DOCTOR TO PATIENT

A Painful Rash -- Is It Shingles?

Medical Author: Melissa Conrad Stöppler, MDMedical Editor: William C. Shiel Jr., MD, FACP, FACR
Shingles (Herpes zoster) is an extremely painful skin rash caused by the Varicella zoster virus, the same virus that causes chickenpox. In people who have had chickenpox, the virus is never fully cleared from the body; instead, it remains dormant in the nerve tissues. When physical or emotional stresses to the body weaken the immune system, the virus re-activates and spreads along the nerve fibers to the particular area of skin supplied by the involved nerve (called a dermatome). The virus responsible for chickenpox and shingles is a member of the Herpesviruses, although it is not the same as the Herpes simplex 1 and 2 viruses that cause cold sores and genital herpes, respectively.
Pain, itching, tingling, or burning of the skin are symptoms of shingles that often precede the rash in an outbreak. The blisters that develop resemble the lesions of chickenpox but are concentrated in the area supplied by the involved nerve. Rarely, more than one nerve is involved. Blisters may occur along the entire path of the nerve or only in certain areas supplied by the nerve. As with the blisters of chickenpox, the blisters in shingles eventually burst and begin to crust over and heal. The entire outbreak can last for three to four weeks.