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  • Writer's pictureDr. Thomas Bailey, MD

What are shingles?

No, we are not talking about your roof.  We are talking about the infection caused by the varicella zoster virus which causes a rash and is commonly referred to as shingles.


Varicella-zoster virus is the virus that causes chickenpox.  Once you are infected with it, it remains dormant in your body along nerve endings and can reactivate later in life.  The reactivated infection is called shingles. Frequently it reactivates as we get older due to our immunity to the virus wearing off.  It can also recur if your immune system is compromised by other conditions, such as from taking certain medications or having cancer.


When it recurs, a rash is usually one of the first signs.  The typical rash has a red base with clear or yellow pustules or vesicles over it.  It has been referred to in the past as looking like “dew drops on a rose petal”.  Here are some examples of the rash. 


Since the virus lives along nerve endings, it will frequently cause a burning, stinging pain which can be quite intense.  This pain can last for several days to several months.  When it lasts more than 3 months, it is referred to as postherpetic neuralgia. Medications such as gabapentin and pregabalin can be helpful in treating this pain.


Should the infection reoccur along facial nerve endings, it may involve the eye, possibly leading to blindness.  It may also cause facial paralysis and problems with your hearing and balance.  Serious infections can even infect the brain and lungs, causing encephalitis, pneumonia and even death.


There are treatments for shingles.  Several antiviral medications are available for treatment and are most effective if started within the first 72 hours of onset of symptoms.  Earlier treatment also reduces the risk of long-standing nerve pain from the infection.  So be sure to contact your physician as soon as possible if you suspect that you may have shingles.


When possible, prevention is always best for health problems, and shingles is no exception.  Since people become exposed to the virus after having chickenpox, receiving the varicella (chickenpox) vaccine before ever having chickenpox is your best defense.  If you have had chickenpox, there are shingles vaccines available which lower the risk of a shingles infection. 


As always, be sure to talk to your doctor about any of the above as each person is unique and recommendations/treatments may vary.

a person with a painful rash on their arm

Note: the above image is AI generated and is not necessarily an accurate representation of the rash that appears with shingles.

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