Questions To Ask Your Doctor
- Ive had chickenpox. Am I at risk of developing shingles?
- What is the best treatment for my shingles?
- The pain from shingles isnt going away. What can I do to make myself more comfortable?
- Im on treatment for shingles. When should I call my doctor if things dont get better?
- I have shingles and my children havent had the chickenpox vaccine. Should I get them vaccinated?
- Is the shingles vaccine right for me?
- Are there any risks associated with the shingles vaccine?
- Will my post-herpetic neuralgia ever go away?
- If Ive never had the chickenpox, should I still get the shingles vaccination?
Key Points About Shingles
- Shingles is a common viral infection of the nerves. It causes a painful rash or small blisters on an area of skin.
- Shingles is caused when the chickenpox virus is reactivated.
- It is more common in people with weakened immune systems, and in people over the age of 50.
- Shingles starts with skin sensitivity, tingling, itching, and/or pain followed by rash that looks like small, red spots that turn into blisters.
- The rash is typically affects just one area on one side of the body or face.
- Treatment that is started as soon as possible helps reduce the severity of the disease.
What Outcome Can I Expect If I Have Postherpetic Pain
Theres no standard treatment for the symptoms of postherpetic pain . Depending on the severity of your pain, you may start with over-the-counter products. If your pain is more severe, one or more prescription medications may be tried. PHN is difficult to treat. Achieving a complete symptom-free state was achieved in less than half the patients with PHN, according to one study.
PHN tends to happen in older individuals who may have other health conditions, which can complicate treatment and results. Pain can last weeks, months and even longer than a year. In some people, the pain can be debilitating. In most people, PHN lessens with time.
A note from Cleveland ClinicThe best way to not get postherpetic neuralgia is to prevent it from happening in the first place. Varicella-zoster virus causes both chickenpox and shingles. Vaccines are available to protect against developing both of these viral infections.
Once you develop chickenpox, the varicella-zoster virus remains in your body for life. If the virus reactivates and causes shingles, you have a few days around the rash outbreak to see your provider and get an antiviral medication, which can significantly lessen your symptoms. Still, if you develop PHN, your provider has many medications available to manage your symptoms.
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Early Intervention Is The Key To Treatment
Antiviral medicines such as valacyclovir , famciclovir or acyclovir , taken orally, are usually used to treat shingles. When taken at the very beginning, Ralph says, they can improve symptoms and reduce the risk of postherpetic neuralgia.
Starting antiviral treatment for shingles more than three days after symptoms start is generally believed to be ineffective because the virus is no longer reproducing. Still, many doctors will try treating the condition with antiviral drugs after this time.
An aggressive, early approach to controlling shingles pain may also reduce a person’s chance of developing PHN. In one study, people who started taking amitriptyline for shingles pain as soon as a rash appeared had less pain after six months than those taking a placebo.
“Rapid initiation of treatment for shingles is very important,” says Rumbaugh. “If treatment is started in the first three days, it can reduce the chance of postherpetic neuralgia and make it less severe if it does occur.” This window of opportunity is often missed, however, because most people don’t get to the doctor that quickly.
What Increases The Risk Of Long
The risk of developing post-herpetic neuralgia increases with age. Four weeks after getting shingles,
- 27% of 55- to 59-year-olds and
- 73% of over 70-year-olds had nerve pain.
Women seem to be more likely to have longer-lasting nerve pain than men. Post-herpetic neuralgia is also more likely to develop if your eyes were affected by shingles.
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What Causes Shingles Pain
Chickenpox, shingles, and postherpetic neuralgia all result from infection with a single virus called varicella zoster virus . Most people catch the varicella zoster virus as children, itch and shiver through the rash and fever of chickenpox, and get better.
But that’s not necessarily the end of the story of varicella infection. After a bout of chickenpox, our immune systems never completely eradicate the VZV virus. They just chase it into hiding. Varicella retreats into nerve cells deep under the skin, near the spine.
For most of us, VZV lies dormant inside our bodies throughout our lives, never causing further problems. In about one-third of people, however, VZV infection has a second act. The virus emerges from hiding, travels along a nerve to the skin, and erupts in a bumpy, painful rash on one side of the body. This sneak attack is called herpes zoster, or shingles.
What Is The Outlook For People With Recurring Shingles
Shingles usually clears up within two to six weeks.
In a small number of cases, the pain can remain once the rash has healed. This is called postherpetic neuralgia . Up to 2 percent of people who get shingles have PHN for five years or more. The risk increases with age.
Recurring shingles isnt preventable. You can reduce your risk by getting the shingles vaccine, even after youve had shingles.
A showed that people who had the shingles vaccine had 51 percent fewer cases of shingles. For people 50-59 years old, the shingles vaccine reduced the risk of shingles by 69.8 percent.
