Check If You Have Shingles
The first signs of shingles can be:
- a tingling or painful feeling in an area of skin
- a headache or feeling generally unwell
A rash will appear a few days later.
Usually you get the shingles rash on your chest and tummy, but it can appear anywhere on your body including on your face, eyes and genitals.
The rash appears as blotches on your skin, on 1 side of your body only. A rash on both the left and right of your body is unlikely to be shingles.
How Is Nerve Pain Diagnosed
The main way your doctor will diagnose nerve pain is by listening to you and examining you.
In the examination, they will probably test your nerves by testing the strength of your muscles, checking your reflexes, and by seeing how sensitive it is to touch.
You may be asked to have tests like:
- blood tests to check your general health and look for underlying conditions
- nerve conduction studies which measure how quickly your nerves carry electrical signals
- a CT scan or an MRI scan to look for anything that could be pressing on a nerve
Signs And Symptoms Of Shingles
Shingles usually affects only a small section on one side of your body and may include:
- Pain, burning, tingling, itching, numbness or extreme sensitivity to touch
- Red rash with fluid-filled blisters that begins a few days after the pain and lasts two to three weeks before scabbing over and healing
- Sensitivity to light
- Malaise a general feeling of unease and discomfort
Pain usually is the first symptom of shingles. For some, it can be intense. Depending on the location of the pain, sometimes it can be mistaken for a symptom of problems affecting the heart, lungs or kidneys. Some people experience shingles pain without ever developing the rash.
The shingles rash commonly occurs on one side of the torso. It often appears as a band of blisters that wraps from the middle of the back to the breastbone, following the path of the nerve where the virus has been dormant. However, the rash can occur around one eye, or on the neck or face.
Shingles generally lasts between two and six weeks. Most people get shingles only once, but its possible to get it two or more times.
See a health care professional as soon as symptoms of shingles appear, especially if:
A person with shingles can pass the varicella-zoster virus to anyone who isnt immune to chickenpox. This happens through direct contact with the rashs open sores. Once infected, the person will develop chickenpox not shingles. Chickenpox can be dangerous for some people.
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When Is Shingles Contagious And How Long Is Shingles Contagious
Individuals are considered contagious until their blisters are dry and crusted over, which takes two to four weeks. Help reduce the spread of shingles by not touching the rash and keeping it covered. During the contagious period, avoid contact with pregnant women who aren’t protected against chickenpox, premature infants and people with weakened immune systems.
Can You Get Shingles After Being Vaccinated
Shingles is a viral infection. It presents with a rash followed by an episode of intense pain in the infected area. This is caused by the virus called varicella zoster. This virus also causes chickenpox. If a child has had chickenpox, the virus may not completely go away, lie dormant in the body and come back years later as shingles. Older individuals and immunocompromised individuals are more likely to develop shingles. The shingles vaccine is generally recommended for those older than 50 years of age and immunocompromised individuals .
The United States Food and Drug Administration has approved two vaccines to effectively prevent shingles: Zostavax and Shingrix. Shingrix provides strong protection against shingles and postherpetic neuralgia . Two doses of Shingrix are more than 90 percent effective at preventing shingles and postherpetic neuralgia. The vaccine is more than 85 percent effective for at least the first four years after vaccination. It is possible to get shingles after being vaccinated since no vaccine is 100 percent effective. However, the vaccine can considerably reduce the risk and intensity of shingles episodes.
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Can Shingles Cause Chronic Pain
In some people, the pain of shingles may linger for months or even years after the rash has healed. This pain, due to damaged nerves in and beneath the skin, is known as postherpetic neuralgia. Others feel a chronic itch in the area where the rash once was. In severe cases, the pain or itching may be bad enough to cause insomnia, weight loss, or depression.
Hows Shingles Without A Rash Diagnosed
Shingles without a rash isnt common, but it may be more common than previously thought because it often goes undiagnosed. Shingles without a rash is difficult to diagnose based on your symptoms alone.
Your doctor may test your blood, cerebrospinal fluid, or saliva to identify the presence of VZV antibodies. This will allow them to confirm a diagnosis of shingles without a rash. However, these tests are often inconclusive.
Your medical history may provide clues that suggest you have shingles without a rash. Your doctor may ask if youve had a recent operation or if youre under increased stress.
Once your doctor suspects you have VZV, theyll use antiviral medicines such as acyclovir to treat the shingles. They may also prescribe drugs for the pain.
Other treatment will vary based on the location and severity of symptoms.
