• Shingles

    (Herpes Zoster; Post-herpetic Neuralgia)


    Shingles is a painful infection of the nerves and skin.


    Shingles is caused by the varicella zoster virus. This is the same virus that causes chickenpox. Shingles occurs in people who have had chickenpox in their lifetime. After causing the first chickenpox infection, the virus is not totally eliminated from the body. Some of the remaining virus settles in nerve roots near the spinal cord. When reactivated, the virus travels along nerve paths to the skin where it causes pain and a rash.
    Shingles Blisters
    Copyright © Nucleus Medical Media, Inc.

    Risk Factors

    Shingles is more common in women, and in people aged 50 years and older. Other factors that may increase your chance of shingles include:
    Shingles can occur in those with no known risk factors.
    Shingles is not usually transmitted from one person to another, but a person who has never had chickenpox and never received the varicella vaccine is likely to get chickenpox if contact occurs with a person who has shingles. Covering shingles sores with a bandage reduces the risk of transmitting shingles to others.


    Shingles may cause:
      • Red and has a slightly raised band or patch, often with multiple small fluid-filled blisters that dry out and crust within several days
      • Develops on one side of the body, but typically does not cross the midline
      • Affects mostly the torso and face
    • The eyes to be affected, in severe cases, which can threaten vision
    • Sensitivity and pain on the skin at the site of the rash; pain may be severe
    • Tingling or itchiness on the skin, which may start a few days before the rash
    • Fever
    • Headache
    • Tiredness
    The rash usually disappears within 3 weeks. In some cases, though, post-herpetic neuralgia (PHN) develops. With PHN, the pain continues for months or even years after the rash has healed. PHN can be severe and difficult to treat.


    You will be asked about your symptoms and medical history. A physical exam will be done. The rash can be diagnosed by its appearance. Fluids may be drawn from the blisters for testing, but this is not done often.


    Shingles cannot be cured. Treatment focuses on:
    • Easing symptoms
    • Speeding recovery
    • Preventing PHN

    Home Remedies and Over-the-Counter Products

    The following will help relieve pain and ease symptoms:
    • Calamine lotion
    • Wet compresses
    • Frequent oatmeal baths
    • Over-the-counter pain relievers
    • Topical pain relievers that are applied to the skin

    Antiviral Medication

    Antiviral medications may control shingles. Antiviral therapy may shorten a shingles episode, but you must start it within 48-72 hours after symptoms first develop. They are especially used in people with suppressed immune systems.

    Treatment for Post-herpetic Neuralgia

    If you develop PHN, your doctor may recommend:
    • Antidepressants
    • Antiseizure medications
    • Prescription pain relievers
    • Topical pain relievers
    • Lidoderm patch
    • Nerve blocks
    • Transcutaneous electrical nerve stimulation (TENS)—a device that generates low-level pulses of electrical current on the skin's surface

    Treatment for Shingles of the Eye

    If you develop shingles on your face, contact your doctor right away. You may be prescribed medications, such as steroids, to treat this condition. Without treatment, permanent eye damage can result, including glaucoma, scarring, and blindness.


    The herpes zoster vaccine is advised for people aged 60 years and older. The vaccine decreases the likelihood of getting shingles and reduces the severity of PHN if shingles does occur.
    If you do have shingles, take these steps to prevent giving chickenpox to others:
    • Keep all blisters covered with a bandage until they are dry and crusted over.
    • If you are a healthcare worker, do not return to work until the blisters are dry and crusted over.
    • Avoid contact with people who are at risk of getting severe varicella, such as:
      • Pregnant women
      • Premature infants
      • People who have a compromised immune system


    National Institute of Neurological Disorders and Stroke http://www.ninds.nih.gov

    National Shingles Foundation http://www.vzvfoundation.org


    Public Health Agency of Canada http://www.phac-aspc.gc.ca

    The College of Family Physicians of Canada http://www.cfpc.ca


    Herpes zoster. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T113997/Herpes-zoster. Updated September 13, 2016. Accessed September 13, 2016.

    Ocular shingles. Wills Eye Institute website. Available at: https://www.willseye.org/health-library/ocular-shingles. Updated October 5, 2011. Accessed February 9, 2016.

    Shingles. American Academy of Family Physicians Family Doctor website. Available at: http://familydoctor.org/familydoctor/en/diseases-conditions/shingles.html. Updated April 2014. Accessed February 9, 2016.

    Shingles: overview. American Academy of Dermatology website. Available at: https://www.aad.org/public/diseases/contagious-skin-diseases/shingles. Accessed February 9, 2016.

    Shingles (herpes zoster). Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/shingles. Updated May 1, 2014. Accessed February 9, 2016.

    1/14/2011 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Tseng HF, Smith N, Harpaz R, Bialek SR, Sy LS, Jacobsen SJ. Herpes zoster vaccine in older adults and the risk of subsequent herpes zoster disease. JAMA. 2011;305(2):160-166.

    6/9/2014 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Forbes H, Bhaskaran K, Thomas SL, et al. Quantification of risk factors for herpes zoster: population based case-control study. BMJ. 2014;348:g2911.

    Revision Information

    • Reviewer: EBSCO Medical Review Board David L. Horn, MD
    • Review Date: 03/2017
    • Update Date: 02/09/2016
  • LiveWell personal health survey

    How healthy are you really? Find out – free.Learn more

    It's time to stop guessing. If you want to make some changes but just aren't sure how, the free personal health survey from LiveWell is a great place to start.

  • HeartSHAPE Spotlight

    At risk for a heart attack? Learn more

    Fight heart disease and prevent heart attacks. HeartSHAPE® is a painless, non-invasive test that checks pictures of your heart for early-stage coronary disease.

  • Calories and Energy Needs

    Calorie NeedsLearn more

    How many calories do you need to eat each day to maintain your weight and fuel your physical activity? Enter a few of your stats into this calculator to find out.

  • Ideal Body Weight

    Ideal Body WeightLearn more

    Using body mass index as a reference, this calculator determines your ideal body weight range. All you need to do is enter your height.

  • Body Mass Index

    Body Mass IndexLearn more

    This tool considers your height and weight to assess your weight status.

  • Can we help answer your questions?

    Wellmont Nurse Connection is your resource for valuable health information any time, 24 hours a day, seven days a week. Speak to a Nurse any time, day or night, at (423) 723-6877 or toll-free at 1-877-230-NURSE.