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Shingles

Shingles...the Short Story

Author: Nili N. Alai, MD, FAAD
Editor: William C. Shiel Jr., MD, FACR, FACR

Discover the causes, symptoms, diagnosis, treatment, and prevention of shingles.Shingles, or herpes zoster, is a very common painful, blistering viral rash. Shingles is caused by reactivation of the chickenpox virus 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.

Once people have had a single bout of chickenpox, the virus lies dormant in the nerve roots near the spinal cord or base of the facial nerve. It is thought that when a person has a weakened immune system or when their immunity to the varicella virus is diminished the virus can reactivate to inflame a nerve and cause shingles. Although shingles may happen at any age, it is most common in the fifth through sixth decades of life. Typically, shingles usually occurs most commonly in adults over the age of 60 or in those who are immunosuppressed (HIV, AIDS, or cancer patients).

Read on to find out about shingles symptoms, treatment, and prevention »

Shingles Overview

Shingles (also termed herpes zoster) is a disease caused by reactivation of the herpes zoster virus (varicella-zoster virus, or VZV) that results in a painful localized skin rash, usually with blisters (fluid filled sacks) on top of the reddish skin. This same virus causes the childhood illness chickenpox. The chickenpox virus (varicella) remains in a dormant state in the body in the root of nerves that control sensation. In about one out of five people, the virus "wakes up," often many years after the chickenpox infection. The virus then travels along a sensory nerve into the skin and causes shingles. The majority of patients who get shingles are over the age of 60; it infrequently occurs in younger people. 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 a broad band. This band is usually only on one side of the body and represents a dermatome -- the area that a single sensory nerve supplies in the skin.


  • Anyone who has had the chickenpox infection or vaccine can carry the herpes zoster virus that causes shingles. Older people (over 50 years of age); those with cancer, HIV, or organ transplant, or people that have a decreased ability to fight off infection have a greater chance of getting shingles.


  • The majority of people with shingles, however, are healthy. No special tests need to be done to see if your immune system is strong.


Next: Shingles Causes »

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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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