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.
Know The Bathing Dos And Donts
Using the right water temperature while bathing or showering can make a big difference in how your skin feels and heals. Ideally, you should bathe with cool or lukewarm water and avoid very hot water.
You can also apply a cool, wet compress to the rash and blisters. The AAD recommends you soak a clean washcloth in cold water and place the cloth on top of the affected area several times a day. Leave it on for 5 to 10 minutes.
You should avoid rubbing washcloths, sponges, or exfoliants on the area.
You can also add colloidal oatmeal or cornstarch to your baths to provide some much-needed itch relief. Just be sure to dry your skin gently after getting out of the bath. Then, follow up with a layer of calamine lotion to soothe your skin, or keep it dry and cover with a bandage if its still weeping.
Shingles: Symptoms And Effects Of Virus
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The same virus that leads to chickenpox, the varicella-zoster virus, causes shingles. Those who have had chickenpox can develop shingles. While recovering from chickenpox, the virus enters your nervous system and remains there, dormant, for years.
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What Are The Symptoms
Shingles symptoms happen in stages. At first you may have a headache or be sensitive to light. You may also feel like you have the flu but not have a fever.
Later, you may feel itching, tingling, or pain in a certain area. That’s where a band, strip, or small area of rash may occur a few days later. The rash turns into clusters of blisters. The blisters fill with fluid and then crust over. It takes 2 to 4 weeks for the blisters to heal, and they may leave scars. Some people only get a mild rash. And some do not get a rash at all.
It’s possible that you could also feel dizzy or weak. Or you could have pain or a rash on your face, changes in your vision, changes in how well you can think, or a rash that spreads. A rash or blisters on your face, especially near an eye or on the tip of your nose, can be a warning of eye problems.
if you think you may have shingles. It’s best to get early treatment. Medicine can help your symptoms get better sooner. And if you have shingles near your eye or nose, see your doctor right away. Shingles that gets into the eye can cause permanent eye damage.
Why Doesnt Having Chickenpox Earlier In Life Provide Immunity Against Having Shingles Later
After having chickenpox, your body doesnt rid your system of the virus. Instead, the virus stays in a portion of the spinal nerve root called the dorsal root ganglion. In most people, the virus simply stays there quietly and doesnt cause problems. Scientists arent always sure why the virus gets active again, but they know stress can be a cause.
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How To Prevent Shingles: Get Vaccinated
Two vaccines may help prevent the shingles virus: the chickenpox vaccine and the shingles vaccine. The shingles vaccine is approved for adults ages 50 and older and for those 18 and older with weakened immune systems or at increased risk of herpes zoster because of a disease or treatment, according to the CDC.
Per the CDC, talk to your doctor about getting a shingles vaccination if you are 50 or older or if you have the following risk factors:
- You have cancer, especially leukemia or lymphoma.
- You are a bone marrow or solid organ transplant recipient.
- You take immunosuppressive medications, including steroids, chemotherapy, or transplant-related medications.
Complications Of Shingles Without Rash
Complications from shingles can be very severe, particularly if the outbreak goes untreated.
- Postherpetic Neuralgia-This condition is caused when the nerve fibers become confused after their interaction with the shingles virus. Postherpetic neuralgia will cause the nerves to send exaggerated feelings of pain from the skin to the brain, even after the shingles outbreak has healed.
- Neurological Problems-Nerves can become permanently damaged after suffering from a shingles outbreak. Facial paralysis, hearing problems, balance problems or inflammation of the brain are all possible side effects.
- Vision Loss-If a shingles outbreak occurs around the eye it can cause a severe infection. This may cause vision damage or permanent vision loss.
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How Long Will The Effects Last
The rash from shingles will heal in 1 to 3 weeks and the pain or irritation will usually go away in 3 to 5 weeks. When shingles occurs on the head or scalp, the symptoms usually go away eventually, but it may take many months.
If the virus damages a nerve, you may have pain, numbness, or tingling for months or even years after the rash is healed. This is called postherpetic neuralgia. This chronic condition is most likely to occur after a shingles outbreak in people over 50 years old. Taking antiviral medicine as soon as the shingles is diagnosed may help prevent this problem.
