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Shingles (Herpes Zoster)

Shingles is a painful, blistering rash caused by reactivation of the chickenpox virus; prompt antiviral treatment reduces pain and lowers the risk of lasting nerve pain.

DermatologicNeurologic
Shingles (herpes zoster) is a painful, blistering rash caused by reactivation of the varicella-zoster virus — the same virus that causes chickenpox. About one in three people in the United States will develop shingles during their lifetime, and the risk rises sharply after age 50. Treated early, shingles is very manageable, and vaccination can prevent most cases. Most people have only one episode, though shingles can occasionally return. Causes and Risk Factors: After a chickenpox infection, the virus never fully leaves the body; it lies dormant in nerve roots and can reawaken decades later:
  • Aging immune system: Immunity to the virus gradually declines with age, which is why most cases occur in adults over 50.
  • Weakened immunity: Cancers such as lymphoma, chemotherapy, long-term steroid use, and organ-transplant medications all increase risk.
  • Physical stress or illness: A serious illness, surgery, or period of intense stress can precede an outbreak.
Symptoms: Shingles typically follows a predictable course over two to four weeks:
  • Early warning: Burning, tingling, itching, or stabbing pain in a band of skin on one side of the body, often days before anything is visible.
  • Rash: Red patches that become fluid-filled blisters in a stripe on one side of the chest, back, abdomen, or face, crusting over in seven to ten days.
  • Flu-like symptoms: Fever, headache, chills, fatigue, and sensitivity to light may accompany the rash.
  • Pain that varies widely: For some people the rash is mildly itchy; for others even light clothing brushing the skin is intensely painful, and the severity of pain does not always match how the rash looks.
  • Eye involvement: A rash on the forehead, nose, or around the eye can inflame structures inside the eye, similar to iritis, and threaten vision — this needs urgent evaluation.
Treatment: Starting treatment quickly — ideally within 72 hours of the rash appearing — shortens the illness and reduces complications:
  • Antiviral medications: Valacyclovir, acyclovir, or famciclovir speed healing and lessen the severity of pain.
  • Pain control: Over-the-counter pain relievers, cool compresses, and calamine lotion help mild pain; nerve-pain medications such as gabapentin may be added for more severe pain.
  • Skin care: Keep the rash clean and loosely covered. Until the blisters crust over, the fluid can transmit chickenpox to people who have never had it or been vaccinated against it.
  • Rest and recovery: Adequate rest, fluids, and loose, breathable clothing over the rash keep irritation down while the skin heals over the following weeks.
Complications: Most people recover fully, but complications become more common with age:
  • Post-herpetic neuralgia: Nerve pain that persists for months or longer after the rash heals — the most common complication. Learn more about post-herpetic neuralgia.
  • Vision problems: Untreated shingles near the eye can cause lasting damage, including vision loss.
  • Skin infection: Scratched or open blisters can develop secondary bacterial infection.
  • Widespread disease: In people with weakened immune systems, the rash can spread beyond a single band and, rarely, affect internal organs — a situation that requires hospital care.
The recombinant shingles vaccine, given as two doses to adults 50 and older (and to younger adults with weakened immune systems), is highly effective at preventing shingles and post-herpetic neuralgia. Because shingles can recur, vaccination is recommended even for people who have already had an episode. If you develop a painful one-sided rash, do not wait — early treatment matters. Contact the primary-care team at Zimmer Medical Group or schedule a visit promptly.

Related Medications

Commonly prescribed medications for this condition

ValacyclovirAcyclovirFamciclovirGabapentin

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