly occurs in people 50 years old and older. The risk of getting shingles increases as a person gets older. People who have medical conditions that keep the immune system from working properly, like cancer, leukemia, lymphoma, and human immunodeficiency virus (HIV), or people who receive immunosuppressive drugs, such as steroids and drugs given after organ transplantation are also at greater risk to get shingles. How often can a person get shingles? Most commonly, a person has only one episode of shingles in his/her lifetime. Although rare, a second or even third case of shingles can occur. Can shingles be spread to others? Shingles cannot be passed from one person to another. However, the virus that causes shingles, VZV, can be spread from a person with active shingles to a person who has never had chickenpox through direct contact with the rash. The person exposed would develop chickenpox, not shingles. The virus is not spread through sneezing, coughing or casual contact. A person with shingles can spread the disease when the rash is in the blister-phase. Once the rash has developed crusts, the person is no longer contagious. A person is not infectious before blisters appear or with post-herpetic neuralgia (pain after the rash is gone). What can be done to prevent the spread of shingles? The risk of spreading shingles is low if the rash is covered. People with shingles should keep the rash covered, not touch or scratch the rash, and wash their hands often to prevent the spread of VZV. Once the rash has developed crusts, the person is no longer contagious. Is there a treatment for shingles? Several medicines, acyclovir (Zovirax), valacyclovir (Valtrex), and famciclovir (Famvir), are available to treat shingles. These medications should be started as soon as possible after the rash appears and will help shorten how long the illness lasts and how severe the illness is. Pain medicine may also help with pain caused by shingles. Call your doctor as soon as possible to discuss treatment options.