How to Recognize Shingles

Is your skin itchy, oozing, or breaking out? Moles, psoriasis, hives, and eczema are just a few of the more than 3,000 skin disorders known to dermatology. Changes in color or texture can result from inflammation, infection, or allergic reactions anywhere on the body. Some skin conditions can be minor, temporary, and easily treated -- while others can be very serious, and even life-threatening.

What Causes Shingles?

Shingles, also known as herpes zoster, is a skin disease caused by the return of a chickenpox infection from latently infected nerve cells in the spinal cord or brain. It begins as a painful sensation which is often mistaken for a musculoskeletal injury or even a heart attack. It is soon followed within one or two days by a red, blistering unilateral (one-sided) rash distributed to the skin supplied by a sensory nerve (a dermatome). Zoster tends to occur most often in the elderly and can be largely prevented or made less severe with a vaccination. 

How Can Shingles Be Treated? 

Treatment with antiviral drugs within 48 – 72 hours of the onset of the eruption may limit the development of persistent, severe pain (neuralgia) at the site of the eruption. It is crucial to detect the onset of shingles early. Severe cases left untreated can cause serious health concerns; if it develops around the eye, shingles can lead to severe eye irritation and possible loss of vision due to herpetic keratitis.  Involvement of the ear can cause imbalance, tinnitus (ringing of the ears) and partial hearing loss. If you start to notice symptoms such as a red blistering rash, seek advice from a medical professional as soon as possible to avoid the worsening and severity of shingles.

What Can Be Mistaken for Shingles?

Shingles are sometimes mistaken as other skin conditions, such as hives, psoriasis, or eczema. The characteristics of a rash can help your doctor or dermatologist determine the root cause (for example, hives are often raised and can look like welts), psoriasis often involves red patches that have white scales throughout the rash). At first, the shingles rash appears as small raised dots on the skin and often develops in a pattern along the nerves of the chest and belly


The only way to be certain about the type of rash you have is to see a doctor or skin specialist. Medical history, examination and the symptoms presenting will be the main indicators for diagnosis and treatment. In many cases, medication can speed the recovery of shingles and are most effective when taken 72 hours following the onset of rash symptoms appearing. 


The best way to work out if a rash is shingles is to see a doctor. In most cases, a doctor can make a diagnosis based on medical history, a physical exam, and symptoms. Anyone who suspects they have shingles should consider seeing their healthcare provider. In some cases, medication is prescribed to speed recovery. Medications are most effective when taken within 72 hours of the rash appearing. 

Is This Preventable? 

Anyone who has ever had chickenpox can get shingles, as herpes zoster, is caused by the same virus responsible for chickenpox: the varicella zoster virus.  Older individuals are more at risk, and for about one in five people, severe pain can continue for months, or even years. It’s not clear why the virus reawakens as we get older, in some people it never reoccurs, but researchers believe that the virus could be triggered as the immune system weakens with age or in conditions of stress. Although some medicines can help treat shingles, there is no cure.


The best preventative measure when it comes to shingles (and its serious complications) is to get vaccinated. If you are over age 50, you should consider getting the shingles vaccine, even if you’ve already had shingles, as it is possible to get this disease more than once. Two vaccines are currently licensed and recommended to prevent shingles in the U.S. These are: Zoster vaccine live (ZVL, Zostavax) has been in use since 2006. The second is the recombinant zoster vaccine (RZV, Shingrix), which has been in use since 2017 and is the preferred shingles vaccine recommended by the Centers for Disease Control and Prevention. Two doses of Shingrix approximately two to six months apart are 90% effective when it comes to the prevention of shingles and is recommended for healthy adults over age 50.

At Idaho Skin Institute, we have seen many patients with onset of shingles, and our staff are skilled in identifying this and all types of skin diseases. Come see us or give us a call to book an appointment if any rash occurs to make sure you treat the symptoms as quickly and effectively as possible. 

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