What Are The Symptoms
The first sign of shingles is often burning, sharp pain, tingling, or numbness in your skin on one side of your body or face. The most common site is the back or upper abdomen. You may have severe itching or aching. You also may feel tired and ill with fever, chills, headache, and upset stomach or belly pain.
One to 14 days after you start feeling pain, you will notice a rash of small blisters on reddened skin. Within a few days after they appear, the blisters will turn yellow, then dry and crust over. Over the next 2 weeks the crusts drop off, and the skin continues to heal over the next several days to weeks.
Because shingles usually follows nerve paths, the blisters are usually found in a line, often extending from the back or side around to the belly. The blisters are almost always on just one side of the body. Shingles usually doesn’t cross the midline of the body. The rash also may appear on one side of your face or scalp. The painful rash may be in the area of your ear or eye. When shingles occurs on the head or scalp, symptoms can include headaches and weakness of one side of the face, which causes that side of the face to look droopy. The symptoms usually go away eventually, but it may take many months.
In some cases the pain can last for weeks, months, or years, long after the rash heals. This is called postherpetic neuralgia.
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.
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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.
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When Should I Get The Shingles Vaccine
The current shingles vaccine is a safe, easy, and more effective way to prevent shingles than the previous vaccine. In fact, it is over 90% effective at preventing shingles. Most adults age 50 and older should get vaccinated with the shingles vaccine, which is given in two doses. You can get the shingles vaccine at your doctors office and at some pharmacies.
You should get the shingles vaccine if you:
- Have already had chickenpox, the chickenpox vaccine, or shingles
- Received the prior shingles vaccine called Zostavax
- Dont remember having had chickenpox
Medicare Part D and private health insurance plans may cover some or all of the cost. Check with Medicare or your health plan to find out if it is covered.
You should not get vaccinated if you:
- Currently have shingles
- Are sick or have a fever
- Had an allergic reaction to a previous dose of the shingles vaccine
If you are unsure about the above criteria or have other health concerns, talk with your doctor before getting the vaccine.
Rebooting The Nervous System
Its like restarting a computer, Dr. Rosenquist says. When its running slowly or acting weird, you restart it. We are trying to turn that nerve off. When it comes back on, hopefully, it will send an appropriate transmission as opposed to a pain transmission.
Treatmentoptions for PHN patients include:
Patientswith refractory PHN rarely need opioid pain medication. However,you should be evaluated by a physician. We cant make a blanket statement abouttreatment. It is individualized, she says.
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Other Health Problems Due To Shingles
Some people develop other health problems after the shingles rash clears, which include:
Postherpetic neuralgia : This is the most common. Occurring where you had the rash, PHN can cause constant tingling, burning, and pain. For others, the pain comes and goes.
Whether the pain is constant or intermittent, it can go on for a long time. You can have PHN for months, years, or the rest of your life. There is no way to know how long it will last.
The pain caused by PHN can become so severe that it interferes with your life, making everyday activities painful. A musician may no longer be able to play an instrument. Some people cannot walk comfortably. It may be difficult to bathe or get dressed. You may have trouble sleeping.
How to prevent PHN: If you have shingles, you can greatly reduce your risk of PHN by getting treated for shingles within 3 days of developing the rash.
Get treated for shingles within 3 days of developing the rash
Taking antiviral medication within 3 days of getting the shingles rash can: Reduce your risk of developing PHN Ease symptoms of shingles Clear the shingles rash more quickly
Other health problems that can develop after the shingles rash clears include:
Blindness or loss of some eyesight
Although rare, some people die of shingles.
Treatment can prevent these complications.
You can find out if you have a greater risk of developing shingles at, Shingles: Causes.
What Causes Internal Shingles
The varicella zoster virus causes shingles. Its the same virus that causes chickenpox. After a bout of chickenpox, the virus becomes dormant in the body and settles in certain nerves and tissue of the nervous system. Later in life, the virus can reactivate and present itself as shingles. Shingles typically appears on the skin along the nerve path where it had been previously dormant. If the reactivation of the virus becomes severe, it can affect not only the skin but other organs too. This is what is called systemic or internal shingles.
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Risk Factors For Nerve Pain After Shingles
Researchers have long known that older people are more likely to get PHN, the nerve pain after shingles, but recent studies have found other factors that increase risks.
