Shingles (Herpes Zoster): Symptoms, Transmission, and Treatment

What is shingles?

Shingles is a painful skin disease caused by the reactivation of the varicella-zoster virus (VZV), which causes chickenpox in childhood or earlier, in nerve tissue years later.

What are the symptoms of shingles?

Pain, burning, stinging, tenderness, tingling, or itching may occur before the rash begins. This is followed by redness and fluid-filled blisters, usually on only one side of the body, following a specific nerve distribution.

Why is shingles painful?

The virus can also affect the nerves. Therefore, the pain may be burning, stabbing, like an electric shock, or worsen with touch.

Who is more likely to get shingles?

The risk increases with age and as the immune system weakens. The Centers for Disease Control and Prevention (CDC) in the United States reports that the risk of shingles and its complications increases especially after age 50.

Is shingles contagious?

A person with shingles does not directly transmit shingles to another person. However, the VZV in active lesions can be transmitted to a person who is not immune to chickenpox, causing that person to develop chickenpox.

How is shingles diagnosed?

Classic shingles can often be diagnosed by physical examination. In cases where the diagnosis is uncertain, VZV can be investigated using polymerase chain reaction (PCR).

How is shingles treated?

Commonly used antiviral options include acyclovir, valacyclovir, and famciclovir. Treatment is planned according to the patient's age, the location of the rash, the severity of the disease, immune status, and kidney function.

When should treatment begin?

Antiviral treatment is most beneficial when started early in the illness. The first 72 hours are usually crucial; however, some patients who present later may also require treatment.

Why is shingles important if it occurs around the eye?

Shingles around the eyes can lead to serious complications such as corneal damage, intraocular inflammation, and vision loss. If you have a shingles-like rash around the eyes or on the tip of your nose, prompt evaluation is necessary.

What is postherpetic neuralgia?

It is when pain in the same area persists for weeks, months, or longer after a skin rash has healed. The risk increases especially with age.

Is there a vaccine for shingles?

Yes. Recombinant shingles vaccine is used to reduce the risk of shingles and its complications. Since national vaccination programs and licensing requirements vary from country to country, the decision in Türkiye should be made according to current national regulations.

When is an urgent or rapid assessment needed?

If the rash is around the eyes or face

If there are changes in vision

If a rash develops around the ear or hearing problems

If there is weakness in the facial muscles

If the rash is very widespread

If there is a severe headache or altered consciousness

If the immune system is suppressed

If there is pregnancy

If the pain is very severe

Frequently Asked Questions

Is shingles a recurrence of chickenpox? It's the reactivation of the same virus.

Can shingles be transmitted to another person as shingles? No; it can cause chickenpox in someone who is not immune.

Is it possible to have shingles without a rash? Rarely, a condition called zoster sine herpete can occur.

Dermatologist's Note

In shingles, the first few days are particularly important. Early assessment is crucial if burning or pain occurs on one side, followed by the development of clusters of blisters in the same area, so that antiviral treatment can be started in a timely manner.