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Remarkable Cases Of Vzv Infection Without Rash
Two remarkable cases of VZV infection without rash deserve mention. The first and most extreme example of VZV infection of the nervous system that we encountered was a 77-year-old man with T cell lymphoma and no history of zoster rash who developed meningoradiculitis of the cranial nerve roots and cauda equina he died 3 weeks after the onset of neurologic disease, confirmed pathologically and virologically to have been caused by VZV . Autopsy revealed hemorrhagic inflammatory lesions with Cowdry A inclusions in the meninges and nerve roots, extending from cranial nerve roots to the cauda equina. The same lesions were present in the brain, although to a lesser extent. VZV antigen and nucleic acid, but not herpes zoster virus or cytomegalovirus antigen or nucleic acid, were found in the infected tissue at all levels of the neuraxis. Thus, VZV should be included in the differential diagnosis of acute encephalomyelor-adiculopathy, particularly since antiviral treatment is available.
Is This Shingles Without A Rash Worried
About 5 weeks ago I injured my back, dont remember doing it but it felt like a pulled muscle. I thought nothing of it but then 2 weeks ago I got tender skin on patches of my back and around to my chest. I thought maybe it was a trapped nerve but the back pain is now just about gone. The skin pain is still there, also my right lymph node is enlarged and the skin around it is also tender. The skin on my back and around to my chest feels like it is tender too , like mild.sunburn or goosebumps, it is on my left side. I went to the doctor but he said theres no rash then its not shingles. He sort of put it down to nerve pain but im not convinced. The last few days I feel a bit tired too. There is no rash whatsoever but the skin pain is very painful at times especially on the groin where the lymph node is.
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Chickenpox Is Caused By The Same Virus
The same virus, varicella zoster virus, causes both chickenpox and shingles.
Chickenpox typically causes an itchy rash that spreads over the entire body, as opposed to just one side of the body or face like shingles. More than 99 percent of Americans born on or before 1980 have had chickenpox, per the CDC. If you dont know if you had chickenpox, check with your family doctor, who can review your records.
Zoster Sine Herpete : Shingles Without The Rash
It is possible for a person to develop shingles without being affected by the rash, although this is rare. When shingles occurs without the rash being present, this is called zoster sine herpete .
When shingles occurs without a rash, the first symptoms of the condition may involve:
- A feeling of numbness in a certain area
- An itchy, burning sensation
- Generalized aches
- Hypersensitivity to touch
When shingles is present, even without the rash, sensations will be concentrated in a specific area of the body â commonly the face, neck, one side of the torso or the eyes. However, in the absence of the shingles rash, zoster sine herpete may still rarely lead toneurological and visceral diseases, such as inflammation of the brain , Varizella pneumonia, paralysis of the facial nerves and problems related to keeping oneâs balance or problems with hearing.
Because shingles shares characteristics with many other conditions, including herpes simplex, impetigo, dermatitis herpetiformis and contact dermatitis, it can easily be confused with these conditions. In cases where a rash is not present, a laboratory test will usually be necessary to establish the presence of the varicella zoster virus in the body.
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Contact Dermatitis Can Cause A Rash And Blisters
Contact dermatitis can also cause a rash, blisters, itching, and burning, per the ACAAI. It occurs when the skin comes into contact with an irritant or an allergen, such as soaps, laundry detergents, shampoos, metals, medications, and more. Allergens like poison ivy, poison oak, or poison sumac can cause red, itchy rashes that may include blisters. Treatment can offer relief and aid healing.
Risk Factors Of Shingles
Anyone that has suffered from chickenpox can develop a shingles outbreak later in life. The likelihood of individuals in the United States developing either disease is diminishing due to the widespread use of vaccinations against the virus. However, there are still risk factors that increase the risk that you may suffer a shingles outbreak.
Weakened Immune System
Diseases that weaken your immune system such as cancer, HIV/AIDS can increase the risk that patients will suffer a shingles outbreak. Because cancer treatments will significantly weaken the immune system, those that have gone through chemotherapy or radiation are also at a higher risk for developing singles. Any other medications that suppress the immune system such as those given to patients going through an organ transplant will have similar effects.
Age
The risk of developing shingles also becomes greater as people age. People over the age of 50 are significantly more likely to develop shingles than any other age group. It is estimated that about half the people who live to age 85 will experience shingles at least once.
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If You Get The Shingles Vaccine Does This Mean Youre 100% Protected From Getting Shingles
No. Just like most vaccines, getting vaccinated with a shingles vaccine doesnt provide 100% protection from disease. However, getting the shingles vaccine reduces your risk of developing shingles.
