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Shingles: Picture, symptoms, diagnosis, treatment

What causes shingles?

The varicella-zoster virus is responsible for causing chickenpox and shingles. Both chickenpox and shingles, herpes zoster, are marked by an outbreak of rash or blisters on the skin.

Small blisters at the onset of shingles oubreak

People who have had chickenpox in the past are at risk of developing shingles because the virus remains inactive in certain nerve cells of the body and can become active later in life.

People in their 70s are now offered a vaccination on the NHS to protect against shingles.

Who gets shingles?

Scientists are not certain why the virus reactivates, or why it only reactivates in about 20% of people who have had chickenpox. There is evidence to suggest that a weakened immune system may cause the virus to break out of its dormant state, multiply, and move along nerve fibres to the skin. You may be at risk of shingles if you:

  • Have a weakened immune system (such as people with cancer or HIV)
  • Are over 50
  • Have been ill
  • Are experiencing trauma
  • Are under significant stress

What are the symptoms of shingles?

Symptoms of shingles include:

  • Pain that is itching, stabbing or shooting
  • Tingling feeling in or under the skin, which is red in the affected area
  • High temperature, chills, and headache

After a few days, a rash appears as a band or patch of raised dots, usually on one side of the body. The rash can appear around the waistline or on one side of the face or torso. The rash eventually develops into red, fluid-filled, round, painful blisters. These blisters usually begin to dry out within a few days or weeks.

How is shingles diagnosed?

Doctors diagnose shingles based on the way the rash looks. The blisters of a shingles rash usually appear in a band on one side of the body. Shingles may also be diagnosed from a scraping or swab of the fluid from the blisters that can be analysed in a laboratory.

How is shingles treated?

There is no cure for shingles, but treatments for the condition can help ease the associated pain and discomfort. Treatments can also help the healing of blisters and rash.

Antiviral medication such as aciclovir, famciclovir and valaciclovir can ease discomfort and reduce the duration of symptoms. In most cases, it is recommended that antiviral medication be started within 72 hours of the first sign of shingles.

Painkillers can also offer relief. Over-the-counter paracetamol or non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen can be effective in relieving mild pain. For more severe cases of pain, prescription NSAIDs or narcotic painkillers may be necessary. In some cases, corticosteroids can be prescribed to ease the discomfort, inflammation, pain, redness, and itching associated with shingles' rash and blisters.

Is shingles contagious?

Yes. People who have never had chickenpox or have not been vaccinated against the disease can develop chickenpox if exposed to the virus.

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WebMD Medical Reference

Medically Reviewed by Dr Rob Hicks on February 26, 2014

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