Shingles, also known as herpes zoster, is a painful rash caused by the varicella-zoster virus, the same virus that causes chickenpox. After a person recovers from chickenpox, the virus remains sleeping (dormant) in certain nerves in the body. As we get older, our immune system becomes weaker and may not be strong enough to control the virus. Shingles occurs if the virus becomes active again, growing down the nerves to reach the skin and appearing as small, painful blisters.
Chickenpox (varicella) is an infectious disease caused by the varicella-zoster virus that goes away on its own. Infection spreads among humans through fluids from the airways, such as from coughing and sneezing, with non-infected household members at high risk of becoming infected as well. The development (incubation) period is 14–16 days, and the first sign of disease is a rash. People are considered contagious for 2–5 days before the onset of skin lesions and for 6 days after the last series of rashes have appeared.The most common complication is infection of lesions with bacteria. Rare complications include lung infection (pneumonia) or brain infection (encephalitis). Children who have weak immune systems, eczema, or recent sunburns have more severe symptoms. Because the virus remains resting (latent) in the parts of nerves that are near the spinal cord (nerve roots) for life, about 1 in 10 adults will get shingles (zoster) when the virus reappears, usually under conditions of stress to the body.After having chickenpox, a person is usually immune for life, although reinfection is possible.
Herpes simplex infection of the lower back and buttocks—also called sacral herpes simplex or genital herpes—is a common recurrent skin condition associated with infection by the herpes simplex virus (HSV). HSV infection usually appears as small blisters or sores around the mouth, nose, genitals, buttocks, and lower back, though infections can develop almost anywhere on the skin. Furthermore, these tender sores may come back periodically in the same sites.Infections with the herpes simplex virus are very contagious and are spread by direct contact with the skin lesions. There are 2 types of HSV: Type 1 and Type 2. HSV Type 1 (HSV-1) infections usually occur around the mouth, lips, nose, or face, while HSV Type 2 (HSV-2) infections usually involve the genitals, lower back, or buttocks. However, HSV-1 can sometimes cause infections in the genitals or buttocks, while HSV-2 can occasionally cause infections around the mouth, lips, nose, or face.Both types of herpes simplex virus produce 2 kinds of infections: primary and recurrent. Because it so contagious, HSV causes a primary infection in most people who are exposed to the virus. However, only about 20% of people who are infected with HSV actually develop visible blisters or sores. Appearing 2–12 days after a person's first exposure to HSV, the sores of a primary infection last about 1–3 weeks. These sores heal completely, rarely leaving a scar. Nevertheless, the virus remains in the body, hibernating in nerve cells.Certain triggers can cause the hibernating (latent) virus to wake up, become active, and travel back to the skin. These recurrent herpes simplex virus infections may develop frequently (every few weeks), or they may never develop. Recurrent infections tend to be milder than primary infections and generally occur in the same location as the primary infection.HSV-2 infections are transmitted sexually or from a mother's genital tract to her newborn baby. HSV-2 is often spread through direct skin-to-skin contact with active lesions on another person. However, people who have herpes simplex virus infections may be contagious even when they do not have any skin lesions, which is called asymptomatic shedding.Because sacral HSV is not located in the groin area, people may not realize that they have a form of genital herpes. In fact, they may think that they have a recurrent skin condition such as shingles, a yeast infection, or an allergic reaction. However, sacral herpes is considered to be a form of genital herpes.
There are many types of skin rashes. A rash is an outbreak of many red bumps or patches on the body. Many conditions can cause an itchy rash. In adults, several types of skin inflammation, various allergic reactions (contact dermatitis), and sometimes infection with a mite or virus can be the cause of a new rash on the skin. Determining that the skin change is recent (generally happening for the first time and lasting less than 1-2 weeks) helps to narrow the possible causes for the rash.