Shingles Distribution on the Skin

Shingles is a condition characterized by painful blisters that typically appear in a linear distribution on the skin following nerve pathways. Shingles is caused by reactivation of a previous infection with the varicella-zoster virus. Shingles is a herpes virus infection (herpes zoster) that usually affects a nerve, causing pain in one area of the body. Infection of the ganglia of the posterior roots of the spinal nerves or the fifth cranial nerve by the varcella-zoster virus (shingles), which also causes chicken pox; it is marked by a painful eruption of vesicles usually on one side of the body along the course of one or more cutaneous nerves.

Shingles is derived from the Latin and French words for belt or girdle, reflecting distribution of the rash in a broad band. This band is usually only on one side of the body and represents a dermatome—the area that a single sensory nerve supplies in the skin.

Today's treatments provide a variety of ways to shorten the duration of a shingles outbreak and to control the associated pain. Sometimes, however, shingles leads to a chronic painful condition called post-herpetic neuralgia (PHN) that can be difficult to treat. Putting a medicated lotion (two brand names: Benadryl, Caladryl) on the blisters might reduce the pain and itching. Putting cool compresses soaked in an astringent liquid (two brand names: Bluboro, Domeboro) on the blisters and sores might make them hurt or itch less.

The first sign of shingles is often burning or tingling pain, or sometimes numbness or itch, in one particular location on only one side of the body. After several days or a week, a rash of fluid-filled blisters, similar to chickenpox, appears in one area on one side of the body. Shingles pain can be mild or intense. Some people have mostly itching; some feel pain from the gentlest touch or breeze. The most common location for shingles is a band, called a dermatome, spanning one side of the trunk around the waistline.

Yes, shingles is contagious. Shingles can be spread from an affected person to children or adults who have not had chickenpox. Instead of developing shingles, these people develop chickenpox. Once they have had chickenpox, people cannot catch shingles (or contract the virus) from someone else. Once infected, however, people have the potential to develop shingles later in life.

Doctors can distinguish shingles from chickenpox (or dermatitis or poison ivy) by the way the spots are distributed. Since shingles occurs in an area of the skin that is supplied by sensory fibers of a single nerve--called a dermatome--the rash usually appears in a well-defined band on one side of the body, typically the torso; or on one side of the face, around the nose and eyes. (Shingles' peculiar name derives from the Latin cingulum, which means girdle or belt.) If a diagnosis is in doubt, lab tests can confirm the presence of the virus.

To help with the pain of shingles, your doctor might have you take an over-the-counter pain medicine like acetaminophen (one brand name: Tylenol) or ibuprofen (one brand name: Motrin). Aspirin is not recommended because using it might cause a liver problem called Reye's syndrome.

Vaccines can help reduce the risk of shingles, while early treatment can help shorten a shingles infection and minimize the chance of complications. If shingles causes severe pain, your doctor might have you take a prescription pain medicine.

Good home care can help you feel better faster. Take care of any skin sores, and keep them clean. Take your medicines as directed. And use over-the-counter pain medicines to relieve pain.

Avoid contact with people until the rash heals. While you have shingles, you can spread chickenpox to people who have never had chickenpox. Be extra careful to avoid people with weak immune systems and pregnant women and babies who have never had chickenpox.