What Are The Symptoms And Stages Shingles
Shingles symptoms appear in stages. At first, you may get headaches or feel like you have the flu, but without a fever. You may also be sensitive to light, have trouble thinking clearly or feel dizzy and weak.
A few days or even weeks later, an area of your body or face will feel itchy, tingly or painful. This is where a rash will appear. The rash will eventually turn into a cluster of blisters that are filled with fluid.
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Your Good Health: Nerve
Dear Dr. Roach: I am a 78-year-old woman, and I am in my 10th week of shingles. I have them on my left chest and back and on my upper arm. I cant go anywhere because I cant stand when my clothes or bra touches me. I now have severe shooting pains on my arm area, mostly at night but also during the day. The rash on my chest, although mostly healed, is still very painful. Im desperate for help. I use lidocaine, which helps for an hour or so. This is my second bout of shingles. I had them 10 years ago. I was advised by my internist not to get the shingles vaccine after that last bout. Is there anything I can do?
P.C.
Shingles, also called herpes zoster, is caused by the recurrence of the chickenpox virus after years or decades of the virus being dormant. The herpes virus can escape the immune system during times of stress or simply as we age.
Pain around the time of shingles is nearly universal, but the duration of time is variable. The type of pain you have now is caused by damage to the nerve and is called acute neuritis.
Once the pain has lasted more than four months, the diagnosis of postherpetic neuralgia is made. Unfortunately, postherpetic neuralgia can last a very long time for people over 65 with persistent, active PHN, the average duration of symptoms was about three and a half years.
Treatment of acute zoster, preferably within 24 hours of the onset of rash, but certainly within 72 hours, with antiviral medications can also help prevent PHN.
K.J.
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 your 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.
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Lasting Pain After Shingles
Pain that continues for a long time after a shingles rash has disappeared is called post-herpetic neuralgia. This is the most common complication of shingles. Its still not clear how it can be prevented or what the best treatment is.
Shingles typically causes a rash accompanied by pain in the affected area. The pain normally goes away when the rash goes away. This usually happens after two to four weeks. Pain that continues for longer is referred to as post-herpetic neuralgia. The word post-herpetic means post-herpes because the pain arises after infection by the herpes zoster virus. In very rare cases pain can come back after a shingles infection, even if it had already gone away and the rash has disappeared.
The main symptom of post-herpetic neuralgia is pain in the nerves . The skin is often overly sensitive and itchy as well. This can make it difficult or painful to wash yourself, turn over in bed, or hug someone. The pain and itching can be very severe and might keep you from sleeping.
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Signs Of Shingles Faqs
Q: Are there further health risks associated with shingles?A: If left untreated, shingles is more likely to result in post herpetic neuralgia , a condition in which a burning pain continues to be felt in the areas affected by shingles for more than three months after the rash and blisters themselves have disappeared. Approximately one fifth of people who are affected by shingles will go on to develop PHN. The likelihood of shingles spreading to internal regions of the body likewise increases in the absence of a promptly initiated treatment and recovery plan.
Q: Are the signs of shingles different in adults to those in children?A: The signs of shingles in children are largely the same as the signs of shingles in adults. However, shingles in children is generally less severe and lasts for a shorter duration than in adults, and most children recover well with no associated health complications. Shingles rarely affects children under three years of age and can only affect children who have already had chickenpox. Shingles are not common in children. However, having a weakened immune system as a result of an autoimmune disease, other chronic or serious disease or because of being overly stressed, however, can increase the likelihood of a child developing shingles.
Good to know: People who have a weakened immune system, and who have never been infected by VZV before, will develop chickenpox the first time they catch the virus, rather than its subsequent form, shingles.
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Prevent Shingles With Vaccination
The Centers for Disease Control and Prevention recommends that almost all people ages 60 and older be vaccinated against shingles, whether or not they had chicken pox in their youth or have had shingles before, says Dr. Oaklander.
The vaccination that prevents chickenpox in children was used to develop a similar vaccine that protects against shingles. It reduces the risk of getting shingles by about half, and shingles rashes that still develop are slightly less likely to cause postherpetic pain, or other serious complications, says Dr. Oaklander.
People with especially weak immune systems, such as those with cancer or anyone undergoing immunosuppressive treatments, should avoid Zostavax since the vaccine contains a weakened form of the live virus. Because Zostavax has only been available since 2006, it is still not yet clear if a single vaccination offers lifelong protection, but at this time, no booster is recommended.
A new shingles vaccine called HZ/su also may be helpful for older adults. A study published in The New England Journal of Medicine found that the vaccine was 97.2% effective among those ages 50 and older, and 97.9% effective for those ages 70 and older. And since HZ/su is not made from a live, weakened virus, it is safe to give to people with weak immune systems. This vaccine still needs to undergo further testing before it can be submitted for FDA approval, which may happen as early as this year.
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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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How Long Does It Take To Recover
As your shingles infection clears up, your oral symptoms will get better.
In general, the blisters begin to scab after 7 to 10 days. It takes 3 to 5 weeks for the infection to clear, but the pain can last for weeks or months.
To work toward a speedy recovery, be sure to carefully follow your doctors treatment plan. Its also important to take care of yourself at home. This includes practicing self-care as mentioned above.
Other things you can do to improve your shingles recovery include:
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Where On The Body Does Shingles Appear
Some people experience shingles pain without ever developing the rash. However, this is rare and most people have a rash.
