Symptoms and Signs of Shingles Symptoms and Treatment

Medical Author:
Medically Reviewed on 3/22/2022

Doctor's Notes on Shingles Symptoms and Treatment

Shingles (also termed herpes zoster) is a common, painful blister-forming rash that occurs in people who've had chickenpox in the past. Signs and symptoms of shingles are as follows: a reddish rash, usually on only one side of the body and/or face. The rash follows skin dermatomes (skin areas that follow a nerve distribution from the spine to the midline of the body). The painful rash has blisters that eventually burst and crust/scab over. Other signs and symptoms may include chills, fever, and fatigue. Unfortunately, some patients have the facial area involved and have facial pain, loss of eye motion, drooping eyelids, headaches, taste problems, and hearing loss. Others can develop PHN (postherpetic neuralgia) that is chronic pain lasting 6 or more weeks that may remain for months or years.

The cause of shingles is reactivation of chickenpox virus (varicella zoster or VSV), usually many years after the person had chickenpox. It is most common in adults over 60 or in immunosuppressed individuals. Reactivation is thought to be due to a reduction in immune surveillance mechanisms in the body.

What Are the Treatments for Shingles?

The best way to treat shingles is to prevent the disease by getting a vaccine to prevent this painful problem. Once you develop the symptoms, however, there is no cure but there are medications that may speed healing and reduce risks of complications.

  • Antivirals (best effects with use early in infection)
  • Pain control (very painful, sometimes debilitating severe pain)
    • Capsaicin topical patch
    • Numbing agents like lidocaine in creams, gels, sprays or patches
    • Gabapentin or other anticonvulsants
    • Tricyclics like amitriptyline
    • Narcotics (short-term use, may be addictive)
    • Injections with corticosteroids or local anesthetics

If your eye is involved, seek an eye doctor immediately.

REFERENCE:

Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.