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.
How Long Does A Shingles Outbreak Last
It can take three to five weeks from the time you begin to feel symptoms until the rash totally disappears.
Other Treatment Recommendations For Shingles
If you think you have shingles, see your doctor as soon as possible. This increases the effectiveness of any treatment your doctor will prescribe for you. The treatment doesnt cure shingles. Its meant to help you manage the pain.
Besides acupuncture, you can use other methods to manage your pain. These include:
- antiviral drugs such as Famvir, Zovirax, and Valtrex
- over-the-counter and prescription pain relievers
- calamine lotion, colloidal oatmeal, andwet compresses
Two vaccines are available for adults ages 50 years and older. The Food and Drug Administration approved Shingrix and Zostavax for use. These vaccines reduce the risk of getting shingles. If an older adult still gets shingles after being vaccinated, the symptoms may be less intense.
Shingrix, made from a dead germ, is the preferred vaccine. People with weakened immune systems can get it. Its risky for this group to get the Zostavax vaccine, which contains a live but weakened germ.
Zostavax has not been sold in the United States since November 18, 2020. If you received this vaccine, the
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Topicals Are Not A Substitute For Medical Treatment
Topical products can help you manage your symptoms. But they arent a substitute for proper medical treatment.
Its important to visit your doctor if youre dealing with shingles. Your doctor can prescribe antiviral drugs and other medications that can shorten the duration of your infection and help you avoid severe complications.
The following creams may be able to help you manage shingles symptoms.
What Are The Pain Complications Of Shingles
Pain, itching, and tingling may continue for several months after the rash healing. At the same time, the pain that remains after the rash has healed may be the most severe complication of shingles. Itching, burning, and pain along the nerves that affect the eyes, nose, mouth, and throat can cause temporary and permanent problems.
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Antidepressants May Offer Surprising Relief
Antidepressants may have been invented for depression, but they are also known to modulate peripheral nerves, Dr. Auwaerter says, thereby dulling PHN pain. Your physician may suggest Pamelor or Aventyl or Elavil . Dr. Auwaerter adds that these medications can sometimes cause side effects like fatigue and sluggishnessthough PHN patients usually only need a low dose, which is unlikely to cause major adverse effects.
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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What You Can Do About Nerve Pain That Lingers After Shingles
Chronic pain that continues after a case of shingles is called postherpetic neuralgia . It is estimated that about 20% of patients will experience this type of nerve pain as a complication of shingles.
Those who have had chickenpox are at risk of developing shingles later in life. People who develop PHN are generally age 60 and older. Although there is no cure for PHN, there are several methods of pain management that can ease symptoms. Fortunately, the type of pain that arises from postherpetic neuralgia improves over time.
Neuralgia affects the nerves, causing structural and functional damage. It can feel like a stabbing or burning pain that radiates along the affected nerve.
Neuropathic pain is not caused by an external injury or stimuli but originates from inside the nervous system. When the herpes-varicella zoster virus is reactivated in the form of shingles, scar tissue forms alongside nerves, creating pressure, and sending pain signals to the brain.
What Can I Take To Feel Better
Your doctor has a host of ways to treat your pain after shingles, including a variety of medications. They include:
Anticonvulsants: These medications were developed to control seizures, but they can also help reduce the pain of postherpetic neuralgia. Examples are:
Talk to your doctor or pharmacist about side effects of any new prescription or over-the-counter medication.
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Articles On Shingles Treatment
The virus that causes chickenpox is also what causes shingles. Itâs called varicella zoster. It can lie quietly in your nerves for decades after causing chickenpox but suddenly wake up and become active.
The main symptom of shingles is a painful rash that comes up on one side of your body or face. See your doctor as soon as you can if you think you might have this condition.
Your doctor may want to put you on medications to control your infection and speed up healing, cut inflammation, and ease your pain. They include:
How Common Is Postherpetic Neuralgia
Varicella-zoster virus causes both chickenpox and shingles. About 99% of Americans over age 40 have had chickenpox. About one in three people in the U.S. develop shingles in their lifetime. Some 10 to 18% of people who get shingles will develop postherpetic neuralgia. Postherpetic neuralgia is the most common complication of shingles.
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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.
What Should You Expect If You Get Shingles
Shingles can be a very painful condition. If you think you have the symptoms of shingles, see your healthcare provider right away. Starting antiviral medications early can ease your discomfort and end symptoms earlier.
A better approach to shingles is to take action and do what you can to lessen your risk of getting it. If you’ve never had shingles in the past, talk to your healthcare provider about getting the shingles vaccine. If youve never had chickenpox, talk with your healthcare provider about getting the chickenpox vaccine.
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Can You Still Develop Shingles If Youve Been Vaccinated For Chickenpox
Yes. Despite being vaccinated for chickenpox, you can still get shingles. No vaccine is 100% protective, and the effectiveness of vaccines lessens with time. However, people who get the chickenpox vaccine are significantly less likely to develop shingles later in life compared with people who never received the chickenpox vaccine. One recent 12-year study found that the number of shingles cases was 72% lower in children who had received the chickenpox vaccine compared with those who didnt.
