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What Is Shingles? Causes, Symptoms and Treatment

Jo has been an ITU nurse at the London North West NHS Trust for 14 years. She obtained her RN at University College London Hospital.


Shingles is an acute, painful inflammation of the nerve ganglia, with a skin eruption, often forming a girdle around the middle of the body.”

What Causes Shingles?

Shingles is a condition caused by the herpes varicella-zoster virus, also known as the zoster virus. The zoster virus is the same virus that causes chickenpox (the herpes varicella zoster virus is different to genital herpes, which is caused by the herpes simplex virus).

The term “shingles” comes from the Latin word “cingulum” which means belt or girdle, due to the belt-like pattern of the shingles rash.

Most of us get chickenpox as children, what we don't realize is that the virus that causes chickenpox does not entirely go away. Some virus particles remain in the nerve root, next to the spinal cord, harmless; the virus lays dormant and inactive after the chickenpox has gone.

The virus is believed to be rendered harmless by the immune system that keeps it under control.

Later in life, however; usually when the body and the immune system has become stressed or weakened, the zoster virus can once more become active. The reason for this is not clear, the reactivation of the virus usually happens years later.

The reactivated virus moves along the nerve to the skin resulting in inflammation of the nerve and area of skin around it to cause Shingles.

Around one in five people will experience shingles sometime in their life, it can happen at any age but most commonly occurs in people over the age of 50. The effects of aging on the immune system may be responsible.

Shingles occur when the body's natural defense, the immune system, is compromised and no longer works efficiently.

Factors that may compromise the immune system include:

  • Aging, our immune system produces antibodies that help to protect the body from foreign or harmful substances such as toxins, bacteria, and cancer cells. However; our immune system changes with age, it becomes less efficient, leaving the body open to various attack.
  • HIV/AIDS, sufferers are more than 25 times more likely to get shingles than the rest of the population.
  • Suppression of the Immune system, shingles is common in people who are undergoing treatment such as, chemotherapy, steroids, or certain drug for the prevention of rejection in organ transplant where around 25 to 45% of people may develop shingles.
  • Physical and emotional stress, when the body is stressed it produces chemicals that can prevent the immune system from working properly.
  • Bone marrow transplant, chemotherapy and radiation treatment given before the operation can weaken the immune system to cause shingles
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Although it is unusual to have shingles more than once, 1 in 50 people will suffer from this condition two or more times in their life. In most cases, shingles happen for no apparent reason, but can be triggered by an episode of stress or illness.

Is Shingles Contagious?

Someone who has shingles is contagious until the last blister has scabbed over. It is not possible to catch shingles as such, however; people who have never had chickenpox, or the chickenpox vaccine, can develop chickenpox from contact with someone with shingles.

Infection can spread through direct “skin to skin” contact with someone displaying an open blister. Through contact with something containing fluid from blister such as wound dressings, towels, flannels, bedclothes or by inhaling the varicella-zoster virus from the air.

To prevent the virus spreading to people who have not had chickenpox; it is important to refrain from sharing towels or flannels, go swimming or take part in contact sports when shingles rash is infectious.

Most older children and adults should already have immunity to the chickenpox virus, either through immunization or having had the condition.

Chickenpox is very common in childhood, 90% of adults raised in the UK are immune. However; we recently experienced a chickenpox epidemic where all travelers entering the country were urged to get vaccinated against chicken pox.

Before the chickenpox vaccine, 11,000 people were hospitalized each year for chickenpox in the US, with annual deaths of 100. Getting the chickenpox vaccine is safer than getting chickenpox or shingles.

Barbara Walters famously caught chicken pox after a New Year's kiss with an old friend, actor Frank Langella.

Mr. Langella, an aging actor, who would later develop a severe case of shingles, were unaware of his condition at the time.

Barbara Walters was subsequently hospitalized after fainting and hitting her head on a marble floor. The actress suffered a concussion and realized that she also happened to have chickenpox that she had never had before.

Symptoms of Shingles

An episode of shingles typically lasts about three to four weeks. The first sign of the condition begins with pain and the unusual sensation known as paresthesias; a sense of tickling, tingling, itching, burning in the area that is affected. Paresthesias sensation is typically followed by a rash that changes to form blisters.


Rash or reddening of the skin becomes blistered and ulcerated within three to four day. The area of ulceration can become infected with bacteria, which can delay healing, this complication happens in 2% of cases.

