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Shingles Facts and Risk Factors

Shingles (also termed herpes zoster or zoster) is a disease caused by reactivation of a previous infection with the herpes zoster virus (also named varicella-zoster virus, VZV, HHV-3, or chickenpox virus) that results in a painful localized skin rash, usually with blisters (fluid-filled sacs) on top of reddish skin. Herpes zoster viruses do not cause the sexually transmitted disease genital herpes. That disease is caused by another virus named herpes genitalis (also termed herpes simplex virus, type 2 or HSV-2).

The chickenpox virus (varicella-zoster, VZV) may remain in a dormant state in the body after an individual has chickenpox, usually in the roots of nerves that control sensation. In about one out of five people previously infected with chickenpox, the virus "wakes up," or reactivates, often many years or decades after a childhood chickenpox infection. When the virus is reactivated and causes shingles, the resulting virus is usually referred to as herpes zoster virus. Researchers do not know what causes this reactivation. What is known is that after reactivation the virus travels along a sensory nerve into the skin and causes shingles. The majority of people who get shingles are over the age of 60; it infrequently occurs in younger people and children. Investigators estimate that about 1 million cases of shingles occur per year in the U.S.

  • The term shingles is derived from the Latin and French words for belt or girdle, reflecting the distribution of the rash in usually a single broad band. This band is only on one side of the body in the large majority of people and represents a dermatome -- the area that a single sensory nerve supplies in the skin. The painful area may occupy part or all of the dermatome (see figure 1 below).
  • Risk factors for shingles are common, and the majority of people have at least one or more risk factors. For example, anyone who has had the chickenpox infection or chickenpox vaccine (live attenuated virus) may carry the herpes zoster virus that causes shingles. Older people (over 50 years of age), those with cancer, HIV, or organ transplant, or people who have a decreased ability to fight off infection due to stress or immune deficiency have a greater chance of getting shingles.
  • However, the majority of people with shingles or risk factors for shingles are relatively healthy. Most people do not need special tests to be done to see if their immune system is strong and functioning normally.
Picture of shingles in a child with leukemia showing a characteristic band of lesions
Picture of shingles in a child with leukemia showing a characteristic band of lesions; SOURCE: CDC
Medically Reviewed by a Doctor on 3/16/2015
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Shingles...the Short Story

Shingles, or herpes zoster, is a very common painful, blistering viral rash. Shingles is caused by reactivation of the chickenpoxvirus called varicella zoster virus (VZV). Shingles occurs in people who have previously been infected with the chickenpox virus at some point in their lives. Shingles usually occurs as a unilateral pain, burning, or tingling and blistering rash extending in a local pattern in the distribution of nerves. Common areas affected by shingles include the face, abdomen, back, buttocks, and chest. Red, itchy patches form across these areas and become small blisters that may be similar in appearance to chickenpox. The rash begins to clear after the blisters break and dry into scabs within two to three weeks.

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Herpes Zoster »

Herpes zoster (shingles) is 1 of 2 distinctive manifestations of human infection with the varicella-zoster virus(VZV), the other being varicella (chickenpox).

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