How to Determine if You Have Shingles (Herpes Zoster)
Jul 21, 2025
Source: Cainiu Health
Dr. Liu Wenmin
Introduction
The initial stage of herpes zoster often presents with erythematous patches, followed by the appearance of clustered papules. These rapidly transform into vesicles containing clear fluid, with surrounding erythema. The skin between clusters of vesicles appears normal, which is a typical manifestation of the rash. Pain is often described as stabbing, electric-shock-like, burning, or cutting in nature, and may occur several days before the rash appears or concurrently with the rash.
Shingles, also known as herpes zoster, can generally be diagnosed through observation of the rash morphology, attention to pain characteristics, monitoring the affected area, virological testing, and imaging examinations. Detailed analysis is as follows:
1. Observe the rash morphology: In the early stages, shingles typically presents as erythematous patches, followed by clustered papules that rapidly develop into clear vesicles. These vesicles have a surrounding red halo, while the skin between clusters remains normal, which is a characteristic rash presentation.
2. Note the pain characteristics: Pain often presents as stabbing, electric-shock-like, burning, or cutting in nature. It may occur several days before the rash appears or simultaneously with the rash. Some patients experience severe and persistent pain, particularly elderly individuals who tend to have more pronounced pain.
3. Monitor the affected area: The rash commonly appears unilaterally along the distribution of nerves on one side of the body, frequently occurring on the chest, waist, abdomen, or face and head. It typically does not cross the midline of the body, presenting a band-like distribution, which correlates with the affected nerve territory.
4. Virological testing: Laboratory tests can be performed on vesicle fluid or skin tissue samples. Using polymerase chain reaction (PCR) technology, varicella-zoster virus DNA can be detected, directly confirming viral infection and providing etiological evidence for diagnosis.
5. Imaging examinations: For shingles affecting special areas such as the face and head, magnetic resonance imaging (MRI) can be performed. This can reveal inflammatory changes in the affected nerves and surrounding tissues, aiding in assessing the extent of nerve damage, confirming the diagnosis, and evaluating disease severity.
In daily life, maintaining a healthy lifestyle, improving dietary habits, engaging in appropriate physical exercise, enhancing physical fitness, and reducing susceptibility to illness are recommended.