In people with a healthy immune system; the ulcers will form a crust and are no longer infectious after 7 to 10 days. The rash often disappears within three to four weeks. However; the scarring and discoloration of the affected skin may persist for much longer.

Although the abdomen and chest are the most common areas affected; shingles rash can appear on any part of the body including the face when a rash occurs close to the eyes it can seriously affect vision.

Shingles can cause early symptoms lasting from one to four days before a rash appears, they includes:

  • Parasthesias
  • Myalgia or muscle pain
  • A fever or high temperature of 38C or over, (this is uncommon)
  • A feeling of being unwell


Postherpetic neuralgia (PHN) is the most commonly occurring complication of shingles. Patients often described PHN as burning that can be mild to severe. PHN affects 10 to 15 percent of shingles sufferers, around half are older than 60 years of age. The nerve pain can last for more than three months after the rash has gone.

Treating the Rash

There is no cure for shingles, but good management and early treatment can relieve the symptoms:

  • Reduce risk of infection by keeping rash as clean and dry as possible
  • Use non-adhesive dressing that will not stick to the blisters, this will also lessen the risk of passing the virus to others
  • Do not use topical antibiotics or plasters, they can prolong healing
  • Contact doctor, Although the symptoms of shingles are often mild in the initial stage, medical intervention should be as soon as possible; preferably, at the first sign of the condition. Early treatment with antiviral medication can help to prevent the shingles virus from multiplying. It reduces the risk of complication and pain during the active stage of shingles. Early treatment is especially relevant where the face and eyes are affected.
  • The wearing of loose-fitting clothes may help to reduce irritation from the rash to maintain comfort. Calamine lotion will contribute to cooling and soothing the skin and can be used to relieve itching as will antihistamine medication. However; before taking medications please read the manufacturers instruction or seek advice from the pharmacist.


Doctor may prescribe medicine for pain including-:

  • Anti-viral, such as Zovirax, Famvir, or Valtrex
  • Paracetamol, available without a prescription, read instruction carefully
  • Non-steroidal anti-inflammatory drugs (NSAIDs), e.g., ibuprofen, avoid in cases of stomach, kidney, or liver problems, gastric bleeding or peptic ulcers, asthma or airway and breathing conditions, pregnancy or breastfeeding. Always check with doctor or pharmacist when in doubt.
  • Opioids, such as codeine may be prescribed by doctors in conjunction with paracetamol
  • antidepressants and anticonvulsants may be used in cases of postherpetic neuralgia.

Treatment for pain can also be in the form of:

  • Cold therapy
  • Transcutaneous Electrical Nerve Stimulation (TENS)

Diet rich in lysine such as meat, fish, cheese, sardines, eggs, soybeans and various legumes may help to prevent an attack of shingles.

Essential vitamins to boost the immune system and manage shingles includes:

  • Vitamin B12, study shows this to be useful in the treatment of shingles, when given intravenously or intramuscularly, it goes to the nerve root to attack the virus.
  • Vitamin E
  • Vitamin C

The doctor should be contacted at the first sign of shingles, always discuss treatment and medication including vitamin therapy.

© 2013 Jo Alexis-Hagues


Sara Johnson from United States on October 19, 2014:

Thanks so much for the well-wishes, tobusiness! Always good to increase my knowledge.

Jo Alexis-Hagues (author) from Lincolnshire, U.K on October 19, 2014:

etaCarinae, so glad you've found this useful and added to your overall knowledge of skin conditions. Shingles can be very painful, it's good to know how to avoid getting it. Thank you for reading and commenting, much appreciated. Take care and my best to you.

Sara Johnson from United States on October 19, 2014:

Wow very good read. I've added to my collection of knowledge on skin disorders today. First, psoriasis, then eczema and now shingles (which I'd never heard of before actually). Voted up!

Jo Alexis-Hagues (author) from Lincolnshire, U.K on June 08, 2013:

Hello Marcia, nice to meet you!...Thank you for taking a look at is so strange!..when I wrote this, I mentioned that as I work in intensive care, I don't get to see many cases of shingles..guess what? I went to work a couple of days ago and Voila!!...I'm presented with my first case of shingles in decades :). I hope my immunity is still good, much too old for chicken pox. thank you again and my best to you.


mours sshields from Elwood, Indiana on June 07, 2013:

Ouch! Looks really painful. And, I've heard it's really painful. I know of people who have had them.

Marcia Ours

Jo Alexis-Hagues (author) from Lincolnshire, U.K on May 27, 2013:

Lurana, thank you for taking a look and for the comment, much appreciated.

