Shingles Picture Slideshow: A Collection of Photos

Varicella zoster virus magnified 500x (left) causes the childhood skin disease chickenpox (right).

Dormant Varicella zoster virus (chickenpox) can cause shingles.

Shingles most commonly occurs in people over the age of 60.

Small blisters form during the initial stage of shingles (left followed by a full skin rash resembling chickenpox lesions (right).

Shingles blisters eventually burst and begin to crust over.

Shingles can be spread to people who have not had chickenpox.

A dangerous complication of shingles infecting the eye.

There is no cure for shingles, but some treatments can reduce the severity and duration of the rash.

In 2006, the FDA approved the first vaccine for adult shingles.

What is shingles?

Shingles (herpes zoster virus) is an extremely painful viral infection of the nerve roots resulting in a skin rash caused by the same virus that causes the childhood illness chickenpox. The reactivated virus responsible for these conditions is called the Varicella zoster virus (VZV).

How is shingles caused?

After an individual has chickenpox, the virus lives in the nervous system where it "sleeps" (is dormant) in the nerve roots. In some people, it remains dormant forever. In others, a weakened immune system can cause the virus to "wake up," reproduce, and travel along the path of the nerve fiber to the skin's surface, resulting in shingles. If the virus becomes active again, it can only cause shingles, not chickenpox.

Illustration of dormant Varicella virus reawakened causing shingles.

Who is at risk for shingles?

Anyone who has ever had chickenpox is at risk for the development of shingles, although it occurs most commonly in people over the age of 60. Weakened immune systems, emotional stress, immune deficiency (from AIDS or chemotherapy), or cancer can cause the virus to reactivate. It has been estimated that up to 500,000 cases of shingles occur each year in the U.S.

What does the shingles rash look like?

Pain, itching, tingling, or burning of the skin are symptoms of shingles that often precede an outbreak. Shingles starts as small blisters on a red base with new blisters continuing to form for three to five days. The painful rash resembles the lesions of chickenpox and is usually localized to a concentrated area. If you think you have shingles, you should see a doctor as soon as possible.

Initial stage of blisters (left) preceding and outbreak of shingles rash (right).

Is shingles contagious?

Yes, shingles is contagious. It can be spread from an infected person to anyone who hasn't had chickenpox as long as there are new blisters forming and old blisters healing. But instead of developing shingles, these people develop chickenpox. Once they've had chickenpox, people cannot catch shingles from someone else. They do, however, have the potential to develop shingles later in life.

What are complications from shingles?

Generally, shingles heals well, resulting in few problems. However, on occasion, blisters can become infected and are usually treated with antibiotics. The most common complication of shingles is postherpetic neuralgia, where damaged nerves cause pain to persist even after the rash is gone. A more worrisome complication is when shingles affects the face (forehead and nose), which may spread to the eye and lead to loss of vision.

Are there any treatments for shingles?

There is no cure for shingles, but treatment may help you get well sooner and prevent other problems. Bathing is permitted, and the affected area can be cleansed with soap and water. Cool compresses and anti-itching lotions (calamine lotion) may also provide relief. Steroids, antiviral medicines, and pain medicines can also help ease recovery. Most people with intact immune systems recover completely from shingles although recurrences are possible.

Is there a shingles vaccine?

In 2006, the FDA approved the first vaccine for adult shingles. The vaccine, Zostavax, is approved for adults over 60 who have had chickenpox. It contains a booster dose of the chickenpox vaccine usually given to children. The single-dose vaccine is more than 60% effective in reducing shingles symptoms, and it reduces the incidence of postherpetic neuralgia by at least two-thirds. Studies are ongoing to evaluate the long-term effectiveness of the vaccine.