People who received the shingles vaccine generally had less severe cases of shingles. They also had
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When Should I See A Doctor Because Of The Side Effects I Experience From Shingrix
Shingrix causes a strong response in your immune system, so it may produce short-term side effects. These side effects can be uncomfortable, but they are expected and usually go away on their own in 2 or 3 days. You may choose to take over-the-counter pain medicine such as ibuprofen or acetaminophen. Contact your healthcare provider if the symptoms are not improving or if they are getting worse.
In clinical trials, Shingrix was not associated with serious adverse events. In fact, serious side effects from vaccines are extremely rare. For example, for every 1 million doses of a vaccine given, only one or two people might have a severe allergic reaction. Signs of an allergic reaction happen within minutes or hours after vaccination and include hives, swelling of the face and throat, difficulty breathing, a fast heartbeat, dizziness, or weakness. If you experience these or any other life-threatening symptoms, see a doctor right away.
How Is Postherpetic Neuralgia Treated
If shingles is caught within the first three days of its outbreak, your healthcare provider may prescribe the antiviral medication acyclovir , valacyclovir or famciclovir . These medications help the rash/blisters heal faster, keep new sores from forming, decrease pain and itching and reduce length of pain after sores have healed.
If your shingles outbreak is not caught early, your healthcare providers has many options to manage your postherpetic neuralgia symptoms.
If your pain is mild, your healthcare provider may recommend:
- Acetaminophen or NSAIDs such as ibuprofen .
- Creams and patches include lidocaine and capsaicin .
If your pain is more severe, your healthcare may prescribe:
- Antiseizure drugs gabapentin and pregabalin .
- Antidepressants, such as escitalopram , quetiapine or amitriptyline.
- Botulinum toxin injections in the area where you are having pain.
Theres no clear-cut superior treatment for PHN. Your provider may need to try more than one medication or prescribe the use of several medications at the same time. You and your provider will discuss options and what makes sense to try for you. Contact your provider if your pain is not lessening after taking your medicine. Take all your medications exactly as prescribed.
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What Is Shingles And Who Can Get It
Shingles is another name for a condition called herpes zoster. It causes a painful rash. You can only get shingles if you had chickenpox in the past.
After you have chickenpox , the virus that causes it stays in your body, in certain nerve cells. Most of the time your immune system keeps the chickenpox virus in these cells. As you get older or if your immune system gets weak, the chickenpox virus may escape from the nerve cells and cause shingles.
Most people who get shingles are more than 50 years old or have a weak immune system. For example, you might get shingles if you have cancer, take medicines that weaken your immune system or have the virus that causes AIDS .
Who Is At Risk Of Getting Shingles
Shingles typically affects older people, but it can also occur in healthy younger persons and even in children. Those whose immune systems have been weakened by cancer, HIV infection, AIDS, or treatment with certain medicines are also at increased risk of getting shingles.
- Anyone who has had chickenpox is at risk of getting shingles later in life. About 1 in 3 people who have not been immunised against chickenpox or shingles will get shingles in their lifetime.
- Shingles usually affects older people. The older you are if you get shingles, the higher your risk of getting serious disease. People who have a weakened immune system are also at risk of getting more severe disease, even if they are young.
- Women have a higher risk of getting shingles than men.
- Most people who develop shingles have only 1 episode during their lifetime. However, you can have shingles more than once.
An attack of shingles during pregnancy will not harm the unborn baby. The mother is already carrying the varicella zoster virus before developing shingles and there is no increase in the risk of passing it on to the fetus if shingles develops. However, an attack of chickenpox during pregnancy can be serious and requires urgent medical attention.
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How Is Shingles Prevented
The best protection against shingles is vaccination. Chickenpox vaccine should prevent you from getting the virus, and so decrease the risk of both chickenpox and shingles. Shingles vaccine reduces the risk of getting shingles and its complications you may still get shingles, but the symptoms are usually less severe and post-herpetic neuralgia is less likely. In New Zealand there are 2 brands of vaccines that protect against shingles Shingrix and Zostavax. These vaccines differ in the way they work, their cost and how they are given. Read more about the differences between Shingrix and Zostavax.
How Can I Take Care Of Myself
- Take a pain-relief medicine such as acetaminophen. Take other medicine as prescribed by your healthcare provider.
- Put cool, moist washcloths on the rash.
- Rest in bed during the early stages if you have fever and other symptoms.
- Try not to let clothing or bed linens rub against the rash and irritate it.
- You develop worsening pain or fever.
- You develop a severe headache, stiff neck, hearing loss, or changes in your ability to think.
- The blisters show signs of bacterial infection, such as increasing pain or redness, or milky yellow drainage from the blister sites.
- The blisters are close to the eyes or you have pain in your eyes or trouble seeing.
- You have trouble walking.
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Who Should Not Get Shingrix
You should not get Shingrix if you:
- Have ever had a severe allergic reaction to any component of the vaccine or after a dose of Shingrix.