Even if you do develop shingles, youll be more likely to have a mild case. Also, youll be much less likely to develop postherpetic neuralgia, a painful condition that can follow a shingles outbreak.
How Is Shingles Diagnosed And Treated
If you think you might have shingles, talk to your doctor as soon as possible. Its important to see your doctor no later than three days after the rash starts. The doctor will confirm whether you have shingles and can make a treatment plan. Most cases can be diagnosed from a visual examination. If you have a condition that weakens the immune system, your doctor may order a shingles test. Although there is no cure for shingles, early treatment with antiviral medications can help the blisters clear up faster and limit severe pain. Shingles can often be treated at home.
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What Are The Symptoms Of Shingles And What Do Shingles Look Like
In the early stages of shingles, a person may experience an itchy, tingly or painful sensation several days before the rash appears. Some people also complain of headache, sensitivity to light, body aches and general lack of well-being prior to the formation of the rash. Rash is the most common feature of shingles. The rash is usually painful, itchy or tingly.
How Long Does Shingles Last
From the time you begin to feel symptoms until the rash has totally disappeared can take three to five weeks.
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The Link Between Crohns Disease And Shingles
If youve never had chickenpox, as a child or as an adult, and youre exposed to the virus lets say you touch someone at the contagious, blister stage of shingles transmission could occur and youd get chickenpox.
If you havent had chickenpox, you cant get shingles. But someone who has never had chickenpox or been vaccinated for it can contract chickenpox through close contact with someone who has shingles.
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Is A Vaccine Available To Prevent Shingles
Two vaccines are available in the United States to reduce your chance of developing shingles and postherpetic neuralgia. One vaccine, Zostavax®, has been available since 2006. The second vaccine, Shingrix®, has been available since 2017. Shingrix is recommended as the preferred vaccine by the Advisory Committee on Immunization Practices, a group of medical and public health experts.
Shingrix® is given as a two-dose shot in the upper arm. You should receive the second dose two to six months after receiving the first. Shingrix has been shown to be more than 90% effective in preventing shingles and postherpetic neuralgia. Its effectiveness remains above 85% for at least four years after receiving the vaccine.
Due to high levels of demand for the Shingrix vaccine and a supply shortage, the vaccine manufacturer is managing the timing and distribution of the vaccine throughout the United States. It plans to continue to manage the availability of the vaccine and hopes to make available the same or increased number of doses and to shorten the wait time for delivery this year .
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Prevention Of Herpes Zoster
Because the risk of serious complications from herpes zoster is more likely in older people, those aged over 60 years might consider the zoster vaccine, which can reduce the incidence of herpes zoster by half. In people who do get herpes zoster despite being vaccinated, the symptoms are usually less severe, and post-herpetic neuralgia is less likely to develop. In New Zealand, the zoster vaccine will be funded from 1 April 2018 for people aged between 66 and 80 years old.
Herpes zoster vaccination is contraindicated in immunosuppressed patients due to the risk of it causing disseminated herpes zoster infection.
What Problems Can Happen
Most cases of shingles heal on their own, with or without treatment, and won’t lead to any other problems. In rare cases, shingles can lead to complications, including:
- Ongoing pain : Damaged nerve fibers in the skin send confused messages to the brain, leading to pain. Pain can go on for a long time after the shingles rash is gone. This is the most common shingles complication.
- Vision problems: Shingles near or in an eye can lead to vision loss.
- Skin infections: A shingles rash can become infected with bacteria, leading to impetigo or cellulitis.
- Nervous system problems: Shingles on the face can involve different nerves that connect to the brain. This can lead to nerve-related problems such as facial paralysis, hearing problems, and problems with balance. In very rare cases, shingles can lead to encephalitis .
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Can Shingles Be Prevented Or Avoided
The best way to prevent shingles is through vaccination. Vaccinate your children for chickenpox. This vaccine reduces their risk for getting chickenpox. You cant get shingles unless youve had chickenpox first.
When you are older, get the shingles vaccine. It is recommended for adults 50 years of age and older. It can prevent shingles. People who have had shingles should get the vaccine to help stop the disease from reoccurring. Common side effects of the vaccine are headache, plus redness, swelling, itching, and soreness at the injection site.
The shingles vaccine is not recommended for anyone who:
- Has had an allergic reaction to gelatin or the antibiotic neomycin
- Has an allergy to any component of the shingles vaccine
- Has a weakened immune system due to conditions such as leukemia, HIV, or AIDS
- Is receiving treatment for cancer
- Is being treated with drugs that suppress their immune system, including high-dose steroids
- Is pregnant or might become pregnant within 4 weeks of getting the vaccine
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