Overview Shingles is a viral infection that causes a painful rash. Although shingles can occur anywhere on your body, it most often appears as a single stripe of blisters that wraps around either the left or the right side of your torso. Shingles is caused by the varicella-zoster virus — the same virus that causes chickenpox. After you've had chickenpox, the virus lies inactive in nerve tissue near your spinal cord and brain. Years later, the virus may reactivate as shingles. Shingles Shingles is characterized by pain or a tingling sensation in a limited area on one side of the face or torso, followed by a red rash with small, fluid-filled blisters. The signs and symptoms of shingles usually affect only a small section of one side of your body. For some, it can be intense. Depending on the location of the pain, it can sometimes be mistaken for a symptom of problems affecting the heart, lungs or kidneys. Some people experience shingles pain without ever developing the rash. Most commonly, the shingles rash develops as a stripe of blisters that wraps around either the left or right side of your torso. Sometimes the shingles rash occurs around one eye or on one side of the neck or face. If left untreated, this infection can lead to permanent eye damage. Shingles affects the nerves The shingles rash is associated with an inflammation of nerves beneath the skin. Shingles is caused by the varicella-zoster virus — the same virus that causes chickenpox. Anyone who's had chickenpox may develop shingles. After you recover from chickenpox, the virus can enter your nervous system and lie dormant for years. Eventually, it may reactivate and travel along nerve pathways to your skin — producing shingles. But, not everyone who's had chickenpox will develop shingles. The reason for shingles is unclear. But it may be due to lowered immunity to infections as you grow older. Shingles is more common in older adults and in people who have weakened immune systems. Varicella-zoster is part of a group of viruses called herpes viruses, which includes the viruses that cause cold sores and genital herpes. Because of this, shingles is also known as herpes zoster. But the virus that causes chickenpox and shingles is not the same virus responsible for cold sores or genital herpes, a sexually transmitted infection. A person with shingles can pass the varicella-zoster virus to anyone who isn't immune to chickenpox. This usually occurs through direct contact with the open sores of the shingles rash. Once infected, the person will develop chickenpox, however, not shingles. Chickenpox can be dangerous for some people. Until your shingles blisters scab over, you are contagious and should avoid physical contact with anyone who hasn't yet had chickenpox or the chickenpox vaccine, especially people with weakened immune systems, pregnant women and newborns. Risk factors Anyone who has ever had chickenpox can develop shingles. Most adults in the United States had chickenpox when they were children, before the advent of the routine childhood vaccination that now protects against chickenpox. Shingles is most common in people older than 50. The risk increases with age. Some experts estimate that half the people age 80 and older will have shingles. Radiation or chemotherapy can lower your resistance to diseases and may trigger shingles. Drugs designed to prevent rejection of transplanted organs can increase your risk of shingles — as can prolonged use of steroids, such as prednisone. For some people, shingles pain continues long after the blisters have cleared. This condition is known as postherpetic neuralgia, and it occurs when damaged nerve fibers send confused and exaggerated messages of pain from your skin to your brain. Shingles in or around an eye ophthalmic shingles can cause painful eye infections that may result in vision loss. Depending on which nerves are affected, shingles can cause an inflammation of the brain encephalitis , facial paralysis, or hearing or balance problems. If shingles blisters aren't properly treated, bacterial skin infections may develop. Prevention Two vaccines may help prevent shingles — the chickenpox varicella vaccine and the shingles varicella-zoster vaccine. Chickenpox vaccine The varicella vaccine Varivax has become a routine childhood immunization to prevent chickenpox. The vaccine is also recommended for adults who've never had chickenpox. Though the vaccine doesn't guarantee you won't get chickenpox or shingles, it can reduce your chances of complications and reduce the severity of the disease. Shingles vaccine People looking to receive the shingles vaccine have two options: Zostavax and Shingrix. Zostavax, which was approved by the Food and Drug Administration FDA in 2006, has been shown to offer protection against shingles for about five years. It's a live vaccine given as a single injection, usually in the upper arm. Shingrix was approved by the FDA in 2017 and is the preferred alternative to Zostavax. Studies suggest Shingrix offers protection against shingles beyond five years. It's a nonliving vaccine made of a virus component, and is given in two doses, with two to six months between doses. Shingrix is approved and recommended for people age 50 and older, including those who've previously received Zostavax. Zostavax isn't recommended until age 60. The most common side effects of either shingles vaccine are redness, pain, tenderness, swelling and itching at the injection site, and headaches. As with the chickenpox vaccine, the shingles vaccine doesn't guarantee you won't get shingles. But this vaccine will likely reduce the course and severity of the disease and reduce your risk of postherpetic neuralgia. The shingles vaccine is used only as a prevention strategy. It's not intended to treat people who currently have the disease. Talk to your doctor about which option is right for you. National Institute of Neurological Disorders and Stroke. Accessed May 9, 2017. Longterm effectiveness of herpes zoster vaccine among patients with autoimmune and inflammatory diseases. Accessed May 9, 2017. In: Ferri's Clinical Advisor 2017. Accessed May 9, 2017. Chickenpox and herpes zoster varicella-zoster virus. In: Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. Accessed May 9, 2017. Centers for Disease Control and Prevention. Accessed May 9, 2017. In: Harrison's Principles of Internal Medicine. Accessed May 9, 2017. Vaccination for the prevention of shingles herpes zoster. Accessed May 9, 2017. Centers for Disease Control and Prevention. Accessed May 18, 2017.
