Shingles (Varicella Zoster) is a painful patch of sores that can appear anywhere on your body. The sores can itch and look very much like chicken pox, (because they are – see below)! They can also look and feel very much like “cold sores”. They are usually limited to one side of the body, can extend from the back around to the front, and rarely cover an area more than 6 inches from top to bottom. There can sometimes be a low grade fever with this as well.

The chicken pox virus (varicella) is in the herpes family – and like all herpes viruses once you get it it LIVES INSIDE YOU for the rest of your life. Shingles is from the virus that has been dormant inside you since you had chicken pox “re-activating” (waking up) and reproducing (making new copies of itself) which need to get out of your body somehow (to go infect new people and make a life of their own) – thus the sores. Shingles is NOT re-exposure.

Shingles is self limited, and will resolve within a few weeks with no treatment. Shingles (like herpes cold sores) can recur repeatedly over your lifespan… most often in the same location on your body. While early treatment with antivirals (Acyclovir) can reduce the severity and the duration of the symptoms, treatment vs. no treatment has no impact on long term health or outcome. In people with seriously compromized immune systems (e.g. on chemotherapy, with advanced AIDS, or post-transplant) Shingles can sometimes spread to involve the entire body and even become life threatening itself, although this is very rare.

While the varicella virus can reactivate and give you shingles at any age, the older you get the more commonly this happens – therefore the most common scenario is for someone to get chicken pox as a child, have the virus lay dormant inside them for half a century or more, and THEN reactivate as shingles one or several times prior to the end of life. When shingles happens in a child or young adult, it is often because their immune system is weakened in some way – either through other illness, malnutrition, inadequate rest, or emotional stress. So, when I see shingles in my patient population (kids) my first concern is not whether or not to give Acyclovir, but rather “What else is going on right now that set them up for this at this time?” Sometimes there is no answer to that (just an unusual coincidence)… but it’s worth thinking about and looking for underlying problems.