Shingles is a painful infection of the nerves and skin.

It is caused by the varicella zoster virus. This is the same virus that causes chickenpox. Shingles occurs in people who already had chickenpox. After causing the first chickenpox infection, the virus does not leave the body. It settles in nerve roots near the spinal cord. Once reactivated, the virus travels along nerve paths to the skin. There it causes pain and a rash.

These risk factors increase your chance of developing shingles. Tell your doctor if you have any of these risk factors:

• Age: 50 or older
• Compromised immune system:
  • People infected with HIV
  • People with lymphoma or leukemia
• Excessive fatigue
• Physical or psychological stress
• Radiation therapy

Shingles can occur in those with no known risk factor other than age.

Shingles cannot be transmitted from one person to another. But a person who has never had chickenpox and never received the varicella vaccine, could get chickenpox if he came in contact with a person who has shingles.

If you have any of these symptoms do not assume it is due to shingles. These symptoms may be caused by other conditions. Tell your doctor if you have any of these:

• Rash:
  • Red, slightly raised band or patch often overlain with multiple small fluid-filled blisters
  • Develops on one side of the body or the other, but typically does not cross the midline
  • Spread to multiple parts of the body—the so-called “disseminated” zoster (in severe cases)
  • Blisters dry out and crust (within several days)
  • Affects mostly the torso and face
• Affected eyes (in severe cases), which can seriously threaten vision
• Pain on the skin at the site of the rash (usually severe)
• Tingling or itchiness on the skin, which may start a few days before the rash
• Skin in the affected area is unusually sensitive to touch
• Fever
• Headache
• Tiredness

The rash disappears within three weeks. The pain may continue months or years after the rash has healed. This is called postherpetic neuralgia (PHN). PHN pain is difficult to treat. It can also be very severe.

The doctor will ask about your symptoms and medical history. A physical exam will be done. Your doctor can diagnose the rash by its appearance. Fluids may be drawn from the blisters for testing but this is rare.

Shingles cannot be cured. Treatment is focused on:

• Easing symptoms
• Speeding recovery
• Preventing PHN

Itching may be relieved by:

• Calamine lotion
• Wet compresses
• Frequent oatmeal baths

Over-the-counter pain relievers:

• Oral medications like acetaminophen (Tylenol) , ibuprofen (Advil) , and naproxen (Aleve)
• Capsaicin , a substance from hot peppers (topical)

Your doctor may prescribe drugs to relieve pain that doesn't respond to over-the-counter remedies.

Certain antiviral medications may control shingles by changing how the virus reproduces in nerve cells. They include:

• Acyclovir (Zovirax)
• Famciclovir (Famvir)
• Valacyclovir (Valtrex)

Antiviral therapy may shorten a shingles episode. But you must start it within 48-72 hours after symptoms first develop. These medications can reduce the severity and duration of PHN. They are for patients with the highest risk for this condition (ie, over 55).

Your doctor may also prescribe a short course of oral steroid medication (eg, prednisone ) if your immune system is functioning normally.