Shingles and Chickenpox (Varicella-Zoster Virus) - Symptoms

Highlights	Complications	Treatment for an Acute Shingles Attack
Introduction	Vaccination	Treatment for Postherpetic Neuralgia
Symptoms	Diagnosis	Resources
Risk Factors	Treatment for Chickenpox	References

Symptoms

The time between exposure to the virus and eruption of symptoms (or incubation period) is between 10 and 20 days. The patient often develops fever, headache, swollen glands, and other flu-like symptoms before the typical rash appears. While fevers are low grade in most children, some can reach up to 105 F.

text continues below

The patient generally begins to feel better once the rash breaks out. One or more tiny raised red bumps appear first, most often on the face, chest or abdomen. They become larger within a few hours and spread quickly, eventually forming small blisters on a red base. They have been described as dewdrops on rose petals. The numbers of blisters vary widely; some patients have only a few spots, others can develop hundreds. Each blister is filled with clear fluid that becomes cloudy in several days. It takes about four days for each blister to dry out and form a scab. During its course, the rash itches, sometimes severely. Usually separate crops of blisters occur over four to seven days, and the entire disease process lasts between seven and 10 days.

Chickenpox itself usually occurs only once, although a few cases of mild second infections, marked by the telltale rash, have been reported in older children years after their first infection.

Symptoms of a Typical Shingles (Herpes Zoster) Attack

Shingles nearly always occurs in adults. It develops on one side of the body. Usually two, and sometimes three, identifiable symptom stages occur:

The first is known as the prodrome, which are a cluster of warning symptoms that appear before the outbreak of the infection.
The second stage comprises the symptoms of the active infection itself.
In many patients, a third syndrome known as postherpetic neuralgia develops.

One form of shingles is known as zoster sine herpes, in which pain occurs first without a rash. Pain is so common to all stages of herpes zoster, in fact, that physicians often refer to all syndromes with a single term, zoster-associated pain (ZAP).

Prodrome (Pain).

Pain is the primary early symptom for shingles and it occurs in all patients. The pain most often occurs in the skin at the site of the re-activated virus. The pain may be experienced as sharp, aching, piercing, tearing, or similar to an electric shock.
The affected skin may itch, feel numb, and be unbearably sensitive to touch. Often the patient experiences a combination of these sensations along with pain.
In addition, some patients may have flu-like symptoms such as muscle aches. (Some people have fever, but it is uncommon.)