When we see older adults complaining of severe, unbearable pain from rashes and blisters, there is a probability that they are suffering from shingles. Shingles is a viral infection caused by the virus that also causes chicken pox—the varicella zoster virus—which is why it is also known as zoster or herpes zoster. The infection is mostly seen in those 60 years and older and occurs when an individual is suffering due to emotional or physical stress and the stress leads to lower immunity. The shingles rashes are usually found on only one side of the body. The infection is not life-threatening, but the pain from the rashes and accompanying blisters can be quite severe and excruciating.

Causes of Shingles

The causative agent for shingles is the varicella zoster virus that has not cleared out completely after a bout of chicken pox, which probably occurred during childhood. The virus remains dormant in the nervous system for years and reactivates when the body’s immunity is low and travels along the nerve pathway to the skin, causing rashes and blisters and leading to shingles.

This disease is seen more often in older adults because their immune systems become weak with age as far as their ability to fight against infections, explains Dr. Alexander Salerno of Salerno Medical Associates.

Dr. Salerno also states that the shingles causative virus, varicella zoster, can be passed on from anyone who is infected to someone who does not have immunity against chicken pox or who has not previously been infected with chicken pox. The virus is passed through the open sores of the shingles rash; however, when the virus is passed on, it causes chicken pox. Therefore, sometimes it is advised to avoid physical contact with others when suffering from shingles.

Symptoms of Shingles

Initial symptoms before the rashes appear are:

  • a tingling pain or burning sensation in a specific part of the body
  • itchiness and numbness in a particular part of the body

Shingles symptoms are seen on one side of the body and may manifest as red rashes that are sensitive to the touch, fluid-filled blisters that can burst open and crust over, along with itching. Some individuals might also experience fatigue, fever accompanied by headaches, and sensitivity to light. These symptoms last for 2 to 3 weeks.

In some cases with serious complications, the symptoms do not subside even after weeks, and the pain can linger on for months or even years, says Alexander Salerno, MD. This condition is known as post-herpetic neuralgia, in which the pain is very severe and can sometimes have adverse effects on routine schedules such as bathing, cooking, eating, or even travelling. In addition, post-herpetic neuralgia can also lead to anxiety, depression, loss of appetite, weight loss, and difficulty concentrating.

Treatment of Shingles

To date, a cure for shingles has not been found; but the symptoms can be minimized and will subside faster with prompt treatment and antiviral medication such as acyclovir, famciclovir, and valacyclovir. Treatment and medication can also be prescribed for specific symptoms.

The best precautionary measure is vaccination, which contains attenuated varicella zoster virus in high concentrations to produce antibodies.


Since 2001, Dr. Alexander Salerno has led Salerno Medical Associates in East Orange, New Jersey. Dr. Alexander Salerno focuses largely on urban communities and on delivering patient education about both medical and behavioral health issues, including alcohol addiction.