What is shingles, and who can get it?
Shingles is another name for a condition called "herpes zoster." It causes a painful rash. You can only get shingles if you had chickenpox in the past.
After you have chickenpox (usually as a child), the virus that causes it stays in your body in certain nerve cells. Most of the time your immune system keeps the chickenpox virus in these cells. As you get older, or if your immune system gets weak, the chickenpox virus may escape from the nerve cells and cause shingles.
What are the symptoms of shingles?
Shingles causes a (usually) painful or itchy, blistering rash. Sometimes the pain starts a few days before the rash appears.
The rash begins with reddish bumps. In a few days, these bumps turn into blisters. You might feel a stinging or burning pain. The rash may wrap around your back and chest, or it may be on one side of your face.
The blisters usually crust over and fall off after 7 to 10 days. You may see changes in the color of your skin when the scabs fall off. In bad cases of shingles, these color changes last forever.
Even though the rash gets better or goes away in a few weeks, the pain may last longer. In most people, the pain goes away in 1 to 3 months.
Shingles can also affect your eyes, causing swollen eyelids, redness and pain. Shingles of the eye can cause scars that affect your vision. It can also lead to glaucoma later in life. Glaucoma is an eye disease that can cause blindness. People who have shingles of the eye should see an eye doctor right away.
How is shingles treated?
Shingles is often treated with acyclovir (brand name: Zovirax), famciclovir (brand name: Famvir) or valacyclovir (brand name: Valtrex). Your healthcare provider will decide which of these medicines might work for you. These medicines shorten the duration of the rash if you start taking them in the first 3 days after you get the rash.
Your healthcare provider might also have you take a steroid medicine to reduce your pain and swelling.
Shingles of the eye is treated with antiviral medicines and steroids.
What can I do about the pain?
To help with the pain of shingles, your healthcare provider might have you take an over-the-counter pain medicine like acetaminophen (one brand name: Tylenol) or ibuprofen (one brand name: Motrin). Aspirin is not recommended because using it might cause a liver problem called Reye's syndrome.
Putting a medicated lotion (two brand names: Benadryl, Caladryl) on the blisters might reduce the pain and itching. Putting cool compresses soaked in an astringent liquid (two brand names: Bluboro, Domeboro) on the blisters and sores might make them hurt or itch less.
If shingles causes severe pain, your healthcare provider might have you take a prescription pain medicine.
What is postherpetic neuralgia?
"Postherpetic neuralgia" is the name used when the pain of shingles lasts for a long time after the rash is gone. About 1 in 5 people with shingles will get postherpetic neuralgia, but the problem is much less common in people under age 40.
Like shingles, postherpetic neuralgia causes a stinging or burning pain. Your skin might become very sensitive to temperature changes or a light touch, such as from a bedsheet or moving air.
Most people with postherpetic neuralgia get better with time. Almost all of them are free of pain within 1 year. A few people have chronic pain (pain that doesn't go away).
How is postherpetic neuralgia treated?
Postherpetic neuralgia is often treated with over-the-counter pain medicines and capsaicin cream (two brand names: Capsin, Zostrix). If these medicines don't help enough, your healthcare provider might try some other treatments, such as a patch that contains lidocaine (brand name: Lidoderm).
Some medicines that are used to treat depression and seizures can also help the nerve pain of postherpetic neuralgia. These medicines don't work very fast, though. It might be several weeks before they help your pain.