Shingles is a painful, blistering rash caused by the varicella-zoster virus which is the same virus that causes chickenpox. After a person has chickenpox, the varicella-zoster virus will remain dormant in nerve tissue near one’s spinal cord or brain. It is not clear why, but much later in life the virus can reactivate and then present as shingles. Risk factors for shingles include age (usually >50), extreme physical or emotional stress or a weakened immune system caused by diseases (such as HIV and cancer) or certain medications (such as steroids or chemotherapy).

Often before the rash of shingles appears, one will feel burning or itching on the skin where it will erupt. Some patients complain of muscle ache for several days prior to the eruption. The rash of shingles appears with numerous blisters on top of a red, inflamed base of skin. Shingles is one-sided: it does not cross the midline of a person’s body. For example: a case of shingles on the trunk will appear on the back to the left or the right of the spine and wrap around that flank and involve only that same side of the abdomen. Many people note that they feel physically ill as well when they have shingles; they complain of fever, muscle ache, headache and fatigue.

Shingles is treated with antiviral medications that will shorten the course and severity of the outbreak – especially if taken within the first 72 hours of the eruption. Occasionally, a systemic steroid is given in conjunction with the antiviral medication in order to decrease the discomfort and inflammation of the rash. Taking antivirals and systemic steroids early in the onset of the eruption is thought to reduce the risk of having long-term nerve pain called Post-Herpetic Neuralgia. Sometimes, because the pain of shingles can be severe, your dermatologist will recommend an over-the-counter analgesic such as acetaminophen and ibuprofen or in rarer instances, a prescription painkiller.