Shingles (herpes zoster) are an outbreak of rash or blisters on the skin that is caused by the same virus that causes chicken pox - the varicella-zoster virus. The first sign of shingles is often burning or tingling pain, or sometimes numbness, in or under the skin.

You may also feel ill with fever, chills, headache, or upset stomach. After several days, a rash of small fluid-filled blisters, reminiscent of chickenpox, appears on reddened skin. The pain associated with shingles can be intense and is often described as "unrelenting."

Anyone who has had chickenpox is at risk for shingles. Scientists think that in the original battle with varicella-zoster, some of the virus particles leave the skin blisters and move into the nervous system.

When the varicella-zoster virus reactivates, the virus moves back down the long nerve fibers that extend from the sensory cell bodies to the skin and cause the characteristic blisters of shingles .

Treatment for Shingles

The severity and duration of an attack of shingles can be significantly reduced by immediate treatment with antiviral drugs, which include acyclovir, valcyclovir, or famcyclovir.

Antiviral drugs may also help stave off the painful after-effects of shingles known as postherpetic neuralgia. Other treatments for postherpetic neuralgia include steroids, antidepressants, anticonvulsants, and topical agents.

Prognosis for Shingles

For most people, the lesions heal, the pain subsides within 3 to 5 weeks, and the blisters leave no scars. However, shingles is a serious threat in immunosuppressed individuals — for example, those with HIV infection or who are receiving cancer treatments that can weaken their immune systems.

People who receive organ transplants are also vulnerable to shingles because they are given drugs that suppress the immune system.

Research on Shingles

Adenosine monophosphate (AMP), a compound that occurs naturally in the body, has been found to be effective against shingles outbreaks. In one double-blind trial, people with an outbreak of shingles were given injections of either 100 mg of AMP or placebo three times a week for four weeks.

Compared with the placebo, AMP promoted faster healing and reduced the duration of pain of the shingles. In addition, AMP appeared to prevent the development of postherpetic neuralgia.

Reference for Shingles Article

Bernstein JE, Korman NJ, Bickers DR, et al. Topical capsaicin treatment of chronic postherpetic neuralgia. J Am Acad Dermatol 1989;21:265–70.

Sklar SH, Blue WT, Alexander EJ, et al. Herpes zoster. The treatment and prevention of neuralgia with adenosine monophosphate. JAMA 1985;253:1427–30.

Sklar SH, Wigand JS. Herpes zoster. Br J Dermatol 1981;104:351–2.

National Institutes of Health