- Chest and back A common shingles pattern is a stripe of blisters that wraps around either the left or right side of your torso. This pattern is often confused with a heart problem, lung pain, or kidney pain.
- Around the eye The rash can start around one eye. You should seek treatment immediately for this, as it can harm your vision.
- Scalp The rash can appear on one side of your head, under your hair.
- Neck and face Shingles may break out over one side of the neck or face.
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Are There Natural Ways To Boost The 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. Eat healthy, maintain a healthy weight, exercise regularly, get seven to nine hours of sleep each night, dont smoke these are all good living tips, not just for reducing your chance of getting shingles, but also many other diseases and health conditions too.
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Timeline Of Shingles Symptoms
Shingles actually doesnt occur without a prior chickenpox infection. VZV lies dormant in nerve roots after you recover where it can reactivate years later, returning as shingles. But though they share the same viral cause, the two conditions are distinct.
The first sign of shingles is usually a burning or stinging sensation in a band-like formation around the waist, chest, stomach, or back.
You may experience itching or become incredibly sensitive to even the softest touch. The weight of bed sheets on your skin may be uncomfortable. You may also experience fatigue, fever, and headache.
After a few days or even up to a couple of weeks, the telltale shingles rash will appear. This rash consists of fluid-filled blisters that worsen quickly. The blisters may look like chickenpox, but they are clustered together.
The shingles rash can vary in color, depending on your skin tone. On darker skin, the rash may be pink, grayish, dark brown, or even purple. On lighter skin, it will be red.
This is the stage at which VZV can be passed on to someone who has never had or been vaccinated against chickenpox.
Blisters typically scab over within a week to 10 days. Shingles typically takes three to five weeks to progress through all of its stages.
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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.
Are There Any Treatments For Phn
There are several treatments for PHN so people do not have to live with the pain after a shingles episode. Treatment includes different types of oral medicines such as:
Anti-convulsants
Anti-depressants
Topical medicines
What about treatment for PHN other than medications?
Acupuncture
Neuromodulation or spinal cord stimulation
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Shingles And Nerve Paths
Shingles is caused by a reactivation of the virus that causes chickenpox. Only people whove had chickenpox or chickenpox vaccines can develop shingles. Having a chickenpox vaccine can lead to shingles because the vaccine contains the virus that causes chickenpox.
Shingles isnt contagious, but people who have not had chickenpox can develop chickenpox if they come in contact with open blisters of somebody with shingles.
After your body fights off a chickenpox infection, the herpes zoster virus remains dormant in your cranial nerves and spinal ganglia until it becomes reactivated. Spinal ganglia are nerve cells that connect your spinal cord to nerves in your body and limbs.
The virus reactivates when your immune system is no longer able to suppress it. Reactivation most commonly occurs in older adults because the immune system tends to get weaker with age, as well as in people with suppressed immune systems.
Once the virus is active, it usually spreads down sensory nerve fibers that lead from your spinal cord to your skin. These nerves carry sensory information like feelings of pain, itchiness, or pressure from your skin to your spinal cord and brain.
Once the virus gets to the end of these sensory nerves, it reaches your skin and usually leads to a rash. This rash often shows up in one or two nearby areas of skin called dermatomes.
A dermatome is an area of your skin where the sensation is supplied by one spinal nerve.
Dont Shrug Off Shingles
- By Matthew Solan, Executive Editor, Harvard Mens Health Watch
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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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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.
The Empowered Patients Guide To Postherpetic Neuralgia
Being vaccinated against shingles is the best way to prevent postherpetic neuralgia , lingering pain from the shingles virus. Heres what you should know about the causes, symptoms, and treatments for this painful chronic condition.
Postherpetic neuralgia , also known as shingles, most commonly occurs as a rash on one side of the torso.
This is no ordinary rash but the ithcy blisters arent even the worst part. A painful condition known as postherpetic neuralgia is the horrible gift that keeps on giving for more than 10% of people who develop it following a bout of shingles.
Oh yeah and the pain? It can be significant. People familiar with the burning, relentless feeling of PHN have likened it to passing a kidney stone mothers have described it as pain worse than labor.
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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.
Back Pain Of The Shingles
After a strenuous weekend of yard work I noticed the skin on parts of my back and legs had become very sensitive to touch. The best way to describe it was like mild sunburn. There were even a couple places around my waist that felt like they had been scratch, but there were no visible scratch marks.
On Friday night of that week my lower back started to hurt. This was right above the lumbar region where the kidneys are located, primarily on the right side. The sensitivity and pain radiated from the spine area, around my waist. It was difficult to sleep and I did lots of tossing and turning. On Saturday morning I got up, had some coffee, read the morning paper and felt better, ready for another weekend of tackling the backyard.
The back pain returned Saturday night, only worse. In the morning the pain would subside. I learned that just standing or walking around made the back pain go away and the more coffee I drank, the better I felt. But I still had the skin sensitivity.
Sunday night was the worse. I figured I had tweaked my back with all the bending over building the raised garden beds. On Monday morning the pain wasnt going away, even with copious amounts of really strong coffee. I then surmised that maybe I had a kidney stone. I started drinking lots of water, and coffee. I started feeling like I had the flu. I was achy, cold, fatigued, and not happy.
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