The Stages of Shingles Rash

A shingles rash can affect anyone who's had chicken pox, although it usually targets people over the age of 50 or those with weakened immune systems 1. The stages of a shingles rash are distinctly noticeable to those who've experienced this painful condition, with unpleasant symptoms beginning even before the rash itself erupts 1.

What Causes Shingles?

Shingles, which is also called herpes zoster, is caused by the varicella zoster virus--a member of the herpes family 1. However, this is not the type of herpes virus that causes genital or oral outbreaks. Varicella zoster first causes chicken pox, usually in children, although after the skin lesions have healed, the virus itself continues to reside in the nervous system. When varicella zoster reactivates, it doesn't result in another outbreak of chicken pox, but rather a shingles rash 1. Most people only get one shingles rash, although there are some who experience two or three 1. While age and poor health are factors that could trigger shingles, it can also erupt for unknown reasons 1.

The First Signs of Shingles

The earliest stage of shingles is the prodomal stage 1. Typical signs and symptoms during this time include pain, burning or a tingling sensation in the area of your skin where the rash will eventually appear. Typically, this is on the chest or back, but the rash can also appear on your abdomen, arm, leg or area around your face. Often a person in the early stage of shingles experiences symptoms of the flu, such as chills, nausea and diarrhea, as well as swelling of the lymph nodes 1.

The Shingles Rash

Three to four days after the prodomal stage, the shingles rash erupts 1. Usually, it will be on only one side of the body. The rash is comprised of many tiny watery blisters that are more painful that they are itchy; the nerve roots that the varicella virus transverses often cause a sharp, pinlike sensation merely on palpation of the rash. The blisters rupture and eventually scab over in about five days, with the rash itself resolving after two to four weeks.

Post-Shingles Complications

Sometimes the pain caused by shingles lingers for a long time after the rash itself is gone and results in a condition called postherpetic neuralgia, which may require pain management until symptoms subside 1. More serious complications of shingles may include loss of vision (when the rash occurs around the eye) and neurological problems, such as facial paralysis, encephalitis and problems with hearing and balance 1.

Shingles Rash Treatment

Shingles can heal on their own without the need for medical treatment 1. However, certain medications can aid the healing process. A doctor may prescribe an antiviral medication such as Zovirax, Valtrex or Famvir--the same medications used to treat oral and genital herpes--as soon as the first signs and symptoms of shingles arise 1. For patients who experience extreme pain, a narcotic pain medication may be prescribed. Other ways to reduce pain caused by a shingles rash may include use of tricyclic antidepressants, anticonvulsants and topical numbing creams 1.