Shingles (Herpes Zoster): Symptoms, Who Is at Risk, Vaccine and Treatment

Shingles, or herpes zoster, is a painful rash illness. It is caused by the varicella-zoster virus — the same virus that causes chickenpox. After someone has had chickenpox, the virus stays in their body, and it can reactivate years later as shingles.

About 1 in 3 people in the United States will have shingles in their lifetime, and an estimated 1 million people get it each year. Most people have it only once, but it can come back.

Signs and complications

The usual sign is a rash on one side of the body, left or right, that is typically painful, itchy or tingly.

Shingles can lead to serious complications, including vision loss. The most common is long-term nerve pain called postherpetic neuralgia (PHN).

Who is at risk

Anyone who has had chickenpox can get shingles — and more than 99% of Americans born before 1980 had chickenpox, whether or not they remember it. Children can get shingles, but it is uncommon.

The risk of shingles and of serious complications rises:

• with age;
• with conditions that weaken the immune system, such as certain cancers — including leukemia and lymphoma — and HIV infection; and
• with medicines that weaken the immune system, such as steroids and drugs given after an organ transplant.

Can shingles spread?

You cannot catch shingles from someone who has it. But someone who has never had chickenpox or the chickenpox vaccine can catch the virus from a person with shingles — and get chickenpox, which could itself turn into shingles later in life.

The virus spreads from shingles through:

• direct contact with fluid from the rash blisters; or
• breathing in virus particles that come from the blisters.

People with chickenpox are more likely to spread the virus than people with shingles.

If you have shingles, protect others

A person with shingles cannot spread the virus before the blisters appear or after the rash has scabbed over. In between:

• cover the rash;
• avoid touching or scratching it;
• wash your hands often, for at least 20 seconds; and
• until the rash scabs over, stay away from pregnant women who have never had chickenpox or its vaccine, premature or low-birth-weight babies, and people with weakened immune systems.

Vaccination

Vaccination is the best protection. CDC recommends two doses of the recombinant zoster vaccine (RZV, Shingrix) to prevent shingles and its complications in adults 50 and older. It is also recommended for adults 19 and older whose immune systems are weakened by disease or treatment.

Treatment

Three antiviral medicines treat shingles: acyclovir, valacyclovir and famciclovir. They make the illness shorter and less severe, and they work best when started as soon as the rash appears — so anyone who thinks they have shingles should contact a doctor promptly.

Over-the-counter or prescription pain medicine may help with the pain. Wet compresses, calamine lotion and warm oatmeal baths may ease the itching.

Sources

Based on "About Shingles (Herpes Zoster)," Centers for Disease Control and Prevention; a work of the United States government in the public domain.