There is a skin disease that, according to those who have suffered from it, can cause pain lasting many years—this is shingles, known as the "most painful skin condition." About one-third of people will experience shingles at least once in their lifetime. Statistics show that in China, millions of people over a certain age develop shingles each year. Every year around the time after the Spring Festival, the number of shingles cases in hospitals rises significantly. Doctors explain that this is mainly due to the high incidence of flu, excessive fatigue, and irregular lifestyles, which weaken the immune system and activate the dormant virus in the body, leading to infection.

The main cause of herpes zoster attacks is decreased autoimmune immunity

Shingles is an infectious skin disease caused by the varicella-zoster virus. Over a certain percentage of adults carry the latent varicella-zoster virus in their bodies. When children are infected with this virus, it first manifests as chickenpox. After being attacked by the immune system, the virus is not completely eliminated but instead hides in the dorsal root ganglia. When the body's immunity declines, the latent virus seizes the opportunity to act up, traveling along the nerves and causing inflammation and necrosis, which leads to pain.

Fan Bifa, Director of the Pain Department at China-Japan Friendship Hospital: People over 50 are the high-risk group, but we’ve recently noticed a trend of younger individuals being affected. Even young adults are gradually showing cases of herpes zoster virus, which is a trend worthy of our attention and concern.

In addition to the increased prevalence among middle-aged and elderly individuals over a certain age, patients with chronic diseases such as diabetes, chronic kidney disease, and chronic obstructive pulmonary disease face a 20% to 30% higher risk of developing shingles. Those with autoimmune diseases, such as rheumatoid arthritis and systemic lupus erythematosus, have a 1.5 to 2 times higher risk of contracting shingles compared to the general population.

The herpes zoster virus damages nerves, causing unbearable pain.

Why does shingles cause much more intense pain than common skin diseases? Even after the surface blisters have healed, some patients still experience severe pain, which can persist for several years.

Fan Bifa, Director of the Pain Department at China-Japan Friendship Hospital: It infects the nerves in our body that manage pain. This virus damages the most crucial structure of the sensory nerve ganglia responsible for pain, leading to severe pain. Most people describe it as knife-cutting, burning, needle-pricking, or heart-piercing pain. As the illness improves, this pain gradually fades away for many. However, due to various reasons, quite a few people end up suffering from stubborn postherpetic neuralgia. Clinically, we’ve seen cases where patients endure pain for years.

Herpes can be recognized before it appears. Early treatment may suppress the outbreak.

Shingles has a long incubation period, with about % to % of patients experiencing pain before the rash appears. Many people often mistake this for other illnesses, delaying treatment. Doctors remind that symptomatic treatment when pain is felt but before the rash appears can significantly reduce the likelihood of postherpetic neuralgia. Some patients may even prevent the onset of shingles altogether.

Li Houmin, Chief Physician of Dermatology at Peking University People's Hospital: The distribution of nerves extends from the spine in bundles to our skin. Shingles occurs when a single nerve is damaged, causing pain that is distributed unilaterally—for example, on the left front or left back of the body. This is called unilateral distribution, and the most common areas affected are the thoracic and lumbar segments, such as the chest, back, or waist. It can also appear on one side of the head or face but never crosses the midline of the body. When experiencing such unilateral pain, we should be alert to the possibility of shingles.

Shingles: Prevention is better than cure.

Most patients with shingles can be cured through treatments such as antiviral therapy, but the most troublesome aspect of this disease is the postherpetic neuralgia, which can persist for a long time. Therefore, prevention of shingles is better than cure.

Experts explain that to prevent shingles, the first step is to maintain a healthy lifestyle by avoiding overexertion, staying up late, catching a cold, and significant emotional fluctuations. These factors can easily lead to weakened immunity and may also trigger shingles. Currently, getting vaccinated against shingles is a well-established preventive method, also known as primary prevention. For individuals aged [specific age] and above, receiving the shingles vaccine can reduce the incidence of shingles by over [specific percentage]%. (Note: The original text contains placeholders for age and percentage, marked as "岁以上" and "%以上." These should be replaced with specific numbers in the final translation for accuracy.)

Fan Bifa, Director of the Pain Department at China-Japan Friendship Hospital: Large-scale data shows that vaccination can significantly prevent herpes zoster. Even if infected, the severity of the disease is greatly reduced. After vaccination, the body has already developed partial or strong antibodies. Even if the disease recurs, these antibodies can aid in the recovery process.

What misconceptions about shingles should be aware of?

Does shingles only occur on the waist? The varicella-zoster virus can replicate and multiply in nerve ganglia anywhere on the body, such as the head, neck, chest, waist, and even the limbs. The waist is just the most common site for shingles to develop.

Wu Wenyu, Director of the Dermatology Department at Huashan Hospital Affiliated with Fudan University: In addition to the common cutaneous form of herpes zoster, there are many special types, such as those occurring around the eyes or ears. There is also a disseminated form of herpes zoster. Herpes zoster around the eyes can affect the eyeball, including the cornea. Mild cases may impair vision, while severe cases can even lead to blindness. Herpes zoster in the ear can cause intense pain and may be accompanied by facial paralysis. In severe cases, it can also result in hearing loss.

Does shingles really not recur?

Dr. Wenyu Wu, Director of the Dermatology Department at Huashan Hospital Affiliated to Fudan University: Many people believe that herpes zoster (shingles) is a lifelong immune disease—once you get it, you won’t get it again in your lifetime. In reality, this is true for most people, but about % of the population may experience it a second, third, or even fourth time in their lives. So why are these individuals more prone to shingles? There are two main reasons. First, they may have underlying autoimmune diseases, which weaken their immune system. Second, some people lead irregular lifestyles, such as frequently staying up late, which can impair immune function and make them more susceptible to recurrent shingles infections. Therefore, these groups are also common candidates for recurrence.

Is shingles not contagious?

Fan Bifa, Director of the Pain Department at China-Japan Friendship Hospital: Current research suggests that shingles is somewhat contagious during the early and acute phases. Therefore, households with elderly and children should take precautions. Generally, by the time it progresses to postherpetic neuralgia, the contagiousness is minimal, and it is often considered non-contagious.