Varicella-zoster is the virus that causes chickenpox, a common childhood illness. After a person has had chickenpox, the virus remains dormant in the nerves for many years. Shingles is the result of reactivation of the varicella-zoster virus. Reactivation of the virus may occur at any time after the development of chickenpox, but usually occurs in middle to late adulthood. Risk factors for developing shingles are older age, increased physical and mental stress, and immunocompromised states. As the virus begins to replicate in the nerve it inflames the nerve and causes symptoms.
Shingles usually begins with symptoms of tingling, burning, tenderness, or pain. The rash usually occurs about 1-5 days later. Once the rash appears it is usually an easy diagnosis for clinicians. The characteristic rash is a painful eruption of small blisters (vesicles) with surrounding redness (erythema).
The rash occurs only on one side of the body in a band or a strip called a "dermatome" and usually does not cross the midline. The dermatome corresponds to where one of the nerves from your spinal cord connects to the skin. It can occur on any dermatome but most commonly involves one side of the body or face.
A dermatome is an area of skin that is mainly supplied by a single nerve.
If someone comes in contact with a person with shingles, will they get shingles too? No, but if a person has never had chickenpox and they come in contact with the fluid from the shingles blisters, they can develop chickenpox. Shingles is treated with antiviral medications like acyclovir or valacyclovir prescribed by a physician. Pain medications or anti-inflammatory agents like prednisone may also be prescribed. Shingles can be complicated by prolonged burning pain well after the rash has resolved (this is called, post-herpetic neuralgia). Post-herpetic neuralgia can occur in approximately 10-20% of patients. The shingles vaccine (Zostavax®) reduces the risk of developing shingles and the long-term pain from post-herpetic neuralgia. The shingles vaccine is recommended for people aged 60 years and older. People who have had shingles can still receive the vaccine to help prevent future occurrences. This is a one-time vaccination and there is no maximum age for getting the shingles vaccine. For more detailed patient info on Shingles, she the CDC website.
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