Shingles

Shingles, also known as herpes zoster, is a painful viral infection that causes a blistering rash on one side of the body. It occurs when the varicella-zoster virus, the same virus that causes chickenpox, reactivates later in life.

While shingles can be extremely uncomfortable, early treatment from a dermatologist or dermatology provider can significantly reduce pain, speed healing, and prevent complications such as postherpetic neuralgia (nerve pain that lingers after the rash clears).

Understanding shingles symptoms, stages, and treatment options is the first step toward faster recovery and relief.

What Causes Shingles?

Shingles is caused by the reactivation of the varicella-zoster virus, which remains dormant in nerve tissue after a person recovers from chickenpox. Years or decades later, the virus can “wake up,” traveling along nerve pathways to the skin and causing a rash.

The reason why the virus reactivates isn’t always clear, but it’s often linked to factors that weaken the immune system, such as:

• Age (especially over 50)
• Stress or illness
• Fatigue or poor sleep
• Certain medications or conditions that suppress the immune system

You cannot get shingles from someone else’s rash. However, someone who has never had chickenpox or the vaccine can develop chickenpox if they come into contact with the open blisters of a person with shingles.

Because shingles is caused by a virus that lives within your body, it’s not fully preventable, but staying healthy, reducing stress, and getting the shingles vaccine can greatly lower your risk.

Early Shingles Symptoms

Shingles usually begins with early warning signs before the rash appears. Recognizing these symptoms can help you seek treatment sooner when antiviral medications work best.

Early shingles symptoms may include:

• Tingling, itching, or burning in one area of the body
• Pain or sensitivity to touch on one side
• Fever, headache, or fatigue
• Mild flu-like symptoms

Within a few days, a red rash develops, usually on the torso, back, chest, or face. The rash soon turns into clusters of fluid-filled blisters that eventually crust over. The entire shingles rash typically lasts 2-4 weeks.

Because shingles affects the nerves, the pain can range from mild discomfort to severe burning or stabbing sensations. If the rash appears near the eyes or ears, it requires immediate medical care to prevent vision or hearing complications.

Stages of Shingles

The stages of shingles occur in a predictable pattern, from early symptoms to healing. Knowing what to expect can make the process easier to manage.

• Prodromal Stage (1-5 days): Tingling, itching, or burning before the rash appears.
• Active Rash Stage (days 3-10): Red patches evolve into fluid-filled blisters that may itch or ooze.
• Crusting Stage (days 10–14): Blisters dry out and form scabs as they heal.
• Recovery Stage (weeks to months): The rash fades, but some people experience lingering nerve pain (postherpetic neuralgia).

Dermatology providers can help reduce discomfort and shorten recovery by treating shingles during the earliest stage before the blisters fully develop.

What Does Shingles Look Like?

The shingles rash usually appears as a stripe or band of blisters on one side of the body. It can also occur around one eye (ophthalmic shingles) or on the face, scalp, or neck.

Common shingles rash characteristics include:

• A cluster of small, fluid-filled blisters on a red base
• Pain, itching, or burning in the affected area
• Blisters that crust over and scab after several days
• Possible sensitivity to light, fever, or fatigue

In most cases, shingles affects only one side of the body and doesn’t cross the midline. The affected skin may remain discolored or sensitive for several weeks even after the rash heals.

Shingles Treatment

Prompt medical attention is the best way to reduce the severity and duration of shingles. Dermatologists and dermatology providers can prescribe antiviral medications and topical treatments to help your skin heal faster and relieve pain.

Antiviral Medications

Antivirals work best when started within 72 hours of rash onset. Common options include:

• Acyclovir, valacyclovir, or famciclovir, which stop the virus from multiplying and shorten the duration of the outbreak.
• These medications can also lower the risk of long-term nerve pain (postherpetic neuralgia).

Pain Management and Skin Care

Because shingles affects the nerves, pain relief is an important part of treatment.

• Over-the-counter pain relievers such as ibuprofen or acetaminophen can help.
• For more severe cases, your dermatologist or dermatology provider may prescribe nerve pain medications or topical lidocaine patches.
• Keep the affected area clean and covered with loose, soft clothing to prevent irritation.
• Apply cool compresses or calamine lotion to soothe itching and burning.

Preventing Complications

Untreated shingles can sometimes lead to complications, particularly in older adults or people with weakened immune systems.

• Postherpetic Neuralgia: Lingering nerve pain that can last for months after the rash heals.
• Ophthalmic Shingles: Occurs near the eyes and may affect vision if untreated.
• Bacterial Infection: Scratching blisters can allow bacteria to enter the skin.

Seeing a dermatologist or dermatology provider early in the outbreak significantly reduces these risks and ensures appropriate care for any lingering symptoms.

Shingles Prevention

The best way to prevent shingles is through vaccination.

• The Shingrix vaccine is recommended for adults age 50 and older, even if you’ve already had shingles or received the older Zostavax vaccine.
• The vaccine is over 90% effective at preventing shingles and its complications.
• Maintaining a healthy immune system through proper sleep, nutrition, and stress management also helps reduce your risk.

If you’ve had shingles once, you can get it again so vaccination remains important even after recovery.

---

Shingles Treatment at Schweiger Dermatology Group

At Schweiger Dermatology Group, our providers are experienced in diagnosing and treating shingles, from the early tingling stage to full recovery. Our dermatologists and dermatology providers offer antiviral prescriptions, soothing topical therapies, and personalized care to relieve pain and prevent complications.

If you suspect shingles, schedule an appointment right away. Early treatment can significantly reduce discomfort and speed healing. Call 844-DERM-DOC or book online today to connect with a dermatology provider near you.

---