Shingles

What is shingles?

Shingles is an infection caused by the same virus that causes chicken pox (varicella zoster). You cannot develop shingles unless you have had a previous infection with chicken pox, usually as a child. Shingles is also called Herpes Zoster, because the varicella virus is in the larger herpes family of viruses. Shingles outbreaks consist of blister-like sores, which most often appear in a band across one side of the body. In fact, the name “shingles” comes from the Latin word for belt or girdle.

How often does it occur?

After you recover from chicken pox, the chicken pox virus is not destroyed. It becomes inactive, lying dormant in the roots of the nerve cells. Later, if the chicken pox virus is reactivated, the symptoms are called shingles.

What causes the reactivation of the virus is not known for sure. However, experts agree that the most likely cause is physical or emotional stress, which contributes to the weakening of the immune system. Infection, surgery, injury or illness can challenge the immune system, which in turn can reactivate the virus. It is also seen as a complication of cancer, AIDS, and in patients taking immune-suppressing medications.

About 1 in 10 people who had chickenpox as children will develop shingles as adults. Although it can occur in anyone over 3 years of age, the risk of shingles increases with age and is seen most commonly in people over 50. It is thought that the immune system may weaken as a natural result of aging.

What are the symptoms?

The first sign of shingles is often burning, sharp pain, tingling, or numbness in or under your skin on one side of your body or face. The most common site is the back or upper abdomen. You may have severe itching or aching rather than pain. You also may feel tired and ill with fever, chills, headache and upset stomach.

After several days, you will notice groups of small, clear, fluid-filled blisters on reddened skin. They look similar to chicken pox. The blisters generally last for 2 to 3 weeks. During that time they turn yellow, then crust over, and finally begin to disappear. Usually there is no scarring. Occasionally they will leave small, pitted scars. Once the blisters are healed, some people continue to experience pain for a month longer.

The degree of pain and discomfort caused by shingles is variable. Usually in a young age group, sores may sting or burn and begin to itch as they heal. Less commonly, especially in older people, shingles can mean extreme pain for weeks or months after the blisters heal. The slightest touch, contact with clothing or even a breeze can be unbearable.

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What is the treatment?

The shingles virus has to run its natural course, but you can get some relief by:

  • applying cool compresses
  • taking acetaminophen (Tylenol) or other mild pain relievers such as ibuprofen (Advil)
  • resting in bed during the early stages if you have a fever and other symptoms. Your rash may be irritated by contact with clothing or bed linen.

Your medical provider also may prescribe:

  • stronger pain killers for more serious discomfort
  • antibacterial salves or lotions if needed to control secondary skin infection with bacteria
  • antiviral drugs: to be most effective, these medications should be started as early as possible. They shorten the course of painful symptoms, minimize blister formation and speed healing. They may also prevent post-herpetic neuralgia. This is the condition of persistent numbness, tingling or pain along the course of the affected nerve that may last for months or even years after the shingles rash. This problem is most likely to occur after a shingles outbreak in a person over 50.

Is shingles contagious?

The virus that causes zoster can be passed on to others, but they will develop chicken pox, if susceptible, not zoster. Shingles is much less contagious that chicken pox because chicken pox can be spread through the air, whereas spread of shingles occurs only with direct contact or indirect contact (for example, a wash cloth) with the blister fluid which contains the virus particles. A person who has never had chicken pox may contract chicken pox by exposure to the shingles rash. Consequently, if you have shingles, avoid contact with infants, children, pregnant women, and adults who have never had chicken pox, until your blisters are completely dry. It is also important to avoid people with weakened immune systems (such as people with AIDS, cancer patients on chemotherapy or transplant recipients on immune-suppressing drugs).

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When do I need to be seen at Health Services?

If you are a Brown student and you are concerned about shingles, you can make a confidential appointment at Health Services by calling 401.863-3953.  Health Services provides a range of services including general health care and emergency medical care. You can request a medical provider by gender or by name. We are located at 13 Brown Street on the corner of Brown and Charlesfield Streets.

After you are seen for your initial diagnosis and treatment, Brown students should contact Health Services if:

  • you generally are feeling worse or develop increasing pain or fever
  • there are signs of bacterial infection of the blisters (increasing pain, redness or milky, yellow drainage from the blister sites)
  • the blisters are close to the eyes or ears, or if you experience vision or hearing problems

What can be done to prevent shingles?

A vaccine to prevent chicken pox is now available. In order to get shingles, you must have had chicken pox sometime in the past. You can also protect your immune system with a healthy lifestyle. Keeping your stress at manageable levels can reduce your chances of getting shingles and other illnesses.

Links you can use

To learn more about shingles, you can visit:

MEDLINE Plus

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Disclaimer: Health Education is part of Health Services at Brown University. Health Education maintains this site as a resource for Brown students. This site is not intended to replace consultation with your medical providers. No site can replace real conversation. Health Education offers no endorsement of and assumes no liability for the currency, accuracy, or availability of the information on the sites we link to or the care provided by the resources listed. Health Services staff are available to treat and give medical advice to Brown University students only. If you are not a Brown student, but are in need of medical assistance please call your own health care provider or in case of an emergency, dial 911. Please contact us if you have comments, questions or suggestions.