- Currently have shingles.
- Currently are pregnant. Women who are pregnant should wait to get Shingrix.
If you have a minor illness, such as a cold, you may get Shingrix. But if you have a moderate or severe illness, with or without fever, you should usually wait until you recover before getting the vaccine.
What Are The Symptoms Of Shingles
Usually, shingles develops on just one side of the body or face, and in a small area. The most common place for shingles to occur is in a band around one side of the waistline.
Most people with shingles have one or more of the following symptoms:
- Fluid-filled blisters
- Tingling, itching, or numbness of the skin
- Chills, fever, headache, or upset stomach
For some people, the symptoms of shingles are mild. They might just have some itching. For others, shingles can cause intense pain that can be felt from the gentlest touch or breeze. Its important to talk with your doctor if you notice any shingles symptoms.
If you notice blisters on your face, see your doctor right away because this is an urgent problem. Blisters near or in the eye can cause lasting eye damage and blindness. Hearing loss, a brief paralysis of the face, or, very rarely, inflammation of the brain can also occur.
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What Causes Postherpetic Neuralgia
Postherpetic neuralgia results from damage to nerve fibers during shingles infection. The nerve fibers at the skin in the affected area send exaggerated pain signals to your brain. Postherpetic neuralgia means nerve pain after herpes. Shingles is also called herpes zoster.
Shingles is caused by the varicella-zoster virus, the virus that causes chickenpox. Once youve had chickenpox, the virus remains in your body for your entire life, but is dormant or silent for years. When the virus becomes reactivated, it causes shingles. A certain percentage of people who get shingles develop PHN.
What Everyone Should Know About The Shingles Vaccine
CDC recommends that adults 50 years and older get two doses of the shingles vaccine called Shingrix to prevent shingles and the complications from the disease. Adults 19 years and older who have weakened immune systems because of disease or therapy should also get two doses of Shingrix, as they have a higher risk of getting shingles and related complications.
Your doctor or pharmacist can give you Shingrix as a shot in your upper arm.
Shingrix provides strong protection against shingles and PHN. In adults 50 years and older who have healthy immune systems, Shingrix is more than 90% effective at preventing shingles and PHN. Immunity stays strong for at least the first 7 years after vaccination. In adults with weakened immune systems, studies show that Shingrix is 68%-91% effective in preventing shingles, depending on the condition that affects the immune system.
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When Should I Contact A Doctor For Shingles Symptoms
As soon as you believe that you may be experiencing a shingles infection, let your doctor know. Starting treatment with an antiviral medication within 3 days of your rash appearing can help decrease the severity of your infection and prevent PHN.
Even if you have had the rash for longer than 3 days, contact your doctor for advice on how to proceed with treatment.
What Causes Shingles
Anyone who has had chickenpox in the past can develop shingles. The chickenpox virus stays in the nerve cells near the spine but is not active. Shingles occurs when the virus becomes active again.
Shingles can occur at any age, but it usually affects people over 40. About 1 in 3 people who have not been immunised against chicken pox or shingles will develop shingles at some stage during their lifetime. Shingles often occurs with no known trigger. It is more likely to occur if you:
- are aged 60 or older
- are experiencing physical and emotional stress
- have HIV and AIDS
- have had an organ transplant
- have recently had a bone marrow transplant
- have a condition which requires treatment that affects the immune system, such as chemotherapy for cancer
Usually, people only get shingles once in their lives. But sometimes, especially if you have a weakened immune system, you might get repeated infections. You cannot catch shingles from someone who has the condition. If you have not had chickenpox, you can catch chickenpox by coming into direct contact with fluid on the blisters of someone who has shingles.
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How Does It Occur
If you have had chickenpox, you are at risk for later developing shingles. After you recover from chickenpox, the chickenpox virus stays in your body. It moves to the roots of your nerve cells and becomes inactive . Later, if the virus becomes active again, shingles is the name given to the symptoms it causes.
What exactly causes the virus to become active is not known. A weakened immune system seems to allow reactivation of the virus. This may occur with normal aging, immune-suppressing medicines, or another illness, or after major surgery. It can also happen as a complication of cancer or AIDS or treatment of these illnesses. Chronic use of steroid drugs may trigger shingles. The virus may also become active again after the skin is injured or sunburned. Emotional stress seems to be a common trigger as well.
What Can I Do About The Pain
To help with the pain of shingles, your doctor might have you take an over-the-counter pain medicine like acetaminophen or ibuprofen . Aspirin is not recommended because you might also get Reye’s syndrome, a liver problem.
Putting a medicated lotion on the blisters might help the pain and itching. Putting cool compresses soaked in an astringent liquid on the blisters and sores also might make them hurt or itch less.
If shingles causes severe pain, your doctor might have you take a prescription pain medicine.
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