MrsBrownsParlour on May 27, 2013:

I knew most of the basic information about shingles but still learned a lot here. This is very useful, especially for people who are suffering from this condition or have family members who are! ~Lurana

Jo Alexis-Hagues (author) from Lincolnshire, U.K on May 27, 2013:

Hi Theresa, it really is a bit of a dilemma... according to the Centers for Disease Control and Prevention, ( CDC) in the US...they are not recommending the shingles vaccine until age 60, although it is approved for people 50-59 years. Some people still develop shingles after taking the vaccine, but it can reduce the severity.

Best to get the facts from your doctor before you decide. Thanks for visit and comment, always appreciated.

take care and my very best to you.

Theresa Ast from Atlanta, Georgia on May 27, 2013:

This is just fascinating -- I am kind of a medical information junkie. I did have chicken pox as a child and I am 58, so I guess I am a prime candidate. I am on Kaiser insurance and last year they were urging those of us over 55 to take this vaccine, but then I read an article that said the vaccine produces full blown shingles about 20% of the time. I passed. Don't know what I will do next fall. Great Hub. Theresa

Jo Alexis-Hagues (author) from Lincolnshire, U.K on May 25, 2013:

Vellur, so nice to see you!...yes this can get quite painful; it needs stopping in it's track and the sooner the better. Thank you for taking a look and for the comment, much appreciated.

Have a lovely weekend and my best to you.

Jo Alexis-Hagues (author) from Lincolnshire, U.K on May 25, 2013:

Faythef, I hope your husband have seen the last of this condition, bless him!... once is bad enough, but three times must be a record. I hope the shot continues to work. Thank you for taking the time, much appreciated and my best to you.

Jo Alexis-Hagues (author) from Lincolnshire, U.K on May 25, 2013:

Hi Flourishanyway, 'Ouch' indeed :), I still feel itchy when I look at the images. Thank you for taking the time, very much appreciated. Have a lovely weekend and my best to you.

Jo Alexis-Hagues (author) from Lincolnshire, U.K on May 25, 2013:

Jaye, you are so right!... we should always err on the side of caution. Thanks again and have a wonderful weekend, my best to you.

Jo Alexis-Hagues (author) from Lincolnshire, U.K on May 25, 2013:

Kashmir, always a pleasure my friend!...many thanks for stopping by, much appreciated. Hope you're well and having a wonderful weekend, my best to you.

Jo Alexis-Hagues (author) from Lincolnshire, U.K on May 25, 2013:

Hi jaye, thank you so much for the very useful comment. It's good to be aware of all the options, and advice given from personal experience is worth it's weight. Much appreciated and my best to you.

Jo Alexis-Hagues (author) from Lincolnshire, U.K on May 25, 2013:

Imkarn, let's hope this one passes us all by....but if you're concerned, you should have a talk with your doctor about getting the vaccine. Always a pleasure to see you, take care and my best to you.

Nithya Venkat from Dubai on May 24, 2013:

Thank you for sharing this hub, this seems very painful and requires immediate care. Never knew about this. Voted up.

Faythe Payne from USA on May 24, 2013:

My husband has had shingles three time..He got the shot two years far so good...

FlourishAnyway from USA on May 24, 2013:

Very well researched hub. Just looking at those photos makes me say, "Ouch." It looks very painful as well as unattractive. I recall having chicken pox as a child and hope never to have the virus crop back up.

Jaye Denman from Deep South, USA on May 24, 2013:

I forgot to mention in my earlier comment that, if you had a light case of chickenpox as a child and are exposed to someone with chickenpox as an adult--the likely result is: shingles! Since most people don't know the severity of an illness they had when a child, it's best that all adults (and children whose parents know they had mild chickenpox) to stay away from anyone who MAY have chickenpox. I can't avoid a cliché here because it's so true--"Better safe than sorry."

Thomas Silvia from Massachusetts on May 24, 2013:

Hi my friend great information here and so well written and researched.

Vote up and more !!! Sharing !

Jaye Denman from Deep South, USA on May 24, 2013:

The new vaccine to prevent shingles isn't 100% effective, but is the next best thing. I had the vaccine when it became available on the advice of my doctor, as anyone over 50 should do.

Karen Silverman on May 24, 2013:

omg..just LOOKING at the pictures brought back memories - and - it wasn't even ME that was suffering!

a man that i worked with had them - i was friends with him and his wife and got to see the full spectrum of symptoms and suffering!

i can only 'pray' that this baby passes me by - hey - i get kidney stones!


excellent JO-b here, my friend!

