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    Massachusetts General Hospital's Center for Pain Medicine delivers comprehensive, multidisciplinary care for individuals with painful disorders including diabetic neuropathy, peripheral nerve injuries, myofascial pain and other musculoskeletal disorders.

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About This Condition


What is shingles?

Shingles, or herpes zoster, is a common infection of the nerves. It is caused by a virus. Shingles triggers a painful rash or small blisters on an area of skin. It can appear anywhere on the body, but it typically appears on only one side of the face or body. Burning or shooting pain and tingling or itching are early signs of the infection. Even after the rash is gone, the pain can continue for months, even years.

What causes shingles?

Shingles is caused when the chickenpox virus is reactivated. After a person has had chickenpox, the virus lies dormant in certain nerves for many years. Shingles is more common in people with weakened immune systems, and in people over the age of 50.

What are the symptoms of shingles?

However, each person may experience symptoms differently. Symptoms may include:

  • Skin sensitivity, tingling, itching, and/or pain in the area of the skin before the rash appears
  • Rash, which appears after 1 to 5 days and initially looks like small, red spots that turn into blisters
  • Blisters typically scab over in 7 to 10 days and clear up within 2 to 4 weeks 

Other early symptoms of shingles may include:

  • Stomach upset
  • Feeling ill
  • Fever and/or chills
  • Headache

The symptoms of shingles may look like other medical conditions or problems. Always consult your health care provider for a diagnosis.

How is shingles diagnosed?

Your doctor will do a complete physical exam and ask about your medical history, specifically about whether you have ever had chickenpox.

Your health care provider will likely know right away that it is shingles based on the unique rash. The rash usually appears one area on one side of the body or face. It appears as red spots, small fluid- or pus-filled vesicles, or scabs.

The doctor may also take skin scrapings for testing.

How is shingles treated?

Specific treatment for shingles will be determined by your health care provider based on:

  • Your age, overall health, and medical history
  • Extent of the condition
  • Your tolerance for specific medications, procedures, or therapies
  • Expectations for the course of the condition
  • Your opinion or preference

There is no cure for shingles. It simply has to run its course. Treatment focuses on pain relief. Painkillers may help relieve some of the pain. Antiviral drugs may help lessen some of the symptoms and minimize nerve damage. Other treatments may include:

  • Bed rest, especially during the early phase of shingles, and if fever is present
  • Creams or lotions to help relieve itching
  • Cool compresses applied to affected skin areas
  • Antiviral medications (such as acyclovir, valacyclovir, and famciclovir)
  • Steroids
  • Antidepressants
  • Anticonvulsants

What are the complications of shingles?

Symptoms of shingles usually don’t  last longer than 3 to 5 weeks. However, complications can occur. The main complications that can result from shingles include:

  • Postherpetic neuralgia (PHN). The most common complication of shingles is called postherpetic neuralgia (PHN). This continuous, chronic pain lasts even after the skin lesions have healed. The pain may be severe in the area where the blisters were present. The affected skin may be very sensitive to heat and cold.
    If you had severe pain during the active rash or have impaired senses, you are at increased risk for PHN. The elderly are also at greater risk. Early treatment of shingles may prevent PHN. Pain relievers and steroid treatment may be used to treat the pain and inflammation. Other treatments include antiviral drugs, antidepressants, anticonvulsants, and topical agents.
  • Bacterial infection. A bacterial infection of the skin where the rash occurs is another complication. Rarely, infections can lead to more problems, such as tissue death and scarring. When an infection occurs near or on the eyes, a corneal infection can occur. This can lead to temporary or permanent blindness.

Can shingles be prevented?

There is a vaccine available to prevent shingles. The vaccine is called Zostavax. It’s advised for healthy adults 50 years of age and older. The vaccine has been found to reduce the number of cases of shingles and the incidence of PHN in older adults.

When should I call my health care provider?

To reduce the severity and shorten the length of the illness, treatment must be started as soon as possible. If you think you have shingles, call your health care provider as soon as possible.

Key points about shingles

  • Shingles is a common viral infection of the nerves. It causes a painful rash or small blisters on an area of skin.
  • Shingles is caused when the chickenpox virus is reactivated.
  • It is more common in people with weakened immune systems, and in people over the age of 50.
  • Shingles starts with skin sensitivity, tingling, itching, and/or pain followed by rash that looks like small, red spots that turn into blisters.
  • The rash is typically affects just one area on one side of the body or face.
  • Treatment that is started as soon as possible helps reduce the severity of the disease.

Next steps

Tips to help you get the most from a visit to your health care provider:

  • Before your visit, write down questions you want answered.
  • Bring someone with you to help you ask questions and remember what your provider tells you.
  • At the visit, write down the names of new medicines, treatments, or tests, and any new instructions your provider gives you.
  • If you have a follow-up appointment, write down the date, time, and purpose for that visit.
  • Know how you can contact your provider if you have questions.


  • Not Your Typical Rash: Why Shingles Can't Be Taken Lightly - 5/31/2012, Mass General

    Anne Louise Oaklander, MD, PhD, associate professor of Neurology, says shingles and post-herpetic neuralgia (PHN), a serious neurological complication in which pain lingers in an area of previous shingles long after the rash heals, cannot be taken lightly. PHN can last for months or years and is a source of severe and disabling pain, particularly for older patients.