Shingles is a disease that affects the nervous system and causes a painful, blistering skin rash. It is caused by the same virus that causes chickenpox: varicella-zoster. Individuals who have had chickenpox recover, but the virus does not leave the body. Although it is dormant, it lingers in some nerve cells. For reasons that aren’t totally understood, the virus can reactivate years later, producing shingles.

Just like chickenpox, people with shingles will feel sick and have a rash on their body or face. The major difference is that chickenpox is a childhood illness, while shingles usually occurs in older people. Most adults live with the virus in their body and never get shingles, but about one in five people who have had chickenpox will get shingles later in life—usually after the age of 50.

When the activated virus travels along the path of a nerve to the surface of the skin, a rash will appear. It usually shows up as a band on one side of the face or body. The word “shingles” comes from the Latin word for belt or girdle because often the rash is shaped like a belt.

Shingles is not contagious. You can’t catch it from someone who has it, but you can catch chickenpox from someone with shingles. So, if you’ve never had chickenpox or been vaccinated, try to stay away from anyone who has the rash until they’ve completely healed. Most people get shingles only once, but recurrences are possible.

Who Is at Risk?

Anyone with the varicella-zoster virus in their body can be at risk for getting shingles. There is no way of knowing who will get the disease, but age and a compromised immune system increase your chances of developing the rash. Immune function wanes as we get older, leaving our bodies more susceptible to infections. Health conditions and related treatments like HIV, cancer, chemotherapy, radiation treatments, and even stress or a cold can weaken the immune system and put a person at risk for shingles.

What Are the Symptoms of Shingles?

Shingles follows a very clear pattern of development. At first, a person will feel a tingling or burning sensation in a specific area on their skin. A few days later, a red rash will break out in this area. After a few more days, the rash will turn into fluid-filled blisters, which dry up and crust over within several days. Most cases of shingles last between three and five weeks.

In addition to the characteristic rash, a person with shingles will likely feel under the weather with chills, fever, upset stomach or a headache. The rash itself can be itchy and very painful, depending on the severity and location.

How Shingles Is Treated

It’s important to see a doctor as soon as the rash appears so that a diagnosis and treatment plan can be developed. Shingles can often be treated at home and hospitalization is rarely necessary. Although there is no cure, early treatment with antiviral drugs can help minimize discomfort and shorten recovery time. A doctor may also prescribe steroids to speed up the healing process and an antidepressant, anticonvulsant or analgesic to help with pain relief. When started within 72 hours of getting the rash, these medicines help shorten the length of the infection and lower the risk of developing complications.

How to Prevent Shingles

Two vaccines, Shingrix and Zostavax, are recommended by the Centers for Disease Control (CDC) to prevent shingles. Ask your doctor if you and your loved one are candidates for vaccination. It is recommended for individuals age 60 and older.

Read: All About the Shingles Vaccine

Complications of Shingles

Shingles is usually not a very serious condition, but complications are possible. In some cases, the blisters can become infected, requiring antibiotic treatments. Scarring can occur, so be sure to keep the affected area clean and try not to scratch!

If the blisters occur near or in the eye, lasting damage or blindness may result. This can be very serious, so it is important to see an eye doctor right away. Other problems may include hearing loss or brief paralysis of the face. In a small number of cases, swelling of the brain (encephalitis) can occur.

After the rash goes away, some people may be left with long-lasting pain called post-herpetic neuralgia (PHN). The older you are when you get shingles, the greater your chance of developing PHN. The pain is felt in the same area where the rash had been and can persist for weeks, months or even years. For some people, PHN is the worst part of shingles. The sharp, throbbing or stabbing pain can make some people feel weak and unable to do things they usually enjoy. Their skin can become so sensitive that they can’t bear to wear even soft, light clothing.

In especially severe cases, PHN pain can interfere with normal daily activities and cause depression, anxiety, sleeplessness and weight loss. If any of these problems arise, make a doctor’s appointment. Usually PHN will get better over time, but there are medicines that may help.

Caring for Someone with Shingles

Aside from to going to the doctor and taking prescribed medications, there is little that can be done to get rid of the infection. Because the pain and itching can be distressing, try to find ways to minimize and distract from your loved one’s discomfort. Getting adequate rest, eating healthy meals, and engaging in gentle exercise and stress-free pastimes will encourage quick healing.

Try to do things that take your loved one’s mind off their symptoms. Watch TV, read interesting books, talk with friends or encourage them to work on a hobby they like. Relaxation is key because stress can make the pain worse. Calming music can be an especially helpful tool. To help with the pain, dip a washcloth in cool water and apply it to the rash. This will soothe the skin and aid in getting the blisters to dry up.