Opt For Otc Pain Relievers
Over-the-counter options like Tylenol can ease the discomfort of shingles rash and even mild PHN. At least for early pain, we often use non-steroidal anti-inflammatory drugs , like ibuprofen or naxopren, Dr. Auwaerter notes. Theyre easy to pick up at any drugstore, but theyre not always ideal for frequent and/or long-term use. NSAIDs can cause stomach irritation and stomach ulcers, and can harm the kidneys unless taken with large volumes of water. If you experience abdominal pain or constipation, ask your doctor to help you find another option.
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Are There Other Ways To Ease The Pain
Most people with postherpetic neuralgia use medication to control their symptoms. But there are other ways to control the pain, too. They include:
TENS : You use a device that shoots tiny electrical currents into the area of pain on the skin. This helps block the pain.
Cold packs: Try a gel-filled one to numb the area unless cooler objects make your neuralgia worse.
Comfortable clothes: Go for looser fits and fabrics such as cotton and silk.
If You Have More Than One Area Of Blisters What Can You Expect If You Go To The Hospital
Its important to note that most people with shingles dont need to be in a hospital, but if you do:
- Youll be in a contact isolation room.
- The door will be kept closed.
- A sign on your door will remind people who have never had chickenpox or the vaccine not to enter.
- The sign will also remind staff to wear gowns and gloves when entering the room.
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Consider The Benefits Of Capsaicin
Another topical treatment is made from chili peppers, and research has shown that it can help with shingles pain reduction. Capsaicin comes in OTC and prescription forms, and it can be applied topically as a cream or by wearing a patchbut its tricky to administer properly. A report in Molecules noted that capsaicin can cause a burning sensation on the applied area, especially if applied in frequent dosages. In rare cases, it can also cause blood vessel constrictions. Be sure to get your doctors guidance before trying this method on your own.
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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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.
Is It Possible To Prevent Postherpetic Neuralgia
Zostavax, the herpes zoster vaccine , has been shown to significantly decrease the risk of shingles. The vaccine is approved by the Food and Drug Administration for adults age 50 and older, and is recommended for all adults 60 and older who arent allergic to the vaccine and who dont take immune-suppressing medications.
People age 50 to 59 may want to talk to their doctor about the shingles vaccine, if they are having ongoing pain or skin issues or have a weakened immune system. The vaccination is not a guarantee that shingles will not occur however, those who get the vaccine usually experience a shorter period of pain.
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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.
What To Do If You Think You Have Shingles
If you suspect that you have shingles, its important to visit a healthcare professional as soon as possible. According to the American Academy of Dermatology , treating shingles within the first 72 hours gives you the best chance of minimizing complications like nerve pain.
Antiviral medications or other medications only available by prescription can shorten the duration of your shingles or lessen the severity.
If a cream or other topical isnt reducing your pain, its a good idea to visit your doctor again. They may recommend trying another treatment like capsaicin cream instead of lidocaine.
If a product is making your symptoms worse, its important to stop taking it right away.
You may be able to reduce your symptoms using home remedies while youre waiting to see a healthcare professional. These include applying a wet cold compress or taking a cool bath.
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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.
Gabapentin For Shingles: Dosage Effectiveness And More
If you contract shingles, your doctor may prescribe certain medications to help you relieve the symptoms and discomfort of the illness. Management of shingles can include pain medication, antivirals, and, depending on your symptoms, other medications to alleviate discomfort and pain at the discretion of your doctor.
In some shingles cases, an individual may develop moderate to severe nerve pain that can extend well beyond the shingles illness and become a chronic condition known as postherpetic neuralgia. Although gabapentin is typically known for its use as an anticonvulsant and treatment to manage seizure-related disorders, its use has successfully treated nerve pain in patients.
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What Is The Outcome For Someone Who Has Shingles
Most people get shingles once, but its possible to get it again.
If you have a healthy immune system, the blisters tend to clear in 7 to 10 days. The rash tends to go away completely within 2 to 4 weeks. The pain may last longer, but usually stops in 1 or 2 months.
For some people, the pain will last longer than the rash. When it does, its called postherpetic neuralgia , which can come and go or be constant. PHN can last for months, years, or the rest of your life. Treatment can help reduce the amount of pain you feel.
Be sure to tell your doctor if you continue to have pain. Treatment can help you feel more comfortable.
For anyone who has a shingles rash, the right self-care can help ease your discomfort. Youll find out what dermatologists recommend at, Shingles: Self-care.
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ReferencesCenters for Disease Control and Prevention . About shingles. Page last reviewed 10/17/2017. Last accessed 4/1/2019.
Dooling KL, Guo A, et al. Recommendations of the Advisory Committee on Immunization Practices for Use of Herpes Zoster Vaccines. Morb Mortal Wkly Rep 2018 67:103-8.
Madkan V, Sra K, et al. Human herpes viruses. In: Bolognia JL, et al. Dermatology. . Mosby Elsevier, Spain, 2008: 1204-8.
Straus SE, Oxman MN. Varicella and herpes zoster. In: Wolff K, Goldsmith LA, et al. Fitzpatricks Dermatology in General Medicine . McGraw Hill Medical, New York, 2008: 1885-98.