What You Need to Know about Shingles

By Rainier Dennis D. Bautista, MD

As a primary care physician, I have seen numerous cases of shingles, and have seen first hand the debilitating effects of this disease on patients’ physical and emotional wellbeing.

Shingles or Herpes Zoster is a disease of the skin and the nerves caused by the varicella-zoster virus, which is the same virus that causes chickenpox. After a person has chickenpox, usually during childhood, the virus remains dormant in their nerve tissue which can become active again in times of stress or when the patient’s immune system becomes weakened, thus causing shingles.

Shingles typically cause a painful rash that appears as a band or patch on only one side of the body or face. The rash starts as a small area of red spots that evolve into fluid filled blisters after several days. These blisters eventually grow and fill with more fluid and may merge together to form larger blisters. After some time, these blisters break open leaving behind small ulcers, which will begin to dry out and form scabs. The scabs then fall off, revealing new skin underneath. This process usually lasts for two to four weeks and can be accompanied by other symptoms such as fever, headache, malaise and fatigue.

The treatment of shingles involves antiviral medication, such as acyclovir, valacyclovir, or famciclovir. These medications can help to reduce the severity and duration of the rash, pain, as well as the risk of complications. Pain relievers, such as acetaminophen or ibuprofen, may also be used to manage the pain. In addition to medication, there are other things that can be done to manage the symptoms of shingles. For example, applying a cool, damp cloth to the rash can help to reduce itching and discomfort. It is also important to get plenty of rest and to avoid stress, as stress can make the symptoms of shingles worse.

A common complication of shingles is Postherpetic Neuralgia, which is a type of pain that persists even after the rash has healed. This pain can last for days or even months. Next, patients who have the rash near their eye are at risk for vision loss. Lastly, patients who have shingles affecting their face and ear might suffer from paralysis of the affected side of the face, in a condition called Ramsay Hunt Syndrome. Patients who suffer from these might need additional medications as well as consultation with specialists.

The best way to prevent shingles is to get vaccinated. The shingles vaccine is recommended for adults over the age of 50, and it is highly effective at preventing shingles and its complications, and consists of two doses taken 2 to 6 months apart.

In addition to vaccination, maintaining a healthy lifestyle can also help to prevent shingles. This includes getting enough sleep, exercising regularly, and eating a balanced diet. Quitting smoking and limiting alcohol consumption can also help to boost the immune system and reduce the risk of shingles.

It is important to note that shingles is not contagious, but the varicella-zoster virus can be spread to people who have not had chickenpox or the vaccine, causing them to develop chickenpox. Therefore, it is recommended that people with shingles avoid contact with infants, pregnant women, and people with weakened immune systems. In conclusion, shingles is a painful and uncomfortable condition caused by the varicella-zoster virus. Although it can be treated with antiviral medication and other measures, prevention through vaccination and a healthy lifestyle is the best approach. If you suspect you have shingles, it is important to seek medical attention promptly to reduce the risk of complications. is a board-certified Family Medicine Physician, and a Fellow of the American Academy of Family Physicians. He is currently practicing at the Primary Care Clinic of Hawaii in Honolulu, Oahu and in Lihue, Kauai.