How Is Postherpetic Neuralgia Treated
Treatments include lotions or creams and/or other medications not specifically used for pain, such as antidepressants or drugs for epilepsy. Regular pain relievers are not usually effective for this type of pain.
If your pain doesnt lessen, you might try therapies like nerve blocks or steroid injections near the area where the nerves exit the spine. Your provider might suggest an implantable nerve stimulator device for severe, ongoing pain that hasnt responded to other treatments.
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Is There A Treatment For Shingles
Several antiviral medicines, acyclovir , valacyclovir , and famciclovir , are available to treat shingles. These medications should be started as soon as possible after the rash appears and will help shorten the illness and decrease how severe the illness is. Pain medicine may also help with pain caused by shingles. Call your provider as soon as possible to discuss treatment options.
What Are The Possible Side Effects Of Shingrix
Studies show that Shingrix is safe. The vaccine helps your body create a strong defense against shingles. As a result, you are likely to have temporary side effects from getting the shots. The side effects might affect your ability to do normal daily activities for 2 to 3 days.
Most people got a sore arm with mild or moderate pain after getting Shingrix, and some also had redness and swelling where they got the shot. Some people felt tired, had muscle pain, a headache, shivering, fever, stomach pain, or nausea. Some people who got Shingrix experienced side effects that prevented them from doing regular activities. Symptoms went away on their own in about 2 to 3 days. Side effects were more common in younger people.
You might have a reaction to the first or second dose of Shingrix, or both doses. If you experience side effects, you may choose to take over-the-counter pain medicine such as ibuprofen or acetaminophen.
Guillain-Barré syndrome , a serious nervous system disorder, has been reported very rarely after Shingrix. There is also a very small increased risk of GBS after having shingles.
If you experience side effects from Shingrix, you should report them to the Vaccine Adverse Event Reporting System . Your doctor might file this report, or you can do it yourself through the VAERS websiteexternal icon, or by calling 1-800-822-7967.
If you have any questions about side effects from Shingrix, talk with your doctor.
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Will Shingles Go Away Without Treatment
Shingles, or herpes zoster, is a painful rash caused by the varicella-zoster virus . This is the same virus that causes chickenpox.
This virus remains dormant in a part of your nervous system called the dorsal root ganglion. It can be reactivated during times of stress or illness, or when the immune system is weakened by an autoimmune disease or cancer.
The risk of developing shingles is relatively low for healthy young adults about 4 out of 1,000 people in the United States, according to the Centers for Disease Control and Prevention . Its much higher for those above age 60. Shingles affects about 1 out of 100 people in this older age group, the CDC says.
Generally, a case of shingles rash resolves within 3 to 4 weeks. It can resolve without treatment, but antiviral treatment can shorten both the duration and severity of the rash.
What Does It Mean To Let Shingles Run Its Course
This refers to the typical course a shingles rash takes, even with antiviral treatment:
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How Is It Treated
It is best to start treatment as soon as possible after you notice the rash. See your healthcare provider to discuss treatment with antiviral medicine, such as acyclovir. This medicine is most effective if you start taking it within the first 3 days of the rash. Antiviral medicine may speed your recovery and lessen the chance that the pain will last for a long time.
Your provider may also recommend or prescribe:
- medicine for pain
- antibacterial salves or lotions to help prevent bacterial infection of the blisters
- corticosteroids
Why Two Types Of Shingles
Most people are infected with VZV at some point. This type of virus stays in your body forever, but it lies dormant most of the time. When it reactivates, it causes shingles.
The infection affects a single nerve and the itching and pain are confined to the path of that nerve. That generally means symptoms in a stripe on one side of your body.
Typical shingles develops from an infection in a sensory nerve
In internal shingles, the infected nerve is deeper in the body, often in the digestive organs. It doesn’t cause a rash because those nerves don’t connect to your skin.
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Can You Diagnose Shingles Before The Rash Appears
The first symptoms of shingles Early symptoms of shingles can appear several days before the more obvious symptoms. However, some people will not have early symptoms before a rash appears. The most common early symptoms occur on one part of the body or face. This often happens in the abdominal area.
Tingling Pain Or Numbness
During the first stage of shingles, before anything appears on your skin, a particular area of your body may begin to feel different. “When a shingles outbreak is starting, you may feel itching, burning, or pain,” Kim says. Often you will feel this on only one side of your body.