Jo Alexis-Hagues (author) from Lincolnshire, U.K on May 24, 2013:

Hi Devika, thank you for taking a look, much appreciated and always good to see you.

Devika Primić from Dubrovnik, Croatia on May 24, 2013:

I knew of someone who had shingles but she had it seen to in the very early stages, and she was over the age of fifty. An interesting and useful Hub tobusiness you did your research excellently and shared this health information for many readers.

Jo Alexis-Hagues (author) from Lincolnshire, U.K on May 24, 2013:

Hi Wetnose, now that we know what to look for, we can get help much sooner. Thank you for for stopping by and for the comment, always appreciated.

wetnosedogs from Alabama on May 23, 2013:

I really don't recall chicken pox for me, but my kids had them. Oh boy, got to watch out for my grown up babes!

Jo Alexis-Hagues (author) from Lincolnshire, U.K on May 23, 2013:

Hi Frank, yep.. if you haven't had chickenpox or been immunized; you should give anyone with shingles or chickenpox a wide berth. Chickenpox is more serious in adults, and can cause sterility in adult male. take care and thank you for taking a look at this, much appreciated.

Frank Atanacio from Shelton on May 23, 2013:

my goodness what a hub.. Ive never had the chicken pox as a child so I try to stay away from folks with shingles.. what a descriptive view and information on shingles thank you tobusiness..:)

Jo Alexis-Hagues (author) from Lincolnshire, U.K on May 23, 2013:

Hi kidscrafts, you've picked up on a very important point, it is very important to get medical care at the first sign of shingles, as I've mention above, treatment by anti viral medication can help to stop the virus from multiplying. It can reduce the damage, pain and complications which your friend had experienced, but we need to know what to look for. Thank you for this insightful comment, very much appreciated.

kidscrafts from Ottawa, Canada on May 23, 2013:

The problem with shingles, is that too often people don't realize what it is and that it's so important to see a doctor as soon as possible otherwise it's so hard to treat. And it's not because someone had chicken pox that that person is immune to shingles.

I know someone who had shingles and didn't see the doctor for several days and years after, that person still suffer nerve damages and it's very painful.

I hope I will never get it.... and if I get it to go right away see the doctor!

Great hub! Excellent informations that everybody should be aware of!

Thank you for sharing!

Jo Alexis-Hagues (author) from Lincolnshire, U.K on May 23, 2013:

Hi Bill, a pleasure to see you!..I haven't seen cases of shingles recently, not many are admitted to intensive care where I work. However, there were many in my early days of nursing, a very unpleasant condition. Thank you for taking a look, always appreciated.

Take care now, my best to you and Bev and enjoy your weekend.

Bill Holland from Olympia, WA on May 23, 2013:

It's interesting, Jo, because I have heard about this all my life but never really knew what it was or what caused it. I've never had it, obviously, but I did have chickenpox, so I guess in a way I have had it. :)

Great information here my friend, written by someone who knows what she is talking about.

I hope you have a great weekend, as will I.


Jo Alexis-Hagues (author) from Lincolnshire, U.K on May 23, 2013:

Hi Alexa...darn...I meant Faith; nice to see you!...I hope neither of us ever get shingles, it is not a pleasant condition. Thank you so much for stopping by, must go now, got to find out if you missed out on anything. :). My very best to you.

Jo Alexis-Hagues (author) from Lincolnshire, U.K on May 23, 2013:

Hi Rose, Yes it does look pretty nasty; many people opted out of getting their children vaccinated back in the late 90s. They saw chickenpox as a rite of passage, little more than a nuisance, compared to whooping cough and measles. I guess we are paying the price.

Thank you so much for being my first and for the great comment, much appreciated.

Take care and my best to you.

rose-the planner from Toronto, Ontario-Canada on May 23, 2013:

The thought of getting shingles is quite scary. Your images are perfect because they are graphic and to the point. I have noticed that there seems to be a lot more cases of shingles these days. I wonder why? Also, I know chicken pox are contagious, however, I was unaware that shingles is contagious. Thank goodness there is a vaccination available now. Great hub! This was very informative. (Voted up)

Faith Reaper from southern USA on May 23, 2013:

Ouch!!! I pray I never get shingles!!! I know it is so very painful, as I've known older persons who got it. It just looks horrible too. Your images are effective as to the nasty looks of shingles.

Very informative hub here.

Voted up +++ and sharing

Blessings, Faith Reaper

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