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Shingles, also known as herpes zoster, is a viral disease caused by the same virus that causes chickenpox known as varicella-zoster virus (VZV). It normally affects a single sensory nerve ganglion and the skin surface that the nerve supplies. 

Chickenpox caused by this virus is highly contagious, affecting normally children and young adults. It produces a large rash of itchy blisters, which typically affects the back and the chest and can spread over the entire body. 

Even after recovery from this disease, this virus stays for many years in some of the nerve cells. Reactivation of these viruses causes shingles, showing almost similar symptoms as shown in chickenpox. The only difference is the rashes that appear in shingles occur only on one side of the body, usually on the face or torso. It is not for everyone, who previously suffered from chickenpox, would suffer shingles. As per the Centers for Disease Control and Prevention (CDC), 1 in every 3 people in the United States develop shingles during their lifetime and around 1 million cases are reported in the U.S. every year. 

Causes 

The main cause of this disease is chickenpox. A virus causing chickenpox in an individual live for years in an inactive form in some of the sensory nerve cells. 

Shingles occur when this virus reactive later in life. Therefore, only people who have had chickenpox can develop shingles. Although the reason for virus inactivation is unclear, some of the possible reasons include emotional stress, use of certain medications, acute or chronic illness, re-exposure to VZV or cancer. 

Sign and Symptoms

Many different signs and symptoms have been observed in people suffering from shingles. The most commonly seen among them are: 

• Burning or severe tingling sensations and itching on one side of the body, which lead to rashes with few days to a week.
• Skin discoloration on face, torso, or neck
• Blisters filled with fluids, which leaked at times.
• Severe pain to the touch
• Fever, headaches, chills
• Upset stomach
• Some of the serious symptoms include:
• Temporary or permanent vision loss
• Blisters in or around the eyes
• Hearing loss or balance problems
• Vasculopathy- inflammation of the blood vessels
• Ramsay Hunt syndrome- a rash appears on the ear or mouth and muscle weakness in one side of the face
• Meningitis- an infection of the membranes lining the brain and spinal cord
• Post-herpetic neuralgia- long-lasting pain in the affected area

Risk factors

• Chickenpox- Anyone who had chickenpox can develop shingles.
• Age- Shingles can develop at any age if the person had chickenpox but it increases as age increases. According to the National Institutes of Health (NIH), shingles are most common in adults over the age of 50 years. 
• Weak Immune system- As per CDC, Shingles more likely develop in people with a weak immune system or suffering from diseases like cancer, especially leukemia or lymphoma, HIV, or one who are on immunosuppressive medications, such as steroids or chemotherapy

Are shingles contagious?

Shingles do not transmit directly to another person but who had never suffered from chickenpox or received its vaccine will get infected with the fluid present in blisters of the infected person, if comes in contact with a person having shingles. 

Shingles do not spread through coughing or sneezing. Only direct contact with fluid from the blisters can spread the virus as it is active in fluid only. If a person does not develop blisters, the virus cannot spread in the traditional sense.

It is advisable to take precautions by covering the rashes or avoid touching or coming in contact with that person. Infants with low birth weight and pregnant women need to take strict precautions.  

Treatments

No cure has been found yet for shingles but numerous treatment options are available. As per the American Academy of Dermatology, a person with shingles should receive treatment within 3 days, as timely treatment can help to prevent complications like chronic nerve pain.

• Antivirals like acyclovir (Zovirax), famciclovir (Famvir), and valacyclovir (Valtrex) are recommended to fight against the infection and antivirals like corticosteroids, such as prednisone (Deltasone), to reduce inflammation. 
• Non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, to relieve pain
• Few topical pain relievers that contain lidocaine or capsaicin, are advised to relieve pain.
• The Food and Drug Administration (FDA) has approved two shingles vaccines for adults aged 50 years and older: Zostavax and Shingrix
• The CDC recommends the newer Shingrix vaccine over Zostavax because it is more than 90% effective and provides long-lasting protection.

Home Remedies

Home remedies that may help relieve the symptoms of shingles include:

• Oatmeal bath – relieves itching
• Cool baths or showers- soothes skin
• Cold compresses- placing washcloths with cold water on the rash, reduces inflammation and relieves pain.
• Anti-itch ointments such as calamine lotion.
• Loose-fitting clothes -gives comfort and relaxation. 
• Eating nutritious meals and doing gentle exercises.

Natural Remedies

Some of the natural remedies also show some relieving effects. This includes like

• Eucalyptus oil- have anti-inflammatory properties and can increase the speed of blisters recovery. 
• Chamomile oil- have anti-inflammatory and antimicrobial properties and can improve ulcers by aiding skin-cell regeneration. 
• Tea tree oil- have anti-inflammatory and antimicrobial properties and can promote wound healing.
• Gentiana scabra-Blue or purple flowering plant found in the United States and Japan. Researchers have found that Gentiana scabra, gives pain relief in shingles and decreases the possibilities of postherpetic neuralgia. People can also take it orally by boiling the plant in the water. 

Summary

Shingles is a viral infection that occurs due to reactivation of the VZV virus and can be developed in anyone who had chickenpox but it is not necessary that everyone can have this disease. Many symptoms are seen like watery blisters. The other most common is Post-herpetic neuralgia, occurring in up to 18% of people. If not treated on time, complications can occur, else recovery occurs within 2-4 weeks. A person should contact a doctor immediately if they think that they have shingles.