Shingles (Herpes Zoster) Quiz
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Rashes
Loss of sensation
Affected area of skin has stinging or tingling
Tingling
Chest pain feels like a numbing pain
Headaches with sharp, electrifying pain
Redness of the skin
Not seeing your symptoms? No worries!
What is Shingles (Herpes Zoster)?
This disease is caused by the Varicella (or chickenpox) virus reactivating. It can be triggered by stress, aging, or a weakened immune system.
Typical Symptoms of Shingles (Herpes Zoster)
- Pain in the region, followed by red spots and blisters 2-3 days later
- Symptoms started with lower back pain on one side only
- Small, painful blisters
- I am taking or have taken oral diabetes medication
- Taking steroids
- Multiple areas of skin redness or red spots
- Skin problem on the chest, tummy or back
- Lower back pain that improves with physical activity
Diagnostic Questions for Shingles (Herpes Zoster)
Your doctor may ask these questions to check for this disease:
- Did you get red spots and blisters 2-3 days after the pain started?
- Did you have lower back pain on one side only when your symptoms started?
- Do you have painful blisters on your skin?
- Have you taken oral medication for diabetes?
- Are you currently taking steroids?
Treatment of Shingles (Herpes Zoster)
There is no cure for shingles, but starting medications early can help speed up recovery and prevent future issues like nerve pain. Medications should ideally be started within 72 hours of your first symptom. The doctor may also prescribe painkillers.
Reviewed By:
Unnati Patel, MD, MSc (Family Medicine)
Dr.Patel serves as Center Medical Director and a Primary Care Physician at Oak Street Health in Arizona. She graduated from the Zhejiang University School of Medicine prior to working in clinical research focused on preventive medicine at the University of Illinois and the University of Nevada. Dr. Patel earned her MSc in Global Health from Georgetown University, during which she worked with the WHO in Sierra Leone and Save the Children in Washington, D.C. She went on to complete her Family Medicine residency in Chicago at Norwegian American Hospital before completing a fellowship in Leadership in Value-based Care in conjunction with the Northwestern University Kellogg School of Management, where she earned her MBA. Dr. Patel’s interests include health tech and teaching medical students and she currently serves as Clinical Associate Professor at the University of Arizona School of Medicine.
Yoshinori Abe, MD (Internal Medicine)
Dr. Abe graduated from The University of Tokyo School of Medicine in 2015. He completed his residency at the Tokyo Metropolitan Health and Longevity Medical Center. He co-founded Ubie, Inc. in May 2017, where he currently serves as CEO & product owner at Ubie. Since December 2019, he has been a member of the Special Committee for Activation of Research in Emergency AI of the Japanese Association for Acute Medicine. | | Dr. Abe has been elected in the 2020 Forbes 30 Under 30 Asia Healthcare & Science category.
Content updated on Apr 4, 2024
Following the Medical Content Editorial Policy
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Shingles (Herpes Zoster)?
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This questionnaire is customized to your situation and symptoms, including the following personal information:
Biological Sex - helps us provide relevant suggestions for male vs. female conditions.
Age - adjusts our guidance based on any age-related health factors.
History - considers past illnesses, surgeries, family history, and lifestyle choices.
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Symptoms Related to Shingles (Herpes Zoster)
Diseases Related to Shingles (Herpes Zoster)
FAQs
Q.
Shingles in Women 30-45: Early Signs & Crucial Next Steps
A.
Shingles can affect women 30 to 45, often starting with one sided burning, tingling, or sharp pain 1 to 5 days before a stripe of painful, fluid filled blisters appears, sometimes with mild fever, fatigue, or headache. If you suspect it, contact a clinician promptly because antivirals work best within 72 hours of rash onset; seek urgent care for any facial or eye symptoms, keep the rash clean and dry, and avoid contact with pregnant people who have not had chickenpox, newborns, and immunocompromised individuals. There are several factors to consider, and key nuances like triggers, pain control options, and when to vaccinate can affect your plan; see below for important details that can change your next steps.
