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Shingles is an intensely painful condition caused by the herpes zoster virus. The virus, herpes zoster causes chicken pox in childhood and most children recover uneventfully. However, in some individuals the herpes virus hides in the nerves and goes to sleep. Later after several decades the virus is triggered and comes back to life. This time the virus causes shingles. No one really knows why the virus suddenly becomes active again, but stress and illness are two known triggers. In most people only one attack of shingles occur but it is something most people never forget.

Herpes zoster and shingles can occur at any age, but is most common in elderly individuals. Individuals who had chicken pox before the age of one and those who have a weak immune system (eg HIV, use of steroids or those with cancer.

Shingles is only contagious for individual who have not previously had chicken pox as a child or the chicken pox vaccine. Individuals who do acquire herpes zoster, the individuals develop chicken pox and not shingles.

The initial symptom is pain and is usually on one side of the body. The pain is often described as knife like or burning. The pain may be associated with tingling and numbness. A few days later, a red linear rash appears. Soon this is followed by small blisters on the rash in a linear fashion. The blisters are often itchy. Over the next several day, th fluid filled blisters do break open and crust over. Scarring from the blisters is very rare.

In most people, the rash may occur on the side of the chest, face, eyes or mouth. Other symptoms include headaches, chills, fever, paralysis of facial muscles, muscle and joint pain, severe fatigue, loss of taste and vision
The diagnosis of herpes zoster and shingles is made by a clinical exam.
Shingles usually resolves on its own without any medical treatment. The majority of people only require medications to ease the pain. The typical medications used to treat shingles include acyclovir, famicyclovir and valacyclovir.

The medications only work when they are administered within 24 hours of the symptoms. The drugs do not cure herpes zoster but only reduce the intensity of pain. In some individuals the duration of illness may be shortened by a few days. while most people can take the medications by mouth, some people may benefit from intravenous medications.

Sometimes anti-inflammatory medications like corticosteroids are used to reduce swelling and pain. However, these drugs do not always work.

Other medications that may be used include antihistamines, pain medications and zostrix. Cool wet compresses, soothing baths, lotions , starch baths, calamine lotion and colloidal oatmeal baths may help reduce pain and itch.

The skin should be kept clean at all times using warm water and dry dressings. Herpes zoster vaccine may help elderly individual who develop post herpetic neuralgia. However, herpes zoster vaccine is only helpful in 50-60 percent of individuals.

In some unfortunate people, herpes zoster virus may cause brain or eye damage resulting in visual loss.