Shingles/Herpes Zoster: Symptoms, Complications, and Treatment


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What is shingles/herpes zoster?

Shingles or herpes zoster is an infection which is characterized by a painful blistering skin rash.

The rash usually affects one side of the body, i.e. the torso and/or one side of the face. It appears in a band formation and therefore the name ‘shingles’, which is Latin for ‘belt’. Shingles is caused by the same virus that causes chickenpox, called the varicella-zoster virus.

The initial warning symptoms appear one to five days before the rash appears. You will feel the warning signs on the location where the rash will appear. These initial symptoms include itching, pain, burning, pricking and stabbing sensation, followed by high fever, chills and muscle pain. The tell-tale rash appears soon after.

If you experience any of these symptoms you need to contact your family physician or a general practitioner without delay.

How does shingles/herpes zoster occur?


When a person (usually children) gets infected by the varicella-zoster virus, he/she develops chickenpox. After the chickenpox heals, the virus remains in a dormant state in the nerve roots or the dorsal root ganglia, which contains the cell bodies of sensory neurons. Years later, this virus may wake up to cause an outbreak of shingles or herpes zoster.

Although the reason for its waking up is not certain, experts believe a variety of conditions can lead to its activation such as 

  • normal ageing
  • weakening of the immune system
  • stress and anxiety

Healthy people and young children too are not exempt from the risk. In fact, anyone who has had chickenpox is at a high risk of developing herpes zoster or shingles.

Appearance of the Blistering Rash

The distinctive feature of this illness is the rash that appears on one side of the body. The rash is accompanied by a pricking and sometimes stabbing pain. It erupts into clusters of small red patches that develop into blisters.

Within 7 - 10 days the blisters break open and a fluid comes out. During this period, if anyone who never had chickenpox before, accidentally touches the oozing blisters of the patient, he/she will develop chickenpox.

Once the fluid comes out, the rash slowly begins to dry and crust. The rash disappears completely after two to four weeks. When the blisters scab and dry, the virus cannot spread anymore.

Because herpes zoster affects the nerve cells in the body, it is very common for the rash to appear in the formation of a band on one side of the body along the path of a nerve.

In some people, the rash may spread to the eyes, and occur inside the eyelids. This can be extremely painful, with the person experiencing stabbing pains in the eye, constant eye watering, sensitivity to light, and blurry vision.

The symptoms in the eyes usually vanish within three to five weeks.

A person with shingles cannot transmit shingles to another person. Though, he can transmit chickenpox to a person, who has never had chickenpox before.


Post-Herpetic Neuralgia (PHN)


Around 20% of the people who suffer from shingles may develop a condition known as post-herpetic neuralgia. This occurs when the proper functioning of a nerve is disrupted due to the damage caused to it by shingles. It is commonly believed that shingles causes scar tissue to develop around the nerve, which when inadvertently pressed, causes pain signals to go to the brain.

Experts, however, are not clear as to why some people go on to develop PHN.

The person suffering from PHN will experience a sudden throbbing, burning, shooting, or even a stabbing pain along the damaged nerve for months, or even years, after the rash has healed.

In some cases, the pain may be continuous for a few months after the rash has healed, however, if the condition runs into years, the person will experience paroxysms of pain along the nerve.

Who is prone to shingles/herpes zoster?

You are at an increased risk of shingles if you:

  • have had chickenpox as a child

  • are above 50 years of age. The risk increases with age, no matter how healthy you are

  • a weak immune system

  • are experiencing any stress or trauma

  • are suffering from any illnesses such as diabetes, HIV, cancer

  • are taking any medications that affect the immune system such as steroids

  • are taking treatments for certain ailments such as cancer

  • are recuperating from any illness, be it even a cold, or flu

  • have erratic sleeping patterns

  • are suffering from malnutrition

What are the symptoms of shingles/herpes zoster? How is shingles/herpes zoster diagnosed?

The most common symptoms of shingles include:

  • a dull constant pain which can be mild or severe, or an intermittently shooting pain in the affected area

  • soreness, burning sensation, itching, or numbness in the affected area

  • exhaustion

  • fatigue

  • sensitivity to light

  • fever

  • headache

  • the appearance of a painful, itchy and red rash on one side of the body and sometimes in and around the eyes

  • a sensation of pins and needles piercing through in the areas of the rash

  • throbbing pain in the eye with burning sensation and irritation

  • soreness and redness in and around the eye

  • extreme sensitivity to light

  • constant eye watering

  • blurred vision


Your general physician can immediately diagnose shingles based on the symptoms.

If the diagnosis is not clear, the doctor may ask you to undertake lab tests, which usually involves scraping a part of your blisters formed from the rash, and testing it in the lab.

What are the complications of shingles/herpes zoster?

