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.
Can I Go To Work With Shingles
You can go to work if you have shingles and are no longer contagious. However, you may need to wait until youre feeling better. Shingles can be excruciating and debilitating.
Youre no longer contagious when the rash and blisters begin to scab over. This is typically 10 days after the rash first crops up.
When To Seek Medical Advice
Shingles is not usually serious, but you should see your GP as soon as possible if you recognise the symptoms. Early treatment may help reduce the severity of your symptoms and the risk of developing complications.
You should also see your GP if you are pregnant or have a weakened immune system and you think you have been exposed to someone with chickenpox or shingles and haven’t had chickenpox before.
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What Are The Symptoms Of Shingles
Early symptoms of shingles may include:
Other signs and symptoms that appear a few days after the early symptoms include:
- An itching, tingling or burning feeling in an area of your skin.
- Redness on your skin in the affected area.
- Raised rash in a small area of your skin.
- Fluid-filled blisters that break open then scab over.
- Mild to severe pain in the area of skin affected.
S Of The Shingles Rash
If you have a rash of blisters on your skin or a rash that looks like any shown below, see your doctor immediately for a diagnosis. If you have shingles, its important to get treatment, preferably within 2 to 3 days.
If youve had the rash for longer than 2 to 3 days, its still important to see your doctor.
A typical shingles rash
Doctors often refer to this rash as the shingles band because it looks like a band that appears on one area of your body, as shown here.
A rash on one side of the body
A key that you have shingles is that the rash only develops on one side of your body.
Close-up of a shingles rash
The shingles rash often causes a cluster of tiny blisters. You may notice that the skin beneath the blisters is red and inflamed, as shown here.
The rash will also feel painful.
Blistering shingles rash on a man’s chest
Although the rash can begin in one area, you may notice that a few scattered blisters develop in other areas, as shown here.
Shingles rash on the palm of a man’s hand
While shingles tends to develop on your body or face, it can appear anywhere on your skin.
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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.
These symptoms many include:
The pain can worsen as shingles develops. The pain can be sharp, stabbing, and intense.
It may also cause hypersensitivity, or an excessive reaction to touch.
There are also other early symptoms of shingles.
Although not every person with shingles will experience them, early symptoms include:
- general feeling of being unwell
Your doctor can often diagnose shingles based on these symptoms. Your doctor may prescribe medication to speed up recovery.
Medication also reduces the chance of complications, so seeking early intervention is important.
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.
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Risk Factors For Adults
Youre at higher risk for contracting chickenpox if:
- you live with unvaccinated children
- you work in a school or childcare space
- you spend more than 15 minutes with an infected person
- youve touched the rash on a person who has it
- youve touched something a person with chickenpox has used recently
Youre at higher risk of experiencing complications from chickenpox if:
- youre pregnant and have never had chickenpox
- your immune system is impaired
- youre on steroid medication
When adults develop chickenpox, they may notice flu-like symptoms before the rash. Adults actually may have stronger a reaction to chickenpox than children.
The National Foundation for Infectious Diseases says adults are 25 times more likely to die from chickenpox than children. Therefore, its extremely important to talk with a doctor to see how you can protect yourself from chickenpox if youve neither been vaccinated nor exposed.
There are a couple of things to consider before pursuing the shingles vaccine.
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.
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Is Chickenpox And Shingles A Form Of Herpes
Though shingles and herpes are two distinct conditions caused by two distinct viruses, the viruses are both members of a family formally known as herpesviridae. The herpes simplex virus takes its formal name from this umbrella term, while the varicella-zoster virus does not.
Although it is a condition unrelated to herpes, shingles is sometimes referred to as herpes zoster, a nickname that references the shared family of the viruses that cause them. Within this viral family, only the herpes simplex virus causes the condition we know today as herpes.
If you are ever unsure whether your doctor is referring to herpes simplex or shingles when you hear the word herpes, ask for clarification.
What Are Shingles Symptoms
Common symptoms of shingles are pain and a rash in a belt-like form that stops at the midline of the body affecting only one side. Symptoms of shingles progress from burning and itching sensations to severe pain at the location of the rash. Early shingles symptoms may include burning, tingling, or a numb sensation on the skin accompanied by headache, upset stomach, and chills.
Later stages include painful fluid-filled blisters that cause severe pain, fever, and severe itching.
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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.
Who Should Not Be Vaccinated With Shingrix
You shouldnt receive the Shingrix vaccine if you:
- Have ever had a severe allergy to this vaccine or any ingredient in this vaccine.
- Are breastfeeding or pregnant.
- Currently have shingles.
- Are ill and have a high fever.
- Have tested negative for immunity to varicella-zoster virus .
Ask your healthcare provider if the benefits of getting the vaccine outweigh any potential risks.
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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.
Seek Treatment Right Away
Many people have the mistaken impression that, like poison ivy, shingles is a nuisance rash that fades on its own. But in fact a shingles rash should alert people, especially in middle or old age, to seek immediate medical help, says Dr. Oaklander.
