zoster

Shingles (herpes zoster) is an infection that causes a painful rash. It is caused by the varicella-zoster virus (VZV). This is the same virus that causes chickenpox. After you have chickenpox, the virus stays in your body. It may not cause problems for many years. But as you get older, the virus may become active again and cause shingles.

Shingles is not contagious. You cannot get shingles from someone else. But you can catch chickenpox from someone with shingles if you have direct contact with fluid from their shingles rash.

The risk of spreading the virus is low if the shingles rash is kept covered. People with shingles cannot spread the virus before their rash blisters appear or after the rash crusts.

Anyone who has had chickenpox can get shingles. But the risk of shingles goes up as you get older. Shingles is most common in people over age 50.

People with weakened immune systems are at higher risk of getting shingles. This includes those who:

• Have immune system diseases such as HIV
• Have certain cancers
• Take medicines that weaken their immune system, such as steroids and medicines you take after organ transplant

Your immune system may be weaker when you have an infection or are stressed. This can raise your risk of shingles.

It is rare, but possible, to get shingles more than once.

Early signs of shingles include burning or shooting pain and tingling or itching. It is usually on one side of the body or face. The pain can be mild to severe.

Up to several days later, you will get a rash. It consists of blisters that typically scab over in 7 to 10 days. The rash is usually a single stripe around either the left or the right side of the body. In other cases, the rash is only on one side of the face. In rare cases (usually among people with weakened immune systems), the rash may be more widespread. It might look similar to a chickenpox rash.

Some people may also have other symptoms:

• Fever
• Headache
• Chills
• Upset stomach

Shingles can cause other problems (complications):

• Postherpetic neuralgia (PHN) is most common complication of shingles. It causes severe pain in the areas where you had the shingles rash. It usually gets better in a few weeks or months. But some people can have pain from PHN for many years, and it can interfere with daily life.
• Vision loss can happen if shingles affects your eye. It may be temporary or permanent.
• Hearing or balance problems are possible if you have shingles within or near your ear. You may also have weakness of the muscles on that side of your face. These problems can be temporary or permanent.

Very rarely, shingles can also lead to pneumonia, brain inflammation (encephalitis), or death.

Usually your health care provider can diagnose shingles by taking your medical history and looking at your rash. In some cases, your provider may scrap off tissue from the rash or swab some fluid from the blisters and send the sample to a lab for testing.

There is no cure for shingles. Antiviral medicines may help to make the attack shorter and less severe. They may also help prevent PHN. The medicines are most effective if you can take them within 3 days after the rash appears. So if you think you might have shingles, contact your provider as soon as possible.

Pain relievers may also help with the pain. A cool washcloth, calamine lotion, and oatmeal baths may help relieve some of the itching.

There is a vaccine, called Shingrix, to help prevent shingles and its complications. The Centers for Disease Control and Prevention recommends that healthy adults 50 years and older get the vaccine. Your provider might also recommend the vaccine if you are over 19 and have a weakened immune system. The vaccine is given in two doses.

If you have shingles, you can help prevent spreading the virus to others by:

• Staying away from:
  • People with weakened immune systems
  • People who have not had chickenpox or the chickenpox vaccine, especially if they are pregnant
  • Premature or low birth weight babies
• Keeping the rash covered
• Not touching or scratching the rash
• Washing your hands often

Centers for Disease Control and Prevention

Chickenpox is an infection caused by the varicella-zoster virus. Most cases are in children under age 15, but older children and adults can get it. It spreads very easily from one person to another.

The classic symptom of chickenpox is an uncomfortable, itchy rash. The rash turns into fluid-filled blisters and eventually into scabs. It usually shows up on the face, chest, and back and then spreads to the rest of the body. Other symptoms include:

• Fever
• Headache
• Tiredness
• Loss of appetite

Chickenpox is usually mild and lasts 5 to 10 days. Calamine lotions and oatmeal baths can help with itching. Acetaminophen can treat the fever. Do not use aspirin for chickenpox; that combination can cause Reye syndrome.

Chickenpox can sometimes cause serious problems. Adults, babies, teenagers, pregnant women, and those with weak immune systems tend to get sicker from it. They may need to take antiviral medicines.

Once you catch chickenpox, the virus usually stays in your body. You probably will not get chickenpox again, but the virus can cause shingles in adults. A chickenpox vaccine can help prevent most cases of chickenpox, or make it less severe if you do get it.

Centers for Disease Control and Prevention

Blisters are fluid-filled sacs on the outer layer of your skin. They form because of rubbing, heat, or diseases of the skin. They are most common on your hands and feet.

Other names for blisters are vesicles (usually for smaller blisters) and bulla (for larger blisters).

Blisters often happen when there is friction - rubbing or pressure - on one spot. For example, if your shoes don't fit quite right and they keep rubbing part of your foot. Or if you don't wear gloves when you rake leaves and the handle keeps rubbing against your hand. Other causes of blisters include:

• Burns
• Sunburn
• Frostbite
• Eczema
• Allergic reactions
• Poison ivy, oak, and sumac
• Autoimmune diseases such as pemphigus
• Epidermolysis bullosa, an illness that causes the skin to be fragile
• Viral infections such as varicella zoster (which causes chickenpox and shingles) and herpes simplex (which causes cold sores)
• Skin infections including impetigo

Blisters will usually heal on their own. The skin over the blister helps keep out infections. You can put a bandage on the blister to keep it clean. Make sure that there is no more rubbing or friction on the blister.

You should contact your health care provider if:

• The blister looks infected - if it is draining pus, or the area around the blister is red, swollen, warm, or very painful
• You have a fever
• You have several blisters, especially if you cannot figure out what is causing them
• You have health problems such as circulation problems or diabetes

Normally you don't want to drain a blister, because of the risk of infection. But if a blister is large, painful, or looks like it will pop on its own, you can drain the fluid.

There are some things you can do to prevent friction blisters:

• Make sure that your shoes fit properly
• Always wear socks with your shoes, and make sure that the socks fit well. You may want to wear socks that are acrylic or nylon, so they keep moisture away from your feet.
• Wear gloves or protective gear on your hands when you use any tools or sports equipment that cause friction.