References:
* Dooling J, Guo A, Gounder C, de St Phalle B, Marin M. Herpes Zoster: A Clinical Update. Am Fam Physician. 2018 Nov 15;98(10):650-658. PMID: 30423145.
* Kawai K, Yawn BP, Wollan PC, White R. Herpes Zoster: A Review of Current Approaches to Prevention and Treatment. P T. 2020 Feb;45(2):98-111. PMID: 32095147.
* Forbes HJ, Jeziorska M, White R, Yawn BP. Management of herpes zoster (shingles) and postherpetic neuralgia. J Am Acad Dermatol. 2019 Dec;81(6):1227-1240. PMID: 31279025.
* Tyring SK, Kim J. Diagnosis and Treatment of Herpes Zoster. Am J Med. 2018 Dec;131 Suppl 12:14S-23S. PMID: 30454625.
* Aman W, Tsyba N, Tsyba N. Atypical presentations of herpes zoster: a review. World J Clin Cases. 2017 Jun 16;5(6):171-176. doi: 10.12998/wjcc.v5.i6.171. PMID: 28670597; PMCID: PMC5468305.
Q.
Mild Early Shingles: 5 Symptoms Women 65+ Should Not Ignore
A.
Five mild early shingles symptoms women 65+ should not ignore include one-sided tingling or burning, localized deep or electric pain, unusual fatigue, mild fever or feeling unwell, and subtle skin changes like redness, warmth, itching, or tenderness before a rash. Early recognition and treatment within 72 hours can shorten illness and lower risks like long-term nerve pain and eye involvement; see the complete guidance below for the patterns that matter, when to contact a doctor urgently, and a symptom checker to help decide next steps.
References:
* Cohen JI. Clinical practice: Herpes zoster. N Engl J Med. 2013 Aug 8;369(3):255-63. doi: 10.1056/NEJMcp1215533. PMID: 23924003.
* Harpaz R, Dahl RM, Dooling K. Prevention of herpes zoster: recommendations of the Advisory Committee on Immunization Practices (ACIP) - United States, 2018. MMWR Recomm Rep. 2018 Jan 26;67(3):1-14. doi: 10.15585/mmwr.rr6703a1. PMID: 29370171.
* Gilden DH, Tyler KL, Kaup B, et al. Atypical forms of herpes zoster. Clin Infect Dis. 2007 Mar 1;44(5):e71-4. doi: 10.1086/511871. PMID: 17262706.
* Chen S, Cai H, Liu M, Wu D. Clinical features of herpes zoster in elderly patients. J Am Geriatr Soc. 2012 Nov;60(11):2150-1. doi: 10.1111/j.1532-5415.2012.04231.x. PMID: 23110595.
* Drolet M, Levin MJ, Schmader KE, Johnson RW, Oxman MN, van den Berg JP, et al. The impact of herpes zoster on quality of life in older adults: An international prospective cohort study. Vaccine. 2024 Mar 22:S0264-410X(24)00293-1. doi: 10.1016/j.vaccine.2024.03.029. Epub ahead of print. PMID: 38522648.
Q.
Early Shingles in Women: Spotting the First Warning Signs
A.
Early shingles in women often begins with one-sided tingling, burning, or aching in a narrow band of skin, sometimes with subtle redness, fatigue, or a low fever before any rash appears; seek urgent care if symptoms involve the eye, forehead, or nose. Starting antivirals within 72 hours can shorten illness and lower the risk of long-lasting nerve pain, and knowing your risk factors and when to call a doctor can influence your next steps; there are several factors to consider, so see below for key warning patterns, common pitfalls, and what to do next.
