What Do You Know About Shingles?

"Varicella" is a Latin word used to distinguish the chickenpox/shingles virus from its much more virulent relative, variola, which causes smallpox. "Zoster" is part of the virus name because it is the Greek word for "girdle"; a common symptom of shingles is painful rash that forms a band (girdle) of blisters halfway around the waist. "Shingles" itself comes from Latin word "cingulum," which also means "belt" or "girdle."

After a bout of chickenpox has ended, scientists believe that the virus moves to nerve cells called sensory neurons near the brain and spinal cord and becomes inactive. When the virus becomes active again, it moves down the nerve fibers to the skin. The virus then multiplies, and pain develops, usually followed in a few days by a rash at the site of the pain. The varicella-zoster virus belongs to a group of viruses called herpesviruses. Shingles is also called herpes zoster.

About 25 percent of healthy adults may develop shingles, usually after age 45. The likelihood of developing shingles increases 10-fold after the age of 60. Once a person develops shingles, he or she usually won't get it again, but some people do. People who have a weakened immune system are more likely to develop shingles and are more likely to have it recur. Researchers aren't sure why only certain people develop shingles. For people ages 60 and older who have had chickenpox, a vaccine called Zostavax can help reduce the risk of getting shingles.

These symptoms may occur first in the area where the rash will appear. Other early symptoms may include fever, chills, headache, or upset stomach. After several days, a rash similar to chickenpox appears. The rash may occur in a band on one side of the waist, on one side of the trunk or on one side of the face. But, although the rash of chickenpox doesn't hurt, the rash of shingles often is quite painful.

Shingles usually lasts 3 to 5 weeks, longer than chickenpox, at 2 weeks or less. The rash generally does not result in scarring.

A person with shingles cannot pass shingles on to anyone else. A person with shingles can, however, pass on the virus. For this to occur, the person with shingles must have the shingles rash present and the second person must not have had chickenpox or the chickenpox vaccine and come in direct contact with the open sores of shingles. The second person will develop chickenpox, not shingles. A person who has been vaccinated against chickenpox is protected from exposure to a person with active shingles.

The length of a shingles outbreak and the severity of its pain can be eased by antiviral medication such as famciclovir, valacyclovir, and acyclovir. This is particularly true if treatment is started within 72 hours after the rash first appears on the skin. Early treatment also helps reduce the risk for a complication of shingles called postherpetic neuralgia, which refers to pain lasting after the shingles rash goes away. Other treatments for postherpetic neuralgia include steroids; antidepressants; antiseizure medications; and topicals, medications that are applied directly to the skin.

One of the main complications of shingles is persistent pain, called postherpetic neuralgia. This may occur because the nerve cells that carry pain signals are most affected by the shingles virus. The pain can be severe and unrelenting. That's why it's important to see your health care provider promptly for treatment if you develop symptoms of shingles. Antiviral medications, steroids, antidepressants, and antiseizure medications may help prevent postherpetic neuralgia. Shingles outbreak on the face is a particularly dangerous condition. Involvement of the seventh and eighth cranial nerve causes a condition called Ramsay Hunt Syndrome, which can result in facial paralysis and inner ear damage. People who develop a shingles rash on the face may have an inflammation of the eyes that can lead to impaired vision. Shingles on the face also may affect the auditory nerves and hearing.