What is shingles?
Shingles, or herpes zoster, occurs when the dormant chickenpox virus, varicella zoster, is reactivated in your nerve tissues. Early signs of shingles include tingling and localized pain.
Most, but not all, people with shingles develop a blistering rash. You may also experience itching, burning, or deep pain.
Typically, the shingles rash lasts two to four weeks, and most people make a complete recovery.
Doctors are often able to quickly diagnose shingles from the appearance of the rash.
1. First symptoms
Early symptoms of shingles may include fever and general weakness. You may also feel areas of pain, burning, or a tingling sensation. A few days later, the first signs of a rash appear.
You may begin to notice pink or red blotchy patches on one side of your body. These patches cluster along nerve pathways. Some people report feeling shooting pains in the area of the rash.
During this initial stage, shingles is not contagious.
The rash quickly develops fluid-filled blisters similar to chickenpox. They may be accompanied by itching. New blisters continue to develop for several days. Blisters appear over a localized area and do not spread over your whole body.
Blisters are most common on the torso and face, but they can occur elsewhere. In rare cases, the rash appears on the lower body.
It’s not possible to transmit shingles to someone. However, if you’ve never had chickenpox or the chickenpox vaccine, it’s possible to get chickenpox from someone with shingles through direct contact with active blisters. The same virus causes both shingles and chickenpox.
3. Scabbing and crusting
Blisters sometimes erupt and ooze. They may then turn slightly yellow and begin to flatten. As they dry out, scabs begin to form. Each blister can take one to two weeks to completely crust over.
During this stage, your pain may ease a little, but it can continue for months, or in some cases, years.
Once all blisters have completely crusted over, there is low risk of spreading the virus.
4. The shingles “belt”
Shingles often appears around the rib cage or waist, and may look like a “belt” or half belt. You might also hear this formation referred to as a “shingles band” or a “shingles girdle.”
This classic presentation is easily recognizable as shingles. The belt can cover a wide area on one side of your midsection. Its location can make tight clothing particularly uncomfortable.
5. Ophthalmic shingles
Ophthalmic shingles affects the nerve that controls facial sensation and movement in your face. In this type, the shingles rash appears around your eye and over your forehead and nose. Ophthalmic shingles may be accompanied by headache.
Other symptoms include redness and swelling of the eye, inflammation of your cornea or iris, and drooping eyelid. Ophthalmic shingles can also cause blurred or double vision.
6. Widespread shingles
According to the U.S. Centers for Disease Control and Prevention (CDC), about 20 percent of people with shingles develop a rash that crosses multiple dermatomes. Dermatomes are separate skin areas that are supplied by separate spinal nerves.
When the rash affects three or more dermatomes, it is called disseminated, or widespread zoster. In these cases, the rash may look more like chickenpox than shingles. This is more likely to happen if you have a weakened immune system.
Open sores of any kind are always susceptible to bacterial infection. To lower the possibility of a secondary infection, keep the area clean and avoid scratching. Secondary infection is also more likely if you have a weakened immune system.
Severe infection can lead to permanent scarring of the skin. Report any sign of infection to your doctor immediately. Early treatment can help prevent it from spreading.
Most people can expect the rash to heal within two to four weeks. Although some people may be left with minor scars, most will make a complete recovery with no visible scarring.
In some cases, pain along the site of the rash can continue for several months or longer. This is known as postherpetic neuralgia.
You may have heard that once you get shingles, you can’t get it again. However, the CDC cautions that shingles can return multiple times in some people.