The initial signs of shingles may feel different for each person. In some cases, shingles can cause intense sensitivity, making it painful to even wear clothes over your skin, while in other cases, your skin may feel numb.
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Can I Give Shingles To Others
No one can catch shingles from you. But the virus can be spread to a person who has never had chickenpox. The virus lives in the blisters that shingles causes. It can be spread until the blisters are completely healed. If you have blisters that have not crusted over yet, you should stay away from:
- Anyone who has never had chickenpox
- Babies under 12 months old
- Very sick people
Tell your doctor if you live with children who have not had chickenpox. They may need to be vaccinated.
Do You Need To Stay Away From Children People Who Are Pregnant Have Cancer Or Anyone With A Weak Immune System After You Get The Zostavax Vaccine
According to the CDC, its safe to be around babies and young children, pregnant women or anyone with a weakened immune system after you get the Zostavax vaccine. Even though the Zostavax vaccine contains a weakened live varicella-zoster virus, the CDC says theres no documented case of a person getting chickenpox from someone who has received the Zostavax vaccine. And remember: You cant get shingles unless youve already had chickenpox.
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Do You Always Get The Typical Rash If You Have Shingles
Occasionally, some people dont get a rash. If you have any of the other symptoms of shingles , see your healthcare provider sooner rather than later. There are effective treatments you can take early for shingles. Even if you dont have shingles, seeing your healthcare provider will help you get your condition diagnosed and treated.
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.
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Where Does Shingles Come From
When you have chickenpox as a child, your body fights off the varicella-zoster virus and the physical signs of chickenpox fade away, but the virus always remains in your body. In adulthood, sometimes the virus becomes active again. This time, the varicella-zoster virus makes its second appearance in the form of shingles.
How Is Shingles Spread
A person must have already had chickenpox in the past to develop shingles. A person cannot get shingles from a person that has shingles. However, the virus that causes chickenpox and shingles can be spread from a person with active shingles to a person who has never had chickenpox or had the chickenpox vaccine. The person exposed to the virus would develop chickenpox, not shingles. A person with shingles can spread the virus when the rash is in the blister-phase. The blister fluid is filled with virus particles. The virus is spread through direct contact with the rash or through breathing in virus particles that get mixed in the air. Once the rash has developed crusts, the person is no longer contagious. A person is not infectious before blisters appear or if pain persists after the rash is gone .
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Dont Shrug Off Shingles
- By Matthew Solan, Executive Editor, Harvard Men’s Health Watch
ARCHIVED CONTENT: As a service to our readers, Harvard Health Publishing provides access to our library of archived content. Please note the date each article was posted or last reviewed. No content on this site, regardless of date, should ever be used as a substitute for direct medical advice from your doctor or other qualified clinician.
If you had chickenpox as a kid, there is a good chance you may develop shingles later in life. In fact, one in three is predicted to get shingles during their lifetime, says Dr. Anne Louise Oaklander, director of the Nerve Unit at Harvard-affiliated Massachusetts General Hospital.
The same varicella-zoster virus that causes chickenpox also causes shingles. After the telltale spots of chickenpox vanish, the virus lies dormant in your nerve cells near the spinal cord and brain. When your immunity weakens from normal aging or from illnesses or medications, the virus can re-emerge. It then travels along a nerve to trigger a rash in the skin connected to that nerve. The rash often appears on only one side of your body. The most common locations are the chest, back, or stomach, or above one eye.
Is The Zostavax Vaccine Still Being Used
Yes. The CDC, however, recommends Zostavax for adults age 60 and older, but not routinely for people aged 50 to 59. Zostavax is given as a single-dose shot versus the two-dose shot for Shingrix. Zostavax is less effective than Shingrix in preventing shingles and postherpetic neuralgia .
You can consider Zostavax if you are allergic to Shingrix or if Shingrix is unavailable because of supply shortage and you want some immediate protection from a possible case of shingles and/or postherpetic neuralgia. Because its a weakened live vaccine, it may be dangerous if you have cancer, HIV, or take steroids, chemotherapy or other medications that suppress your immune system. Ask your healthcare provider if the Zostavax vaccine is an option for you.
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