Rebecca Campen, M.D., J.D. is an Assistant Professor of Dermatology at Harvard Medical School and former Deputy Director of the Harvard/Massachusetts General Hospital Cutaneous Biology Research Center (CBRC). She currently serves as Senior Advisor to the CBRC and divides her time between clinical practice of dermatology at the Massachusetts General Hospital and private practice in Savannah, Georgia. Dr. Campen is the author of two books for medical students and residents, Going Into Medical Practice and Blueprints in Dermatology.

Question:

Can someone have shingles without a major rash — just extreme skin sensitivity and itching?

Answer:

Shingles is caused by the reactivation of the chickenpox virus (varicella zoster). After a bout of chickenpox the virus hides away in nerve roots of the body in a "dormant" state, not causing any damage. Years later the virus may become active again, resulting in the painful, blistering rash called shingles.

The shingles rash usually occurs along a nerve tract, appearing as a bright pink streak with large blisters on one side of the body. Several days before the rash appears, the area of skin where the rash is about to develop usually starts "stinging and burning," sometimes accompanied by "shooting" pains and itching. The blistering rash usually follows, but in rare cases there may be no rash.

If you think you have shingles or your skin burns and stings, see your doctor immediately. Antiviral medication prescribed by your doctor can shorten how long you have the shingles and can reduce the incidence of severe pain ("postherpetic neuralgia") that can linger long after the rash has gone.