Shingles is a fairly harmless, but very painful skin disease. It manifests itself as a red rash and small, fluid-filled itchy vesicles that form a sort of belt. Shingles is most common in the area of the abdomen or waist. It is caused by reactivation of the chickenpox virus.


People can have shingles from the herpes zoster virus. This is the same virus that causes chickenpox. If a person has had chickenpox, this virus remains inactively present in the body throughout life. Sometimes, the virus can become active again after many years. This usually happens if someone has a poor immune system. Shingles is highly contagious: by having contact with the fluid from the vesicles, a person who has not had chickenpox so far, can get chickenpox. After infection, it takes thirteen to eighteen days before the first symptoms occur.


Shingles causes the following signs and symptoms:


The diagnosis of shingles can often be based on the clinical picture, how it looks, the typical shape and pain. Some vesicular fluid is sometimes taken to be examined under the microscope or grown on the virus, but usually that’s not needed.


In healthy people with not too extensive shingles, it is not necessary to start treatment. Without medication, the shingles disappear on its own after approximately a month. In patients with an impaired immune system, it’s wise to take antiviral drugs. These patients can be seriously ill with fever and general symptoms and should sometimes even be admitted to the hospital for an infusion of antiviral medication.
Also when the infection breaks out around the eye, it’s wise to start with antiviral tablets. The ophthalmologist often examines the eyes and an antiviral eye cream is added to the treatment. If the infection is located around the ear, prednisone is sometimes given to prevent damage to hearing and to the facial nerve.
If necessary, painkillers are prescribed and sometimes creams that prevent the vesicles to be infected with bacteria. A sprinkle powder or an ointment is usually given for the itch.
Severe and painful shingles can be combated with neural therapy (by injection in the lower back). This therapy is intended to reduce swelling of the nerve, to combat acute pain and to prevent the occurrence of a permanent neural inflammation, which may cause symptoms for many years. Neural therapy is given by an anesthesiologist.
There is a vaccine available that halves the probability of having shingles.


Shingles usually resolve on its own in one to two weeks. Afterwards, the skin remains spotty for a few weeks. Shingles usually causes no scars, unless the patient has been scratching. Long-term problems remain occasionally: the site remains spotty or numb or the patient continues to suffer from itch or sometimes severe pain. These residual symptoms mainly occur in the elderly. Rarely, a patient gets shingles for a second time.