In one study published in the journal Neurology, researchers — including Dworkin — looked at data from 965 people with shingles. The researchers identified five risk factors for developing PHN in people who had been recently diagnosed with shingles:
- Presence of symptoms before the rash appeared, like numbness, tingling, itching, or pain
- Severe pain during the illness’s initial stages
Importantly, the researchers found the more risk factors you have, the greater the risk of developing PHN.
For instance, 17% of women with shingles and 26% of those who had severe pain went on to get PHN. But 50% of women who were over age 60 and had symptoms before the rash, severe rash, and acute pain went on to get PHN.
Focus On Prevention Doctors Say
Prevention is the best way to avoid a shingles episode.
There is a vaccine that prevents the onset of shingles in people exposed to chickenpox. The CDC recommends that people age 60 and older get one dose of the vaccine. Vaccines are readily available at a doctors office and drug stores. In 2011, the Food and Drug Administration extended the vaccine use for people aged 50 to 59.
Wigand-Bolling said the vaccine reduces the incidence of shingles by 51% and the neuralgia associated with shingles by 67%. The doctor said the vaccine is injected and once vaccinated a person is protected for life.
Unless contraindicated because of pregnancy or being an organ transplant recipient or on chemotherapy, everyone over age 50 should be vaccinated, Wigand-Bolling said. I would recommend getting vaccinated to patients who may not have had chicken pox, or those who dont remember having chicken pox.
More than 90% of those identified in the study at increased risk of stroke and heart attack after a shingles episode hadn’t been vaccinated for shingles. The people in the study who had the vaccine still got shingles, it’s worth noting.
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How Long Does Shingles Last
Most cases of shingles last three to five weeks.
- The first sign is often burning or tingling pain sometimes it includes numbness or itching on one side of the body.
- Somewhere between one and five days after the tingling or burning feeling on the skin, a red rash will appear.
- A few days later, the rash will turn into fluid-filled blisters.
- About one week to 10 days after that, the blisters dry up and crust over.
- A couple of weeks later, the scabs clear up.
Where A Shingles Rash Forms
A shingles rash typically occurs on the face, neck, or chest, on just one side of the body.
The affected area of skin is called a dermatome, a region supplied by the sensory fibers of a specific spinal nerve. Outbreaks can involve two adjacent dermatomes, but rarely two non-adjacent dermatomes.
The exception may be in people whose immune systems are severely comprised, such as those with advanced HIV infection. They’re often at risk of disseminated shingles , shingles of the eyes or internal organs, and a recurrence of shingles within six months.
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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.
What Can I Do For The Pain
To help with the pain of shingles, your doctor might have you take an over-the-counter pain medicine. This could include acetaminophen or ibuprofen .
Applying a medicated anti-itch lotion to the blisters might reduce the pain and itching. Placing cool compresses soaked in water mixed with white vinegar on the blisters and sores might also help.
If shingles causes severe pain, your doctor might prescribe a stronger pain medicine.
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Is The Condition Curable
There is no cure for shingles, but attacks can be rendered less severe and their duration shortened with the use of prescription antiviral drugs.
Several antiviral medicinesacyclovir, valacyclovir, and famciclovirare available to treat shingles and shorten the length and severity of the illness. These medicines are most effective if you start taking them as soon as possible after the rash appears. If you think you have shingles, contact your healthcare provider as soon as possible to discuss treatment.
Pain medicine, either over-the-counter or a prescription from your doctor, may help relieve the pain caused by shingles. Wet compresses, calamine lotion, and colloidal oatmeal baths can also help relieve itching.
Long Term Side Effects
In rare cases, the live shingles vaccine, Zostavax, can cause a skin rash or shingles.
The rash that occurs with shingles can affect any area of the body, but it often appears as a line of blisters that wraps around the torso.
Within a few days the blisters cluster, and they continue to form for several more days. The blisters can take 2â3 weeks to heal, according to the American Academy of Dermatology.
Other common symptoms of shingles include:
two shingles vaccines for adults: the recombinant zoster vaccine and the zoster virus vaccine .
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Treating Shingles On The Face
Treatment is the same no matter where shingles develop. Treatment will involve taking an antiviral drug to reduce the severity of the outbreak and help it disappear more quickly.
People will see the best results if they take antiviral medication within 72 hours of the rash appearing.
