Shingles, or herpes zoster, occurs when the dormant chickenpox virus, varicella-zoster, is reactivated in your nerve tissues. Early signs of shingles include tingling and localized pain. Most, but not all, people with shingles develop a blistering rash. You may also experience itching, burning, or deep pain. Typically, the shingles rash lasts two to four weeks, and most people make a complete recovery. Doctors are often able to quickly diagnose shingles from the appearance of the rash.
Early symptoms of shingles may include fever and general weakness. You may also feel areas of pain, burning, or a tingling sensation. A few days later, the first signs of a rash appear. You may begin to notice pink or red blotchy patches on one side of your body. These patches cluster along nerve pathways. Some people report feeling shooting pains in the area of the rash. During this initial stage, shingles is not contagious. The rash quickly develops fluid-filled blisters similar to chickenpox. They may be accompanied by itching. New blisters continue to develop for several days. Blisters appear over a localized area and do not spread over your whole body. Blisters are most common on the torso and face, but they can occur elsewhere. In rare cases, the rash appears on the lower body. It is not possible to transmit shingles to someone. However, it is possible to get chickenpox from someone with shingles by direct contact with active blisters if you have never had chickenpox or the chickenpox vaccine. The same virus causes shingles and chickenpox.
Blisters sometimes erupt and ooze. They may then turn slightly yellow and begin to flatten. As they dry out, scabs begin to form. Each blister can take one to two weeks to completely crust over. During this stage, your pain may ease a little, but it can continue for months, or in some cases years. Once all blisters have completely crusted over, there is low risk of spreading the virus.
Ophthalmic shingles affects the nerve that controls facial sensation and movement in your face. In this type, the shingles rash appears around your eye and over your forehead and nose. Ophthalmic shingles may be accompanied by headache. Other symptoms include redness and swelling of the eye, inflammation of your cornea or iris, and drooping eyelid. Ophthalmic shingles can also cause blurred or double vision.
There's no cure for shingles, but prompt treatment with prescription antiviral drugs can speed healing and reduce your risk of complications. These medications include:
- Acyclovir (Zovirax)
- Valacyclovir (Valtrex)
- Famciclovir (Famvir)
Shingles can cause severe pain, so your doctor also may prescribe:
- Capsaicin cream
- Anticonvulsants, such as gabapentin (Neurontin)
- Tricyclic antidepressants, such as amitriptyline
- Numbing agents, such as lidocaine, delivered via a cream, gel, spray or skin patch
- Medications that contain narcotics, such as codeine
- An injection including corticosteroids and local anesthetics
Shingles generally lasts between two and six weeks. Most people get shingles only once, but it is possible to get it two or more times.