Why do belt roses always have painful blisters

Shingles: First Signs and Symptoms

First signs

The burning and boring to cutting pain typical of shingles, which also vary in strength, can be felt days before the vesicles form. Itching and sensitivity to touch in the affected skin area are also often present. This can be accompanied by a feeling of illness, fever and fatigue.

Symptoms of shingles

Acute skin symptoms

In the area of ​​the painful skin area, reddish rashes (spots, papules) develop at the same time as the first pain or up to 7 days later, which soon transform into fluid-filled blisters. They typically stand together in small groups.

In principle, herpes zoster disease can affect any nerve root. In addition to the most common occurrence on the trunk, arms, legs, neck and face are affected. When the so-called Trigeminal nerve (Trigeminal neuralgia) affects the eyes, nose, forehead and the hairy scalp on one side of the face. Inflammation of the conjunctiva and cornea (Cornea) of the eye or, rarely, the optic nerve with visual disturbances. If the ear canal is affected, one speaks of Herpes zoster oticuswith facial paralysis, dizziness and hearing problems. If the disease occurs in the facial area, therapeutic intervention is always advisable.

Otherwise the shingles heals similarly to the chickenpox with a normal course after 2-4 weeks. In most cases, however, early treatment is advisable, especially in the case of pain. As with chickenpox, the fluid-filled vesicles must not be scraped open to prevent bacterial inflammation and possibly leave scars.


Shingles can also occur in several skin areas next to each other. In very rare cases, in addition to shingles, inflammation of the meninges and the brain can occur. In immunocompromised people such as cancer patients, AIDS patients or organ transplant recipients, the viruses can spread uncontrollably and cause life-threatening processes that also affect organs such as the brain, lungs and liver. Shingles can even appear all over the body in these patients, in which case it cannot be differentiated from primary chickenpox.

Post-zoster neuralgia (PZN)

Some people feel pain in the area of ​​skin that has healed for months. The symptoms stem from nerve damage in the peripheral nerve that was previously affected by shingles. Older patients in particular are at risk, 50-75% of those affected are between 60 and 70 years old.

The pain often only develops in intensity after the blisters have healed and can get worse over time. The pain (Greek: "algos") after (Latin: "post") subsidence of the zoster is what doctors call post-zoster neuralgia (PZN).

Doctors distinguish three forms of PZN pain:

  • constant burning, boring pain
  • short, shooting attacks of pain
  • violent pain to the touch. The pain often spreads to neighboring areas of the skin that were not affected by the shingles.

Almost all PZN patients suffer from high levels of suffering and are desperate. Your pain is usually very stressful.