In most cases, a doctor will prescribe the drugs famciclovir and valacyclovir. People with weak immune systems may need to take a different drug, such as acyclovir, instead.
Most research suggests anti-shingles drugs are safe for people who are breast-feeding, but those who are pregnant or breast-feeding should discuss medications with their doctors.
People who develop PHN may also require pain medication. PHN medication may include oral drugs, such as opioids or creams that people can apply directly to the skin.
Treatment And Management Options
Ice pick headaches are so brief in duration that they often dont provide a window of opportunity to take medication.
However, if youre prone to frequent attacks, prophylactic use of pain-reducing medication may make sense for you. Prophylactic medications are medications you can take to prevent headaches.
You can speak with your doctor to find out which type of medication will be best for you.
You and your doctor can consider the following drugs:
- Indomethacin. An oral nonsteroidal anti-inflammatory drug , indomethacin blocks inflammation, reducing pain. Its a prescription medication often used to treat headaches, including ice pick headaches and migraine headaches. About 35 percent of people with ice pick headaches dont respond to this medication.
- Melatonin . The hormone melatonin is available without a prescription. Its used to reduce insomnia, as well as headaches.
- Gabapentin.Gabapentin is a prescription medication used primarily as an anticonvulsant and to treat nerve pain.
It may help to keep a diary, outlining your daily activities, emotions, food intake, and ice pick headache occurrence. Some apps may also help you keep track. If youre able to identify a specific trigger, avoiding it may help.
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Shingles Headache A Comprehensive View
The headaches can be so piercing they are mixed up with migraines. This happened to Lin-Manuel Miranda, the creator of Hamilton, as fans witnessed in his Twitter updates. He had to be quarantined from his newborn and wife until antibiotics cleared up the outbreak.
Sufferers have described shingles headache a comprehensive view as stabbing pain near the eye, paired with nausea, and dull pain in between episodes. One woman described the onset of the headache as pins and needles that progressed into stabs like a knife for 5 to 10 minutes each episode.
Preventing Nerve Pain After Shingles
But if you’re worried about PHN, don’t despair. There are medications that can cut your risks of getting the condition. There are three antiviral drugs used: famciclovir , valacyclovir , and acyclovir . These medications need to be started within two to three days of the onset of shingles.
“If you look at the clinical trials with any of these drugs in people over 50,” says Dworkin, “they cut the rate of pain at six months in half. That’s a very significant improvement.” They are also very safe and have few side effects, he says.
But who needs the drugs? Dworkin says there’s not a clear consensus yet.
There are some obvious cases. “I think everyone would agree that someone who is over 50 and has severe symptoms should get preventative treatment,” he tells WebMD.
But for younger people or those with fewer risk factors, the course is less clear.
“Some people think that everyone who gets shingles should get preventative treatment with antiviral medicines, because the medicines are so safe and have such few side effects,” he says.
Others argue that preventative treatment should only be given to those at greater risk. The main reason for this, Dworkin says, is cost.
“A full course of treatment could cost anywhere between $100 and $160,” he says. “That can add up, and insurance companies might not want to pay if the risks are very, very low.”
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Severe Headache With Shingles
I was diagnosed with shingles this past Monday. My rash started on my scalp and now has spread to neck and ear. The doctor I saw at the urgent care clinic told me to take Advil for the pain and gave me a rx for antiviral. The pain is much worse than it was on Monday and the rash is spreading, but when I called Dr office to try to get something for the pain they acting like I was being a cry baby and told me to just take Advil for pain. I now have ringing in my ear and a terrible headache that won’t go away and the burning pain of the rash just feels like that whole side for my head is on fire. Any advice on what I can do? I’m in the US….
1 like, 12 replies
Posted 5 years ago
You likely have it in your trigeminal nerve. It’s a VERY painful nerve, and maybe about the worst place you could get it. I would recommend you phone your regular GP soon and see if you can get in. If that’s not an option try a dermatologist. There are drugs that can help with this. One is amitriptyline, which is an old anti-depressant that helps heal your nerves . Also the drugs you see advertised for nerve problems with diabetes can be used. The sooner you get treatment the better off you may be here. I would not let this go for several days.
Posted 5 years ago
Actually a dermatologist might be better Tammy. I ended up having way better luck going that route.
Posted 5 years ago