Shingles, also known as herpes zoster, is a painful skin condition that occurs due to the reactivation of the virus that causes chickenpox. It is most often recognized by a blister-like skin rash that appears in specific patterns on the body. Symptoms of this rash can include pain, burning, itchiness, and tingling. Patients with recurrent bouts of shingles might be able to recognize some symptoms before the skin lesions appear. Others experience prolonged pain at the site of the skin lesions for months or years.
The most obvious of the symptoms of shingles is the skin rash that it causes. Affected patients have eruptions of raised, pus-filled lesions. This rash can be red and painful. Initially the rash resembles blisters, but after these lesions burst the underlying area becomes crusted with a yellowish scab.
Rashes associated with shingles often appear in a certain pattern on the skin. They are said to have a dermatomal pattern, which means that they affect an area of the skin that gets its sensation from one specific nerve. This distribution occurs because shingles represents a reactivation of the varicella-zoster virus that had been lying dormant in the root of the nerve. The dermatomal pattern of shingles often only affects a strip of skin on one side of the body. Although the most common location is on the lateral or posterior chest wall, any area of the body could theoretically be affected.
Other symptoms of shingles involve the pain and discomfort associated with the rash. The pain can be sharp, tingling, or burning in nature. Some patients develop a symptom called allodynia, which is feeling severe pain after lightly touching the rash. The pain felt by the patient is significantly out of proportion to the stimulus that triggered it. Other patients experience itchiness at the site of the rash, and if they scratch enough that the underlying skin is broken they can put themselves at risk for bacterial infection.
Patients with shingles tend to have recurrent episodes of this condition. The blisters typically resolve after a couple of weeks, but can crop up again in months or years. Some patients are able to identify when they are going to have a recurrence of shingles because they feel symptoms such as tingling and burning of the skin before any blisters are seen. Identifying these symptoms as early as possible can help these patients get the best treatment for their shingles attack.
Some patients have symptoms of shingles even after the blisters resolve, a condition known as "post-herpetic neuralgia." They continue to have pain for months after the rash resolves. Symptoms can include tingling, numbness, burning pain, or the sensation that their skin is crawling.