Shingles: What Does it Look Like : Signs, Causes & Treatment

Shingles (Herpes Zoster) is a viral infection characterized by a burning sensation and distinctive rash. While it can affect anyone, adults over 50 are particularly vulnerable to this condition.

What triggers this dormant virus to reactivate? How can recognizing the signs and stages of shingles facilitate better treatment and recovery?

From a previous bout of chickenpox to stress and a weakened immune system, multiple factors can trigger shingles. This article delves into the signs, causes, stages, and treatment options for shingles, so that you can effectively manage their symptoms and seek appropriate care.

What are Shingles?

Shingles, also known as Herpes Zoster, is a viral infection that causes a painful rash. This condition occurs when the varicella-zoster virus (VZV)—the same virus that causes chickenpox—reactivates in the body after years or even decades of dormancy.

Most commonly affecting older adults and individuals with weakened immune systems, shingles can be highly painful and lead to long-term complications.

Signs and Symptoms of Shingles

The first signs of shingles usually involve a burning or tingling sensation on one side of the body. This discomfort often precedes the appearance of the shingles rash and can be intense, leading some to seek medical care even before the rash appears.

Common symptoms of shingles include:

Localized Pain: Usually, the pain is limited to a specific area where the rash will later appear. This pain may vary from mild to severe and is often described as burning or stabbing.
Red Rash: A few days after the onset of pain, a red rash begins to develop. This rash typically appears in a stripe-like pattern on one side of the body or face.
Blisters: The rash eventually evolves into fluid-filled blisters, similar to chickenpox. These blisters may break open, forming small sores that eventually crust over.
Itching and Tingling: Even before the rash appears, many experience itching or tingling in the affected area.
Fever, Headache, and Fatigue: These are general symptoms that may accompany the rash.

In severe cases, shingles can affect the eyes or ears, leading to complications like vision loss or hearing issues.

Causes of Shingles

The cause of shingles lies in the reactivation of the varicella-zoster virus, which remains dormant in the nerve tissue after a person recovers from chickenpox. Years or decades later, the virus can reactivate due to a weakened immune system, advancing age, or other stressors on the body. When the virus becomes active again, it travels along the nerve pathways to the skin, leading to the classic shingles rash.

Risk Factors of Shingles

Several factors increase the likelihood of developing shingles:

Age: Shingles is more common in individuals over the age of 50. The risk increases significantly with each passing decade.
Weakened Immune System: Conditions like HIV, cancer, or treatments such as chemotherapy and long-term steroid use can weaken the immune system and trigger shingles.
History of Chickenpox: Anyone who has had chickenpox carries the varicella-zoster virus, which increases the risk of developing shingles later in life.
Stress: Emotional or physical stress can weaken the immune response and may contribute to the reactivation of the virus.
Certain Medications: Drugs that suppress the immune system, such as immunosuppressants or organ transplant medications, can also increase the risk.

Shingles Stages

Shingles typically progresses through three stages:

Pre-eruptive (Prodromal) Stage: In this stage, the affected person may experience pain, itching, or tingling in the area where the rash will eventually appear. These symptoms can last for a few days before the actual rash develops. This stage is also characterized by general symptoms like fatigue or mild fever.
Eruptive Stage: During this phase, the telltale red rash begins to emerge, often forming a band or strip on one side of the body or face. Fluid-filled blisters appear and can be highly painful. This stage can last for 7-10 days as the blisters burst and crust over.
Postherpetic Neuralgia (PHN): In some cases, the pain persists even after the rash has healed. This chronic pain condition, known as postherpetic neuralgia, can last for months or even years, especially in older adults.

Diagnosis of Shingles

Shingles is typically diagnosed based on a physical examination. A healthcare provider can usually identify the condition by its distinctive rash and accompanying symptoms.

In cases where the diagnosis is unclear, especially during the prodromal stage, a viral culture or skin biopsy may be performed to confirm the presence of the varicella-zoster virus. Blood tests may also be used to detect the virus or antibodies to confirm past chickenpox infection

Treatment of Shingles

There is no cure for shingles, but early treatment can help alleviate symptoms, shorten the duration of the illness, and reduce the risk of complications.

Common treatments for shingles include:

Antiviral Medications: Drugs like acyclovir, valacyclovir, and famciclovir are commonly prescribed to fight the varicella-zoster virus. These antivirals are most effective when started within 72 hours of rash onset.
Pain Relief: Over-the-counter pain relievers such as ibuprofen or acetaminophen can help manage mild pain. In more severe cases, prescription pain medications or nerve-blocking agents may be recommended.
Topical Creams: Calamine lotion or numbing creams can help reduce itching and discomfort. Capsaicin cream may also be used to relieve nerve pain.
Corticosteroids: In some cases, doctors may prescribe corticosteroids to reduce inflammation, especially when shingles affect the eyes or other sensitive areas.
Antidepressants or Anticonvulsants: For patients experiencing postherpetic neuralgia, certain antidepressants or anticonvulsants can help manage chronic pain.

Shingles is not contagious in the same way as chickenpox, but it is possible to spread the varicella-zoster virus to someone who has never had chickenpox or been vaccinated against it. In such cases, the exposed individual would develop chickenpox, not shingles.

To reduce the risk of developing shingles, vaccination is recommended. The Shingrix vaccine is the most effective option, providing over 90% protection in preventing shingles and postherpetic neuralgia. It’s recommended for adults over the age of 50, even if they have had shingles before. The vaccine helps strengthen the immune system, reducing the likelihood of the virus reactivating

Complications of Shingles

While shingles typically resolve within a few weeks, some individuals, particularly older adults, may experience complications. The most common complication is postherpetic neuralgia, where the pain persists long after the rash has healed. Other potential complications include:

Vision Loss: If shingles affect the eye (ophthalmic shingles), it can lead to serious complications, including corneal damage and vision loss.
Neurological Issues: In rare cases, shingles can lead to inflammation of the brain (encephalitis), facial paralysis, or hearing problems.
Skin Infections: The open sores from the blisters can become infected, leading to bacterial skin infections that may require antibiotics.

If you suspect you have shingles, don’t wait for them to worsen. At the ER in Fort Worth, our certified full-service laboratory enables quick diagnosis through comprehensive testing. Shingles can be distressing, which is why we operate 24/7 to provide immediate care in Fort Worth, Watauga, Haltom City, and the greater Dallas-Fort Worth areas.

Our expert ER physicians provide rapid treatment to manage your symptoms and prevent complications like postherpetic neuralgia. Call us now or visit our facility to put yourself on the fast track to relief

Get Emergency Shingles Care