Aging & Health A to Z

Shingles

Causes & Symptoms

You probably had chickenpox as a young child in primary school or earlier. The fever, blisters, and itching lasted for a week or so, depending on how serious your case was. Once the blisters dried, you were no longer considered contagious and were allowed to return to school. Now we know that the varicella zoster virus that causes chickenpox never completely leaves your body, even after you return to perfect health. The virus goes undercover, hiding in within the nerves beside your spinal cord. Years later, the virus particles can reactivate. They move outward along the nerve fibers until they reach the skin, at which point they cause the painful rash we call shingles.

Location of the rash: The shingles rash covers only a small area on your body, and is always confined to one side. The lines of blisters follow the nerve fibers that grow outward from the spinal nerve roots under the skin.

• If the virus particles were hiding dormant in an area near the top part of your spinal cord, you may get blisters on your neck, face, head, mouth, eyes, or ears as they spread along the facial nerves.
• If they were dormant somewhere in the middle of your back, your rash will probably form a narrow “belt”-like band that starts at the spine and comes around one side of your body to the front of the chest or abdomen. This is the most likely area for the rash to appear.
• Viruses that took refuge towards the bottom of your back may migrate down the nerves of your legs and into your feet, causing patterns of blisters in those areas of your body.

Risk Factors

Only people who have had chickenpox at some earlier time in their life may develop shingles. Scientists do not yet understand why the viruses become active again after many years, but the following factors are known to increase your risk of developing the condition:

• older age, especially older than 60 years – the older you are, the higher the risk. This is the primary risk factor.
• a weakened immune system – resulting from cancer treatment (chemotherapy or radiation), infection with HIV, long-term steroid medications, or treatment to prevent rejection of an organ transplant
• extreme stress – even a single stressful life event can weaken your immune system
• physical stress – such as a cold or sunburn
• your chickenpox infection occurred before you were one year old.

Symptoms and Warning Signs

The first symptom is usually:

• pain, tingling, burning, or itching on one side of the body, without rash at first. These sensations may be intensely painful and unpleasant.  In rare cases, this pain is the only symptom and the rash never develops.

This symptom is followed by:

• red patches on the skin
• fluid-filled blisters in the area of the red patches.

Other symptoms that you may notice include:

• stomach pain
• fever and/or chills
• generally sick feeling and “achiness”
• fatigue.
• headache
• swollen glands in various parts of your body (lymph nodes)
• joint pain
• muscle weakness
• genital lesions (sores).

If your shingles occurs on your face or near your eyes or ears, serious symptoms may occur such as:

• difficulty moving some face muscles
• drooping eyelid
• loss of eye movement
• problems with vision
• hearing loss
• problems with taste or changes in tasting.

Updated: March 2012
Posted:  March 2012