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Herpes simplex virus (HSV) infections are caused by 2 types of HSV: type 1 (HSV-1) and type 2 (HSV-2).
Figure 1 – An itchy, vesicular lesion was caused by an unusual case of herpes simplex virus type 1 infection.
The virus moves along the nerve fibres and affects cells of the skin, resulting in a skin rash.
It is intended for general information purposes only and does not address individual circumstances. Other symptoms that may be present include pain when you urinate or painful sexual intercourse. Self-treatment may make it harder for the health care provider to find the source of the problem. It is caused by the herpes varicella-zoster virus, the same virus that's behind chickenpox. It is not a substitute for professional medical advice, diagnosis or treatment and should not be relied on to make decisions about your health. The virus is never fully cleared from the body and shingles occurs when the virus reactivates. Never ignore professional medical advice in seeking treatment because of something you have read on the BootsWebMD Site.
When signs do occur, they usually appear as one or more small blisters or sores on or around the mouth, lips, nose, face, genitals, and buttocks. What does the shingles rash look like?Pain, itching, tingling, burning are all symptoms of shingles that may occur several days before the outbreak of the rash. HSV infections are very contagious and are spread by direct contact with the skin lesions.Herpes labialis is a common disease caused by infection of the mouth area with HSV-1. Starting as small blisters on a red base, with new blisters continuing to form for three to five days, shingles is painful. Most persons in the United States are infected with HSV-1 by age 20 years.The blisters or sores associated with HSV infection may take 2 to 4 weeks to heal completely the first time they occur. A culture was positive for HSV-1.Herpes simplex virus type 2Persons with HSV-2 infection are often unaware of their illness for several reasons.
Typically, another outbreak can appear weeks or months later at the same site, but it almost always is less severe and of shorter duration than the initial outbreak.
They may have become infected with HSV-2 during sexual contact with a person with a genital HSV-2 infection who does not have visible sores and may not know that he or she is infected. Shingles symptoms: Before the rashThe first symptoms of shingles appear one to four days before the rash.


Although HSV can remain in the body indefinitely, the number of recurrent HSV infections tends to decrease over a period of years.Herpes simplex virus type 1Although lesions caused by HSV-1 infection typically appear on the mouth, lips, nose, and face, they can develop anywhere on the skin. In addition, they may never have signs and symptoms or may have very mild signs that either they do not notice or they mistake for such skin conditions as insect bites.
For example, a 25-year-old woman sought evaluation of an itchy lesion on her neck, shown in Figure 1. However, if signs and symptoms occur during the initial outbreak, they may be pronounced and may include sores, fever, and swollen glands.Figure 2 shows a pruritic eruption that was confined for several days to the buttocks of a 73-year-old woman. The first time someone is exposed to the virus, it causes the widespread, itchy sores known as chickenpox. Almost a year earlier, a similar lesion had occurred at the identical site after she had worked in the yard. Her physician had suspected rhus dermatitis at the time and had prescribed a topical corticosteroid; the lesion had resolved. She was widowed and had had no sexual contacts for many years.Antiviral therapy was started because the woman’s physician suspected HSV infection. Additional information from the history revealed that the woman had been exposed to HSV-2 infection many years ago. Figure 2 – This pruritic eruption on the buttocks of an elderly woman is an example of herpes simplex type 2 infection.
If you have shingles symptoms, seek medical advice even if you think you've never had chickenpox. Many childhood cases of chickenpox are mild enough to go unnoticed, but the virus can still linger and reactivate. To reduce the risk of complications, it's important to start treatment as soon as possible.
How long does shingles last?Shingles blisters usually scab over in seven to 10 days and disappear completely in two to four weeks. In most healthy people, the blisters leave no scars, and the pain and itching go away after a few weeks or months. But people with weakened immune systems may develop shingles blisters that do not heal in a timely manner.
Who's at risk of shingles?Anyone who has ever had chickenpox can get shingles, but the risk increases with age. Recently, she had started to use new brands of both soap and shaving cream. Figure 3 – A tender blister on the posterior thigh of a 28-year-old woman is characteristic of herpes simplex virus type 2 infection. However, it is possible for a person who has never had chickenpox to catch chickenpox from fluid from the blisters of someone with shingles. Can shingles cause chronic pain?In some people, the pain of shingles may linger for months or even years after the rash has healed. This pain, due to damaged nerves in and beneath the skin, is known as postherpetic neuralgia.


The patient received counseling on being evaluated for other sexually transmitted infections as well as on the ramifications of genital HSV-2 infections.Herpes labialisAlthough initial herpes labialis may not cause symptoms or mouth ulcers, the virus remains in the nerve tissue of the face and may reactivate, producing recurrent cold sores, usually at the same site. Symptoms of primary herpes labialis may include a prodrome of fever, followed by a sore throat and mouth and submandibular or cervical lymphadenopathy. In severe cases, the pain or itching may be bad enough to cause insomnia, weight loss, or depression. In children, gingivostomatitis and odynophagia are also observed.Painful vesicles develop on the lips, gingiva, palate, or tongue and are often associated with erythema and edema.
Other complications of shinglesIf the shingles rash appears around the eye or forehead, it can cause eye infections and temporary or permanent loss of vision. The lesions ulcerate and heal within 2 to 3 weeks.A classic manifestation of herpes labialis is shown in Figure 4.
After returning from a skiing trip to Colorado, a 24-year-old woman sought medical attention for an eruption of sudden onset on her lip. These complications can usually be prevented by commencing treatment for shingles as soon as possible.
She was otherwise healthy, and her only medication was an oral contraceptive.Figure 4 – These painful vesicles that erupted suddenly and were accompanied by low-grade fever and a sore throat are characteristic of herpes labialis. Ramsay Hunt SyndromeAnother shingles complication is Ramsay Hunt syndrome, which affects some nerves in the head. Symptoms include earache, hearing loss, dizziness, vertigo, tinnitus, loss of taste and Bell's palsy paralysis of the face. Treatment: Antiviral medicationWhile there is no cure for shingles, antiviral medications such as aciclovir, valaciclovir and famciclovir may be recommended to reduce the severity and length of an attack. Treatment: Rash reliefOver-the-counter pain killing medication and anti-itch lotions, such as calamine, can relieve the pain and itching of the shingles rash. If the pain is severe or the rash is concentrated near an eye or ear, seek prompt medical advice. Home care for shinglesColloidal or oatmeal baths are an old standby for relieving the itch of chickenpox and can help with shingles as well.
To speed up the drying out of the blisters, try placing a cool, damp flannel on the rash (but not when calamine lotion or other creams have been applied). The Department of Health says the Zostavax vaccination programme will prevent 38% of the 30,000 cases seen every year in people over 70.
Additionally, those who get the jab but still go on to develop shingles can expect to see a 55% reduction in symptoms.



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