In most cases one to three weeks is the initial phase characterized as a skin rash. Some associated symptoms include headaches, pain, tingling, flu like symptoms, nerve pain and fever. While some of these symptoms are more common than others, they are all followed with a sensation of burning pain, itchiness, oversensitivity, or a “pins and needles” sensation. The pain from the rash can be mild or severe depending on the location where, the rash resides on the dermatome (area of your body that rely on specific nerve connections to the spine). Lastly, shingles can occur in children we well; however, age is more likely to exacerbate the severity of the disease.

After the primary infection of Chicken pox your body will develop an immunity against the Varicella-Zoster Virus until around the age of 50, where 1 to 3 persons immune system will weaken triggering a shingles outbreak. Later life poses the highest risk towards the reemergence of shingles after lying dormant in the sensory ganglia of the spinal and cranial nerve. This is due to the natural degradation of the human immune system which also includes immunocompromised individuals along with increased amounts of stress. Additionally, prolonged stress can pose another high-risk factor for the reactivation of the VZV. Finally, if a shingles outbreak is left untreated permanent nerve damage may occur known as post-herpetic neuralgia.

How does Varicella Zoster Virus stay dormant?
The primary infection also known as chickenpox is the initial encounter with the Varicella-Zoster Virus. The virus is highly contagious and can be transmitted through respiratory droplets or open blisters. Once infected the individual will develop symptoms of fever, rash, and itchy blisters. Following the chickenpox outbreak, instead of being eradicated, the virus will enter a latent (inactive) phase within the nerve cells near the spinal cord, essentially a dormancy period in the dorsal root ganglia. In some individuals, the virus can reactivate later in life. The reason for reactivation of the Varicella Zoster Virus is not yet fully understood, known contributing factors are age-related, decline in immune function, and stress. Once the virus has been reactivated, it travels along the dermatome (nerve pathway), where it will destroy nerve cells and multiply until it reaches the skin. Characteristic symptoms of shingles can occur including tingling, itchiness, burning nerve pain, and the development of a rash in a specific area of the body. Distribution of symptoms and timeframe is based on where your shingles outbreak is located. It is worth nothing that not everyone who contracted chickenpox will development shingles in later life, and the factors for triggering reactivation are not yet completely understood. However, if a shingles outbreak occurs without any treatment permanent nerve damage may occur as well as other shingle rash outbreaks.