Shingles Symptoms and Complications

Identifying and Understanding the Shingles Rash

Man scratching his face
Man scratching his face. Getty Images/Teri Dixon/Stockbyte

One million people in the United States experience shingles every year, according to the Centers for Disease Control and Prevention. Still, there is a lot of confusion over what shingles is exactly. 

Let's gain a better understanding of the symptoms and complications of shingles in this question and answer style format. 

View Image Gallery: Spotting the Early Signs of Shingles

What Is Shingles?

Shingles — also known as herpes zoster — is an infection of the nerve roots and is most common in people older than 50.

It's also common in people with weak immune systems, like people with HIV or people with certain cancers, especially leukemia and lymphoma. 

Shingles occurs when the chickenpox virus becomes re-activated — so anyone who has had chickenpox can get shingles. Why the virus becomes active after years of lying quiet in the body is not entirely understood. 

What Are the Symptoms of Shingles?

Shingles occurs in two stages: the prodromal stage and the eruptive stage. The symptoms vary depending on the stage.

Prodromal Stage - This stage begins about 2 to 7 days before the skin rash. Symptoms include  numbness, tingling, burning, itching, or shooting pain on one side of the face or body -- at the site where the skin rash is about to erupt.

Some people experience systemic, or whole-body, complaints during this stage as well. These include:

    Eruptive Stage: During this stage, sores filled with clear fluid, known as vesicles, erupt on the skin in a cluster-like pattern. Often redness and swelling accompany the rash. 

    The rash forms over a period of three to five days and is often uncomfortable. A person's pain is variable, ranging from very mild to severe.

    Eventually the vesicles crust over and then heal within 2 to 4 weeks. 

    The pain from shingles can last for weeks, months, or even years after an outbreak. Long-term pain after shingles is called postherpetic neuralgia.

    Where Do Shingles Erupt?

    The shingles rash can affect many different parts of the body, depending on which nerve root is affected. According to the CDC, a common location is the trunk. Usually the rash does not cross the midline, but it can.

    How Do I Know if I Have Shingles?

    Keep in mind that a shingles rash can often be mistaken for chickenpox or a poison ivy rash. The best way to find out if your symptoms are consistent with shingles is to see your doctor. 

    What are the Complications of Shingles?

    People with weak or impaired immune systems, like people with HIV, are more likely to have complications from shingles. They are also more likely to have a severe, widespread rash that resembles chickenpox. Complications include:

    • potential vision loss if shingles involves the eye
    • bacterial infection of the shingles rash 
    • organ-specific inflammation (e.g., encephalitis, if the brain is infected by the shingles virus)

    Fortunately for people with HIV, shingles is now declining since the emergence of combined antiretroviral therapies.

    Take Home Message

    If you think you are having a shingles outbreak, contact your doctor right away to ensure a proper diagnosis and treatment plan. 

    View Image Gallery: Am I Getting Shingles?

    Sources:

    Centers for Disease Control and Prevention. (2014). Shingles (Herpes Zoster): Clinical Overview. Retrieved September 28th 2015. 

    Centers for Disease Control and Prevention. (2014). Shingles (Herpes Zoster): Signs and Symptoms. Retrieved September 28th 2015. 

    Centers for Disease Control and Prevention. (2014). Shingles (Herpes Zoster): Complications. Retrieved September 28th 2015.

    Grabar S et al. Incidence of herpes zoster in HIV-infected adults in the combined antiretroviral therapy era: results from the FHDH-ANRS CO4 cohort. Clin Infect Dis. 2015 Apr 15;60(8):1269-77.

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