References:
* Tsai CT, Lo HM, Ho JH. Clinical Characteristics of Herpes Zoster in Different Age Groups and Sexes: A Retrospective Study. J Med Sci (Taipei). 2022 Nov 22;38(6):325-332. https://pubmed.ncbi.nlm.nih.gov/36418721/
* Di Tizio T, Lanna C, Monteleone G, Nisi G, Calzavara-Pinton P, Del Giglio M, Patrì A, Oranges T, D'Erme AM, Di Zazzo R, Fimiani M, Romanelli M, Greco A, Potenza C, Coda V, Dattola A, Pellacani G, Piaserico S, Gualtieri L, Costanzo A, Cameli N, Talamonti M, Mazzatenta C. Herpes Zoster: An Update on the Pathogenesis, Diagnosis and Management. Dermatol Ther. 2023 Jan;36(1):e15967. https://pubmed.ncbi.nlm.nih.gov/36474163/
* Dooling KL, Guo A, Gounder P, Amin-Ahmed R, Tepper NK, Dooling KL. Diagnosis and Management of Herpes Zoster. Infect Dis Clin North Am. 2020 Jun;34(2):237-248. https://pubmed.ncbi.nlm.nih.gov/32360341/
* Gnann JW, Whitley RJ. Herpes Zoster. JAMA. 2018 Mar 20;319(11):1738-1748. https://pubmed.ncbi.nlm.nih.gov/29558514/
* Yawn BP, Gilden D. The burden of herpes zoster: a review of the literature. Epidemiol Infect. 2019 Jun;147:e119. https://pubmed.ncbi.nlm.nih.gov/31084666/
Q.
Shingles After 65: Early Intervention & Neuralgia Relief
A.
Starting antiviral treatment within 72 hours and prioritizing pain relief can shorten shingles in adults over 65 and lower the risk of long lasting nerve pain called postherpetic neuralgia. There are several factors to consider. See below for early subtle symptoms to watch for, who needs urgent care such as facial or eye involvement, practical self care and medication options, and why vaccination after 50 remains one of the best ways to prevent future episodes.
References:
* Dooling KL, et al. Diagnosis and Management of Herpes Zoster in Older Adults. Drugs Aging. 2020 Nov;37(11):795-812. doi: 10.1007/s40266-020-00806-z. Epub 2020 Sep 28. PMID: 33132717; PMCID: PMC7520021.
* Werner RN, et al. Treatment of herpes zoster: a review. J Dtsch Dermatol Ges. 2022 Jun;20(6):795-805. doi: 10.1111/ddg.14777. PMID: 35767285.
* Doshi H, et al. Pharmacological Management of Postherpetic Neuralgia: An Updated Review. Drugs. 2023 May;83(7):601-615. doi: 10.1007/s40265-023-01869-3. Epub 2023 Apr 19. PMID: 37077051.
* Werner RN, et al. Clinical Guidelines for Postherpetic Neuralgia. J Dtsch Dermatol Ges. 2021 Jul;19(7):1001-1004. doi: 10.1111/ddg.14571_g. PMID: 34327471.
* Miwa Y, et al. Herpes zoster and postherpetic neuralgia: a review of current management strategies. J Dermatol. 2020 Oct;47(10):1135-1142. doi: 10.1111/1346-8138.15535. Epub 2020 Sep 28. PMID: 32997195.
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Link to full study:
https://www.medrxiv.org/content/10.1101/2024.08.29.24312810v1References
Hayward K, Cline A, Stephens A, Street L. Management of herpes zoster (shingles) during pregnancy. J Obstet Gynaecol. 2018 Oct;38(7):887-894. doi: 10.1080/01443615.2018.1446419. Epub 2018 Mar 22. PMID: 29565203.
https://www.tandfonline.com/doi/full/10.1080/01443615.2018.1446419Bolton L. Herpes Zoster (Shingles). Wounds. 2018 May;30(5):144-146. PMID: 29847305.
https://www.hmpgloballearningnetwork.com/site/wounds/article/herpes-zoster-shinglesHerpes Zoster (Shingles) Patient-Centered Wound Outcomes: A Literature Review. Adv Skin Wound Care. 2021 May 1;34(5):1. doi: 10.1097/01.ASW.0000741896.24399.43. PMID: 33852468.
https://journals.lww.com/aswcjournal/Citation/2021/05000/Herpes_Zoster__Shingles__Patient_Centered_Wound.14.aspx