Symptoms and Signs of Shingles

Medical Author:
Medically Reviewed on 8/13/2021

Doctor's Notes on Shingles

Shingles is caused by the varicella zoster virus, the same virus that causes chickenpox. Anyone who has had chickenpox can develop shingles later in life. Once chickenpox illness has run its course, the virus remains in the body in nerve tissues. In some people, the virus becomes re-triggered, causing shingles. While the illness can occur in children, about half of all cases occur in adults over age 60. 

Symptoms of shingles include a rash and blisters. Shingles can also cause several complications:

  • One complication is acute bacterial infection, causing cellulitis, a bacterial skin condition. If this occurs, the area will become reddened, warm, firm, and tender, with red streaks forming around the wound
  • Another complication of shingles occurs when the virus affects the face of a patient, specifically the forehead and nose. While unlikely, it is possible for shingles to affect the eye (herpes zoster ophthalmicus), leading to loss of vision. 
  • A rare complication of shingles is Ramsay Hunt syndrome which involves the cranial nerves (cranial nerves V, IX, and X), with symptoms that may include peripheral facial nerve weakness and deafness. The typical rash is often observed around the ear and ear canal. 
  • A common complication of shingles is postherpetic neuralgia, when nerve pain associated with shingles persists beyond one month, even after the rash disappears.

What Is the Treatment for Shingles?

Treatment of shingles involves one of several antiviral medications. These medications help shorten the illness, decrease its severity, and speed the healing of skin lesions. Antiviral drugs can also help prevent the potential complications sometimes encountered with shingles. They are most effective when started within 72 hours of the first appearance of the rash.

Other treatments (in addition to antiviral drugs) may include:

  • Pain medication to help relieve discomfort 
  • Over-the-counter antihistamine medication to help alleviate localized itching
  • In certain complicated cases, a corticosteroid medication may also be prescribed

REFERENCE:

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