Herpes zoster infection — commonly called shingles — is caused by the varicella zoster virus, which also causes chicken pox. When you get chicken pox, the inactive virus can remain in some of the nerves in your body for many years. Although vaccines for chicken pox and shingles are available, neither guarantees that you will not get the disease. Shingles can cause a chronic pain known as post-herpetic neuralgia. The same virus may cause Ramsey Hunt syndrome, an infection of the facial nerve that can be extremely painful due to irritation and swelling of the nerve.
Pain – The First Sign
The first sign of shingles is usually pain on one side or in one area of the body. It may be accompanied by tingling or burning sensations. Sometimes shingles causes intense itching as well. The area affected will depend on which nerves are involved. The most common location is a strip that wraps around one side or the other of your torso, but it may occur around one eye, one side of the face or neck or along any nerve path in the body. The burning sensation can be extremely painful. The symptoms of shingles can also mimic other health problems such as heart or kidney disease.
Skin Redness and Blisters
Redness of the skin followed by blisters is usually the next symptom in most people. The blisters are small and filled with clear to yellowish fluid. Blisters may occur singly or in clusters, and are usually surrounded by bright red, slightly swollen skin. As the disease progresses, the blisters will begin to break, leaving open areas of raw tissue that ooze clear, yellow or pink-tinged fluid. Eventually, the blisters develop yellow crusts that gradually dry, leaving patches of reddened skin in their wake. Most blisters do not cause permanent scarring, although it may take a few weeks for the redness to fade. Occasionally a person with shingles will have typical pain, itching and burning, but will not develop a rash.
In addition to the rash, some people have what are called systemic symptoms. You might have a fever and chills or feel generally ill, as if you have the flu. In addition to the pain of the blisters, you might develop pain in the abdomen or joints. Some people develop headaches even if the rash is on the torso. Swollen glands, called lymph nodes, are common in areas close to the infection. Fatigue is another common symptom of shingles.
Because shingles affects the nerves of the body, you may develop a number of symptoms related to sensation or movement, particularly if the infection is in the facial area. You might have difficulty moving muscles in the face or be unable to move your eyes. Ptosis — a condition in which one eyelid droops and cannot be raised by using the eye muscle – is another possible symptom. You might develop hearing problems if the virus affects nerves in the ear. When the nerves of the eyes are involved, you might have vision problems. Shingles can also cause problems with your ability to taste things.
Shingles usually lasts for two or three weeks. Although it is unusual to develop shingles more than once, there are a number of possible complications. Post-herpetic neuralgia is more common in people over the age of 60 and results from damage to the nerves. The pain can be very severe and may last for a long time. Infections from bacteria can occur because there are open areas in the skin. If the bacteria get into the blood stream, you might develop a systemic infection known as sepsis or an infection of the brain called encephalitis. Shingles in the eye can cause blindness and in the ear can cause deafness.
You are more likely to develop shingles if you are older than 60, had chickenpox before the age of one or your immune system is weakened. There is no known way to prevent shingles and half of all people who reach the age of 85 may develop the condition. Shingles may be contagious to pregnant women and is spread by respiratory droplets in the same way as the common cold, so avoid women of childbearing age and children who have not had chickenpox while the disease is active.