What Causes Shingles?

There is a viral infection that causes those who have it to develop a painful rash. It is known as shingles. This rash can develop in any place on a person’s body. It often appears to be a single stripe of blisters. The rash could wrap itself around the left or right side of a person’s torso.

Why is Shingles Painful?

This is a result of having the varicella-zoster virus (VZV). Having VZV is not a life-threatening situation. It is an extremely painful condition. Certain vaccines can decrease the risk of VZV. When a person gets early treatment, it may help decrease an infection. It may also decrease the chance for complications to occur. One of the common complications people experience is postherpetic neuralgia. This causes a person to experience pain a long time after their blisters have healed.


There are symptoms and signs of VZV that will affect a small section of a person’s body.

  • Itching
  • Tingling, pain, numbness, or a burning sensation
  • Blisters that are fluid-filled and will break open then crust over
  • A few days after the pain a red rash begins
  • Fatigue
  • Fever
  • Sensitivity to light
  • Headache


VZV is the same virus responsible for chickenpox. Once a person has had chickenpox, the virus will be inactive for many years and found in the nerve tissue near their brain and spinal cord. Not everyone who has had chickenpox will develop this condition. According to the CDC, approximately 99 percent of individuals in the United States who were born prior to 1980 have had chickenpox. When someone has a weakened immune system, it enables the virus in their body to reactivate.


This is something associated with a person’s immune system not being strong. As a person ages, they are more likely to experience certain things that weaken their immune system.

  • Medical procedures that involve using immunosuppressants medication when completed. This could involve a kidney transplant, bone marrow transplant, and more.
  • Decline in immunity that is age-related
  • Treatment of autoimmune diseases with immunosuppressants. This involves lupus, rheumatoid arthritis, Crohn’s disease, and others.
  • Using immunosuppressant medication, such as anti-inflammatory medication, chemotherapy, as well as long-term corticosteroids, and more
  • Experiencing conditions or diseases that attack a person’s immune system. This could involve hypogammaglobulinemia, HIV, and others.


An individual with VZV can pass the virus on to another person who does not have immunity to chickenpox. This can happen if someone comes in direct contact with the open sores associated with the rash. Once an individual is infected, they will develop chickenpox. They may not have VZV.


When a person believes they have VZV, their physician will ask specific questions. They will want to know when the symptoms started. If they’ve had the VZV vaccine and when they first noticed the rash. If they had the chickenpox vaccine, if they are in pain, and where the pain is located. They will evaluate a rash based on its location, pattern as well as appearance. If the diagnosis isn’t clear to a physician, they may perform a VZV test. This involves taking a sample of the lesion with a swab for testing.


When a person has VZV on their face, it can result in serious complications. This includes brain swelling, blindness as well as hearing impairment. Should a person believe they have VZV on their face, they should see their physician immediately.

Antiviral Medication

VZV can not be cured. It can get better on its own. Certain medications are used to treat this condition and provide pain relief. Antiviral medication will speed a person’s recovery, decrease their risk of complications, and lower the severity of a person’s VZV symptoms. Individuals who are over 50 or have a weak immune system have benefited the most from taking antivirals. They should be used within 72 hours of the first symptom. The most common antivirals used are acyclovir, valacyclovir, and famciclovir.

Pain Medication

If the pain is mild, over-the-counter (OTC) anti-inflammatory medication can be effective. This includes acetaminophen and ibuprofen. Weak opioids such as tramadol or codeine may also be used. In some cases, stronger prescription opioid pain medication may be necessary. Hydrocodone is often used in cases involving moderate to severe pain.

Shingles cream

Topical pain relievers involving soothing shingles cream can be placed directly on the skin. Lidocaine is a common shingles cream. Soothing shingles cream also comes in the form of a patch, spray, capsaicin, or gel. Other types of shingles cream could involve calamine lotion for itchiness, diphenhydramine, and hydroxyzine.

Shingles Vaccines

In 2006, the only VZV vaccine available for older people was Zostavax. In 2017, a new vaccine was approved called Shingrix. According to the CDC, Shingrix is believed to be more than 90 percent effective. A person is given two doses of Shingrix. They are administered two months apart. This is given to people who already had shingles or don’t know if they had chickenpox as a child. For individuals who are 50 or older, and get the vaccine, their risk of getting VZV decreases by approximately 50 percent. A person can have pain from the rash for several months or even years once it has crusted over. When this happens, it is known as postherpetic neuralgia (PHN). It is a complication of VZV, and the pain people experience from it can be incapacitating. A person getting VZV more than once is extremely rare.


A person needs to contact their physician if they believe they may have VZV. It is extremely important in certain situations.

  • The rash is painful and widespread
  • The painful rash is located near an eye. If not quickly treated, it could result in an infection that causes permanent eye damage.
  • A person or someone close to them has a weakened immune system.
  • A person is 60 years old or older. People at this age are susceptible to complications.

When VZV reactivates, it can result in a painful blistering rash. Individuals who have a weakened immune system or are at risk of having a weakened immune system are at a higher risk of getting an infection. Most cases of VZV are easily treatable. Most adults in the United States have had chickenpox. If VZV is something a person is experiencing, they may want to consider speaking with a pain management specialist.