Shingles is a self-limiting condition which disappears within three weeks. However, in people with very low immunity, it may take a serious turn. Delaying, or not undertaking medical treatment can cause serious complications which include:

  • Postherpetic Neuralgia - which is nerve pain caused by the damage to nerves by the varicella-zoster virus. The stabbing pain can remain for months and even for years in patients.

  • Eye Complications - which can occur if the rash spreads to the eyes. Swelling of the cornea may occur which can leave permanent scars. Shingles in the eye can also cause the retina to swell, or increase pressure in the eye which can lead to glaucoma and eventually loss of vision.

  • Skin Infections - may occur if the area affected by the rash is not kept clean, which can lead to scarring.

  • Neurological Complications - can ensue if the shingles affects the nerves in the brain. The neurological complications include Guillain-Barre Syndrome, Ramsay Hunt Syndrome, Bell’s palsy, encephalitis, meningitis, and even stroke anytime in the year following the illness.

  • Disseminated Herpes Zoster- is when the virus spreads to other organs. People with compromised immune systems ( those suffering from cancer, HIV/AIDS), are at a risk of Disseminated Herpes Zoster. This can be life-threatening especially if it affects the lungs.

What is the treatment for shingles/herpes zoster?

Though there is no known cure or for that matter treatment for shingles, your general physician may prescribe antiviral medicines, which will reduce the pain and duration of shingles. He may also prescribe some topical antibiotics to apply on the rashes which will reduce the stinging and prevent infection.

Would you like to consult a doctor for Shingles/Herpes Zoster ?

Patient Experiences

Effective Treatment for Shingles/Herpes
I am suffering from herpes infection my doctors in army hospital they tell me its is not cure you take life time some medicines after I try homoeopathy I came Dr sunil clinic and after 6 month medication my problem is 99% reduced I am very happy Dr good...Read Less
Doctor in this story :Dr. Sunil Kumar Dwivedi
S.D. Homoeopathy
Correct Diagnosis and Treatment Second Time Round For Herpes/Shingles
I am an elderly person residing in Noida. About 3 months back I had small eruptions on my face and I was under severe excruciating pain which used to radiate right across the left side of my face. I consulted a dermatologist in Noida and he told that my pain was due to my tooth; but when I showed the dentist he could not find anything. Then one fine day my cousin visited me and finding me in extreme distress brought me over to Yatharth Hospital where I met Dr. Sethi. Dr Sethi listened to my woes & frustration very patiently; and then told me that I was suffering from HERPES. He treated me for this highly painful dreaded disease. Within a few days my pain subsided and before the end of the month I was back to my normal self all thanks to Dr. Sethi. Also I cannot thank my cousin enough for taking me to such an experienced and wonderful doctor. What I truly loved about Dr. Sethi was; that unlike today’s doctors; he is so patient and calm in listening to your symptoms/ problems that half your disease is cured by his positive assuring demeanour. I specially took this effort to write a feedback because I want to tell people especially of my age that there is somebody who will treat you with a personal touch. I strongly recommend him for any skin problem or disease. God bless you! ...Read Less
Doctor in this story :Dr. Pradeep Sethi
Yatharth Wellness Hospital
Treatment In Time for Shingles/herpes After a Round of Misdiagnosis
I got herpes infection and got blisters with so much burning sensation. My previous doctor missed the diagnosis. But Dr shruthi identified the problem and treated it in time. So thankful....Read Less
Doctor in this story :Dr. Sruthi Alla
Skin and Hair Inc.

Questions answered by trusted doctors

Verified User
I was affected with herpes zoster virus.Its been 48 hours till now. I had visited doctor but forgot to ask if there any limitations for food and drinks??can any one help me. Thank u
Dr. Aman Sharma
Dermatologist, Delhi
There's no significant food and drink restrictions just go ahead alcohol and eating out or eating very spicy stuff as it may aggregate symptoms.
Verified User
I read online that shingles can be a cause of a weak immune system. I have shingles and i am only 24. How do I check if my immune system is weak?
Dr. J.Mariano Anto Bruno Mascarenhas
General Physician, Chennai
You can do the relevant blood tests to know about your immune system
Dr. Sharath Kumar K N
General Physician, Mandya
Hello, shingles occur due to reactivation of the chicken pox virus in the body. Yes Weekend immune system predisposes to reactivation, there are several causes for these weekend immune system like, stress, lack of sleep, during the time of periods in women, having unhealthy fast foods, hypothyroidism, smoking, drinking, lack of exercise, Fever due to any other cause, Excessive tiredness, fasting, dehydration, rarely, genetic causes for immune disorders, hiv etc. This infection can be treated with antivirals and all the above bad heath habits to be avoided. Please consult a general physician.
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