What Is Shingles?
Shingles is a virus that causes an itchy, painful rash on your skin. It’s caused by the varicella-zoster virus, which is the same pathogen that causes chickenpox. In order to get shingles, you have to have had chickenpox at some point in your life. Once you’ve had chickenpox, the virus never fully leaves your body. Instead, it lies dormant in nerves near your brain and spine. Later on, the virus that’s lying dormant re-activates and travels along your nerves to your skin. Instead of coming back as chickenpox again, it appears as shingles.
Although the same virus causes both illnesses, shingles differs from chickenpox in a few key ways. People typically experience chickenpox in childhood, while shingles often appears in later adulthood. Chickenpox often begins with flu-like symptoms before causing a bumpy, itchy, red rash. Shingles, however, mostly causes nerve pain and a severe rash. While chickenpox is highly contagious, shingles is not as easy to spread. And, you can’t catch shingles from someone else who has it if you’ve never had chickenpox. Instead, you’ll develop chickenpox.
In order to get shingles, you have to have had chickenpox at some point in your life. Doctors are still unsure why the varicella-zoster virus reappears this way, typically later in adulthood. However, they believe it may have something to do with the fact that, in general, people’s immune systems begin to weaken as they age. People who’ve had shingles also commonly note that it appears during stressful times in their lives, such as when a loved one passes or they’re enduring some tribulations at work. It likely isn’t the stress itself that makes the virus reappear, though. Stress can suppress your immune system, giving the virus an opportunity to begin causing symptoms of shingles.
Shingles Symptoms and Progression
Like chickenpox, one of the most prominent symptoms of shingles is a rash. However, instead of appearing as small, distinct round welts like chickenpox, shingles causes a large, spreading rash that turns into fluid-filled blisters. These blisters eventually rupture and scab over.
While the first signs of chickenpox typically resemble those of the flu and include a fever, headache and fatigue, shingles often begins differently. Instead, shingles causes nerve-related sensations like itching, tingling, numbness or shooting pains from the virus traveling along the nerves to the skin. These sensations may begin a few days or a week before other symptoms start presenting. You might also experience flu-like symptoms, but it’s common for these not to be present when shingles begins.
If you’ve had chickenpox, you may remember that the rash spread all over your body. Shingles, in contrast, often begins on your torso or face and may not spread too far. It starts as a red rash with small red bumps that swell and form blisters. This rash can cause very intense pain that people sometimes describe as “shooting” and “fiery,” along with itching. These feelings may last for a month or longer, and your skin may also be highly sensitive to touch. The rash generally begins to appear between one and five days after the skin pain and sensations.
One distinguishing feature of the shingles rash is that it usually only develops on one side of your body. It forms in bands or “stripes” on your torso or in a large blotch on your shoulders. It’s also common for people to develop shingles patches on one side of their face and scalp. If you get shingles on your head, it’s essential to be under the care of an experienced physician. The rash can travel into your eye and cause vision damage and loss.
After the blisters form, they begin filling with pus and may last a few days in this stage before bursting. After the blisters have burst, they scab over. You may continue to experience pain until the rash fades away — and in some cases afterwards. When the pain continues after the shingles rash has disappeared, it's known as postherpetic neuralgia.
Although it’s not possible to stop shingles completely once it starts, some treatments can ease your symptoms and may even keep the virus from progressing the way it normally would. Your doctor can give you a type of medication called an antiviral, which can stop the shingles virus from replicating and developing fully. However, this treatment is most effective if you begin it within three days of the onset of your symptoms, which is why it’s essential to contact your doctor right away if you start experiencing shingles symptoms.
Your doctor may also have some options that can be helpful for treating shingles-related pain. You may be given a medication called gabapentin, which lessens nerve pain, along with other pain relievers. Your doctor might also prescribe amitriptyline, which is an antidepressant that can relieve some of the anxiety you’re feeling. Some tried-and-true remedies also can help ease the painful sensations, including oatmeal baths, cool compresses and numbing lotions with lidocaine.
Even if you’ve already had shingles, one option for future prevention is to receive a shingles vaccine, which can keep you from developing this illness for several years after receiving the shots. These vaccines are approved for adults over age 50 or 60, depending on the type your doctor decides is right for you.