What Is Shingles?
Shingles (herpes zoster) is caused by reactivation of the varicella-zoster virus — the same virus responsible for chickenpox, which stays dormant in nerve tissue after a childhood infection and can reactivate later in life. The rash follows the path of a single nerve, typically appearing as a band on just one side of the body.
Shingles becomes more common with age and with anything that weakens the immune system. Pain, burning, or tingling often precedes the visible rash by a few days, and the condition can lead to lingering nerve pain (postherpetic neuralgia) in some patients, especially if treatment is delayed.
Causes
- Reactivation of the dormant varicella-zoster (chickenpox) virus, usually years after the original chickenpox infection
- Age — risk increases significantly after age 50
- A weakened immune system from illness, stress, or certain medications
- Shingles is not caused by new exposure to chickenpox, though someone with active shingles can spread chickenpox (not shingles itself) to someone who has never had chickenpox or the vaccine
Symptoms
- Pain, burning, tingling, or numbness in a band on one side of the body, often before any rash appears
- A red, blistering rash that follows the same band-shaped pattern
- Sensitivity to touch in the affected area
- Sometimes fever, headache, or fatigue alongside the rash
Treatment Options at Dermatology of Seattle
- Antiviral medication, most effective when started within 72 hours of rash onset
- Pain management strategies for acute shingles pain and, when needed, longer-term nerve pain
- Evaluation and urgent referral for shingles affecting the eye or face
- Guidance on reducing spread to others while blisters are active
When to See a Dermatologist
See a doctor as soon as possible if you suspect shingles — antiviral treatment works best within 72 hours of the rash appearing. Shingles near the eye, on the tip of the nose, or affecting the face needs urgent evaluation to help protect vision. Anyone with a weakened immune system should also seek prompt care.
Frequently Asked Questions
Can I get shingles more than once?
Yes, though it's less common. Most people only get shingles once, but recurrence is possible, particularly with a weakened immune system.
Is shingles contagious?
Shingles itself isn't spread person-to-person the way a cold is, but the virus can be transmitted through direct contact with open blisters to someone who has never had chickenpox or the chickenpox vaccine — in that person, it would cause chickenpox, not shingles.
Is there a vaccine to prevent shingles?
Yes. A shingles vaccine is recommended for most adults over 50 and can significantly reduce the risk of developing shingles, as well as the severity and complications if it does occur. Ask your doctor whether it's right for you.