Often the mere mention of shingles can produce an impressive string of expletives.

Why? Because shingles can hurt. A lot.

"Shingles is an infection of the skin caused by the chickenpox virus," said Dr. Terence Neff, a board certified pediatrician at Coeur d'Alene Pediatrics. "In order to have shingles, you have to have had chickenpox. That's how the virus gets into the system.

"The chickenpox virus is in the family of the herpes virus and the immune system has a difficult time clearing the herpes virus. You never really do get rid of it."

Dr. Paul Dunn, a board certified dermatologist at Advanced Dermatology & Skin Surgery in Coeur d'Alene, said that getting treatment for shingles within the first one to two days following the appearance of symptoms is the key to an effective resolution.

"The most common symptom," he said, "will be an eruption that is a reddish plaque with a cluster of blisters. In most cases, there will be several of them.

"They're usually painful and can be itchy or feel like pins and needles. The severity of the pain varies from person to person, in part dependent on the location of the blisters, which usually affect one section of the body.

"The most common location for them is around the left mid-back, maybe wrapping around to the front section. It might not even affect the lower back at all. Or the right side."

What's responsible for causing this misery? It's that sneaky chickenpox virus - it goes into hiding for years after its victims believe they've already trounced it.

According to Dr. Leanne Rousseau, a board-certified family medicine physician at Kootenai Clinic, "The virus goes dormant in a nerve. Then, years later, with the weakening immunity of illness, increasing age, suppression of the immune system or just plain stress, the virus gets activated again. The most likely noticeable early symptom of shingles is an itchy or burning sensation along the distribution of that nerve at the skin."

During those first critical 48 hours after onset of symptoms, treatment includes pain mitigation and an anti-viral medication such as acyclovir or valacyclovir.

And yes, there is a way to prevent - or at least ease - the misery of shingles. Most physicians will recommend that people age 60 and over get vaccinated for the disease.

Neff noted that the shingles vaccine is actually a stronger form of the chickenpox vaccine.

Is shingles contagious? Yes and no. "You can't transmit shingles to another person, but you can technically transmit it in the form of chickenpox to someone who hasn't previously had chickenpox," Rousseau said. "Therefore if you have shingles, avoid contact with babies who haven't been vaccinated yet."