What is Shingles (Herpes Zoster)?

Shingles (herpes zoster) occurs when the varicella zoster virus, which can remain dormant after chickenpox, becomes active again. It typically causes painful, blistering skin changes in a single nerve distribution and may involve nerve inflammation. This page reviews common symptoms, risk factors, how shingles is diagnosed, which specialists to consult, and when urgent assessment is warranted.

Quick overview

After an initial chickenpox infection the varicella zoster virus can lie dormant in nerve roots. When it reactivates, it usually produces a painful, blistering rash that follows a single dermatome (a nerve’s skin distribution). Severity and extent vary between people.

Typical symptoms and course

Early signs often include burning, tingling or sharp pain in a localized area, followed by red patches and clusters of blisters. Blisters commonly crust over within days. Some people also have fever, headache or fatigue. In some cases, pain can continue after the rash heals (postherpetic neuralgia), lasting weeks to months.

Causes, risk factors and possible complications

Shingles results from reactivation of varicella zoster virus. Risk increases with older age, weakened immune defenses, chronic illness, and certain medical treatments that affect immunity. Complications, while uncommon, can include persistent nerve pain, eye involvement (which may threaten vision), and facial nerve problems. People with weakened immune systems may have more severe or widespread disease.

Diagnosis and which specialist to consult

Diagnosis is most often clinical, based on the appearance and pattern of the rash. Laboratory tests such as PCR on lesion samples can confirm the virus in unclear cases. For initial care, contact Primary Care (family medicine) or Dermatology and Venereal Diseases. If the eye is involved, see Ophthalmology; if there are neurological signs or severe neuropathic pain, Neurology may be needed. Complex infections or cases in immunocompromised people may require Infectious Diseases and Clinical Microbiology input.

Prevention, follow-up and urgent warning signs

There are preventive options that reduce the risk of shingles or its complications—discuss these with your healthcare provider. Follow-up care may be needed for persistent pain or complications. Seek urgent medical assessment if you develop vision changes or eye pain, rash affecting a large area of the face, high fever with confusion, or rapidly spreading rash especially if you have a weakened immune system.

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