The Usual and Unusual Symptoms of Shingles

Shingles is quite common. In fact, one in three people in the U.S. will develop the shingles infection in their lifetime, according to the Centers for Disease Control and Prevention. Symptoms can vary from mild annoyances to a widespread blistery and painful rash.

"Shingles is caused by a reactivation of the virus that causes chickenpox," explains Rhoda Chang, MD, a primary care physician with WakeMed Health & Hospitals in Raleigh, N.C.

The varicella-zoster virus (VZV) gives rise to chickenpox and shingles infections, says the CDC. Usually, shingles develops in people who have had chickenpox earlier in their life, but this is not always the case.

"There have been reported cases of shingles in the younger population who have had the chickenpox vaccine," says Dr. Chang. "It is possible to get shingles even if you have had the vaccination."

Some people are at a higher risk for shingles. "People over the age of 50 or people who have a medical issue that compromises the immune system are more likely to get shingles," says Dr. Chang. "Those who have had recent transplants are at risk as well."

A rash is the distinctive mark of shingles. "When the rash occurs, it is often in one area and side of the body," says Dr. Chang. "People tend to get the rash on their face or trunk. It doesn't commonly occur on the arms or legs."

"The rash tends to be kind of pink with small blisters, and it's usually painful," she says. "The pain of the rash is a giveaway that it's shingles. Rashes that aren't shingles can be bumps and itchy spots in all different places."

Less common symptoms include fever, headache, sensitivity to light, sore throat and fatigue, according to the Mayo Clinic. Sometimes you can feel strange sensations, too. "Some people will notice that, before the rash arises, they feel an uncomfortable, tingly sensation in the area where the rash will come out," says Dr. Chang.

People sometimes wonder whether you can have a cough related to the shingles virus, and whether shingles causes pneumonia. Research has found a relationship between these conditions.

For instance, a case study discussed in the Canadian Medical Association Journal in November 2012 noted that 5 to 15 percent of adults who contract chickenpox end up with a condition involving their lungs, like pneumonia. Cough, shortness of breath are typical symptoms of this complication, the journal article states. If you develop such symptoms, call your doctor right away.

Read more: What Foods to Avoid During a Shingles Outbreak

Shingles can be an uncomfortable and often painful infection, making prevention all the more important. "In terms of prevention, there is a vaccination to prevent shingles which we recommend as primary care providers," says Dr. Chang.

Shingles cannot be passed from one person to another, but the virus can be. VZV can be spread in the window of time that the blistery rash is present, according to the CDC. You aren't infectious before the blisters form or after they crust over.

To prevent VZV from spreading to others, the CDC encourages people with the infection to cover the affected areas, avoid touching or scratching the rash and wash their hands often.

Read more: Things to Eat When You Have a Virus

"Early identification is key," says Dr. Chang. "Recognizing shingles within the first 48 hours after you see the rash is important because that's when medication for treatment is most effective."

Antiviral medicines like acyclovir, valacyclovir and famciclovir are used to treat shingles, says the CDC. Dosing may vary, but people typically take these medicines for at least seven days. Over-the-counter pain medications, like acetaminophen and ibuprofen, can help ease your discomfort, says the American Academy of Dermatology (AAD), and if the pain severe, your doctor may medicine to reduce the inflammation, such as a corticosteroid.

"Shingles is [usually] not life-threatening," says Dr. Chang. "The reason why it can be a problem is that it can cause a lot of nerve inflammation and damage. Long-term nerve pain is the biggest complication from shingles." About 10 to 18 percent of people who get shingles experience this nerve pain, according to the CDC.