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Shingles
Reviewed by Medicinsk Expert•Last updated: 2026-10-22•Condition

Shingles

Shingles, or herpes zoster, is a painful rash caused by the reactivation of the varicella zoster virus, the same virus responsible for chickenpox.

Overview

After a person recovers from chickenpox, the varicella zoster virus remains inactive (latent) in nerve cells for life. In some individuals, the virus reactivates, causing shingles. While it can occur at any age, it is most common after age 50.

Symptoms

  • A severely painful, itchy, or tingling rash, usually on one side of the torso.
  • Blisters that form, break open, and scab over within a few days.
  • Herpes zoster ophthalmicus: A form of shingles affecting the eye and surrounding skin, which can cause permanent vision impairment.
  • Postherpetic neuralgia (PHN): A complication where severe pain, itchiness, or an overactive pain response (allodynia) persists in the affected region long after the rash has healed.

Causes & Risk Factors

The primary risk factor for shingles is age, as the immune system's ability to control the virus diminishes over time. Other factors include:

  • Immune System Impairment: Conditions or medications (such as chemotherapy or organ transplant drugs) that weaken T cells can trigger reactivation.
  • HIV Infection: Because HIV kills T cells, it increases the risk of virus reactivation.
  • Genetics: Research suggests that variants in the HLA complex—a family of genes that helps the immune system distinguish foreign invaders from the body's own proteins—may influence the risk of developing shingles or PHN.

Frequency

Shingles occurs in 20 to 30 percent of people during their lifetime. The risk is higher in women and individuals of non-Hispanic white ancestry. Vaccination programs for chickenpox and shingles are expected to reduce the incidence of the condition and its complications over time.

Frequently Asked Questions

ntiviral drugs such as acyclovir, valacyclovir, or famciclovir work best when begun within 72 hours of the first rash or pain symptom; starting later may still help but the benefit in reducing pain and shortening the outbreak diminishes.
Prompt antiviral therapy, adequate pain control (e.g., NSAIDs, gabapentin, or lidocaine patches), and early use of corticosteroids in selected cases can reduce nerve inflammation; maintaining good skin hygiene and avoiding smoking also support nerve healing.
If the rash or pain extends to the forehead, upper eyelid, or tip of the nose (Hutchinson’s sign), or if you notice redness, swelling, vision changes, light sensitivity, or eye pain, seek ophthalmology or emergency evaluation immediately to prevent permanent vision loss.
The recombinant zoster vaccine (Shingrix) is non‑live and is generally considered safe for most immunocompromised patients, but timing should be coordinated with your treating physician; the older live‑attenuated vaccine (Zostavax) is usually avoided in people with significant immune suppression.
Source: MedlinePlus, National Library of Medicine

MedlinePlus brings together authoritative health information from the National Library of Medicine (NLM), the National Institutes of Health (NIH), and other government agencies and health-related organizations.

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