Rapid treatment with one of three antiviral drugs, acyclovir , valacyclovir , or famciclovir , can shorten a shingles attack and reduce the risk of serious damage, such as:
- Long-term pain. Pain that lingers in the area of a healed shingles rash is called postherpetic neuralgia. This often-disabling pain can last several months to a year.
- Prolonged itching. Many people are left with an itchy area from their shingles, which can be as disabling as chronic pain. It is most common on the head or neck.
- Damage to vision and hearing. Pain and rash near an eye can cause permanent eye damage and requires an urgent ophthalmological exam. When the nerve to the ear is affected, it can permanently damage hearing or balance.
- Strokes and heart attacks. A PLOS Medicinestudy that tracked about 67,000 people ages 65 and older who were newly diagnosed with shingles found that stroke risk more than doubled in the first week after the shingles diagnosis. The same study reported an increased risk for heart attacks in the three months after shingles, but the additional risk dissipated after six months.
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What Are The Complications Of Shingles
After the shingles rash has disappeared, you might continue to have nerve pain in that same area. Postherpetic neuralgia can last for months or years and become quite severe.
More than 10% of people who get shingles develop postherpetic neuralgia. Researchers dont know why some people get postherpetic neuralgia and others dont. It may be that nerves become more sensitive or that the virus may be invading and damaging the central nervous system.
Other complications include:
- Other types of nerve issues like numbness or itching.
- A bacterial infection of the shingles rash.
- Eye and ear inflammation if the rash is near these organs.
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.
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Shingles On Your Buttocks
You can get a shingles rash on your buttocks. Shingles usually only affects one side of your body, so you may have a rash on one buttock but not the other.
As with other areas of the body, shingles on your buttocks may cause initial symptoms like tingling, itching, or pain.
After a few days, a red rash or blisters may develop. Some people experience pain but dont develop a rash.
. After the varicella-zoster virus initially reactivates, your skin may:
Shingles usually develops on one side of your body, often on your waist, back, or chest.
Within about 5 days, you may see a red rash in that area. Small groups of oozing, fluid-filled blisters may appear a few days later in the same area. You may experience flu-like symptoms such as a fever, headache, or fatigue.
During the next 10 days or so, the blisters will dry up and form scabs. The scabs will clear after a couple of weeks. After the scabs clear, some people continue to experience pain. This is called postherpetic neuralgia.
Urgent Advice: Get Advice From 111 As Soon As You Suspect Shingles
You might need medicine to help speed up your recovery and avoid longer-lasting problems.
This works best if taken within 3 days of your symptoms starting.
111 will tell you what to do. They can arrange a phone call from a nurse or doctor if you need one.
Go to 111.nhs.uk or .
Get an urgent GP appointment
A GP may be able to treat you.
Ask your GP surgery for an urgent appointment.
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Can Shingles Be Prevented
There are 2 vaccines available to reduce the likelihood of developing shingles, Zostavax and Shingrix. If you are over 50, you can talk to your doctor about whether you need it. It is recommended for everyone over 60 and is given free of charge in Australia to people aged 70 to 79.
Vaccination will not guarantee that you will not get shingles, but it will reduce your chance of developing the condition. The vaccine used to protect against shingles is not the same as the vaccine used to protect against chickenpox. Read more about the chickenpox vaccine here.
Are There Natural Ways To Boost Your Immune System To Help Lessen The Chances Of Developing Shingles
Stress is a risk factor for developing shingles, so limiting your stress can be helpful. Try meditation, yoga or other relaxation methods.
Other things you can do include:
- Eat a healthy diet.
- Aim for seven to nine hours of sleep each night.
- Dont smoke or use tobacco products.
These are all tips for an overall healthy lifestyle, not just for reducing your chance of getting shingles.
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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.
How Long Does It Take For Shingles To Progress
Shingles progresses into blisters over three to five days and begins to crust over after seven to ten days. The rash is preceded by a prodromal phase lasting 48-72 hours or longer, consisting of throbbing pain and numbness in the area affecting the nerve. Once the rash blisters, it can last another three to five days before the lesions scab over.
After the lesions crust over, it may take two to four weeks to heal completely. At this time, pain may still be present. The most painful stage of shingles is when you have fluid-filled blisters. This usually occurs three to five days after the rash first appears.
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When Should I See My Doctor
See your doctor as soon as possible if you are experiencing any symptoms of shingles. Starting treatment with antiviral medicines within 3 days of the rash appearing should reduce the severity of symptoms and the risk of further complications, including post-herpetic neuralgia.
See your doctor straight away if you have symptoms of shingles and are experiencing the following:
- symptoms that affect your eye area
- a temperature of 38°C or higher
You should also see your doctor if you are pregnant, or have a weakened immune system due to medicine that suppresses the immune system, or a condition that weakens your immune system.
You Cannot Get Shingles From Someone With Chickenpox
You cannot get shingles from someone with shingles or chickenpox.
But you can get chickenpox from someone with shingles if you have not had chickenpox before.
When people get chickenpox, the virus remains in the body. It can be reactivated later and cause shingles if someone’s immune system is lowered.
This can be because of stress, certain conditions, or treatments like chemotherapy.
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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.