How Bad Can Shingles Get

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.

What Are The Signs & Symptoms Of Shingles

Often the first shingles symptoms happen in the area where the rash will appear. A person may have tingling, itching, or pain in this area. When the rash shows up, the pain may be mild or severe.

The rash starts as groups of tiny pimples on one side of the body or the face. It’s often in the shape of a band or belt. The pimples change to pus-filled blisters that break open and scab over in about 710 days. The scabs usually heal and fall off about 24 weeks after the rash starts.

Some kids with shingles also may have a fever and a headache, and might feel tired and achy. Rarely, a child has the pain of shingles without the rash. More severe symptoms can happen, but usually in people over age 50.

When To See A Healthcare Provider

You should see a healthcare provider as soon as you first notice signs and symptoms of shingles. The National Institute on Aging recommends that people see their practitioner no later than three days after the appearance of a shingles rash.

Early treatment will reduce your risk for complications, heal the rash quicker, and even reduce the potential for scarring.

It is always a good idea to reach out to your healthcare provider if you notice persistent pain or an itchy rash on your body. This is especially important if you are older because, with older age, the risk of developing PHN after a shingles outbreak is higher than for younger adults.

Even if you have already been diagnosed, you should reach out to your practitioner if the rash spreads to your face, an eye, or an ear. You will need immediate attention if you think your rash or a shingles blister has improperly healed or appears infected. Signs of a skin infection might include swelling, redness, pain, pus, and itching in the affected skin area.

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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.

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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Shingles: Not Just A Band Of Blisters

Shingles is a common condition in which the virus that causes chickenpox reactivates after years of lying dormant in your body. As the virus reactivates, it causes pain and tingling and eventually a rash of short-lived blisters.

“Shingles normally isn’t a serious condition, but in some people the rash can cause an eye infection,” explains Jeffery Wheeler, M.D., Mayo Clinic Health System family physician. “Vaccines can help reduce the risk of shingles, while early treatment can help shorten a shingles infection and lessen the chance of complications.”

One complication is called postherpetic neuralgia, which can cause the skin to remain painful and sensitive to touch for months or years. When identified early, shingles can be treated with prescription medications that help shorten the infection and reduce the risk of complications.

Dr. Wheeler says signs and symptoms of shingles may include:

• A feeling of pain, burning, tingling, itching, numbness or extreme sensitivity in a limited area of your body
• A red rash with fluid-filled blisters that begins a few days after the pain and lasts two to three weeks before scabbing over and healing

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.

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Risks Associated With Shingles

• When to See a Healthcare Provider

Shingles is a common condition caused by the varicella-zoster virusthe same virus that causes chickenpox. For most healthy adults, shingles is not life-threatening, although it can be quite painful.

Untreated shingles can lead to complications in certain people. This might include older adults and those with compromised immune systems. Complications in these groups could lead to death.

Learn about shingles, its complications and risk factors, and when to reach out to your healthcare provider.

hirun / Getty Images

Which Shingles Vaccine Is Best

Eventually, your doctor will start mentioning the shingles vaccine which can help prevent shingles from developing, as well as reduce its severity if it does still develop. The shingles vaccine can also reduce your risk of postherpetic neuralgia, one of the most common complications of shingles.

“Because shingles becomes increasingly more common as a person ages, the shingles vaccine is currently recommended for people over the age of 50. There are two vaccine options, Shingrix and Zostavax, with Shingrix being the newer of the two vaccines and the preferred choice as it is more effective.”

When it comes to how the shingles vaccine works, Shingrix is a shot that requires two doses administered six months apart. There are temporary side of effects of this shingles vaccine that can be unpleasant, however. Shingles vaccine side effects typically don’t last more than three days, but include:

• Redness or swelling

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How Is Shingles Diagnosed And Treated

If you think you might have shingles, talk to your doctor as soon as possible. Its important to see your doctor no later than three days after the rash starts. The doctor will confirm whether you have shingles and can make a treatment plan. Most cases can be diagnosed from a visual examination. If you have a condition that weakens the immune system, your doctor may order a shingles test. Although there is no cure for shingles, early treatment with antiviral medications can help the blisters clear up faster and limit severe pain. Shingles can often be treated at home.

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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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.

Shingles Vaccine Reduces Your Risk Of Getting Shingles

While there is no cure for shingles, getting the shingles vaccine can greatly reduce your risk of getting this disease.

Shingles vaccine reduces risk

The CDC recommends the shingles vaccine for healthy adults who are 50 years of age or older.

If you think you may already have shingles, treatment is important. It can reduce your pain and how long the rash lasts.

Find out how dermatologists diagnose and treat this condition at, Shingles: Diagnosis and treatment.

3 Centers for Disease Control and Prevention . Prevent Shingles: Get vaccinated. Page last reviewed July 23, 2018. Last accessed March 28, 2019.

ImageGetty Images

ReferencesCenters for Disease Control and Prevention . Prevent Shingles: Get vaccinated. Page last reviewed July 23, 2018. Last accessed March 28, 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.

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Does The Shingles Vaccine Contain Thimerosal

You may be concerned about additives to the shingles vaccine, like thimerosal.

Thimerosal is a preservative that contains mercury. Its added to some vaccines to prevent bacteria and other germs from growing in them. The shingles vaccine contains thimerosal.

The worry about thimerosal arose when early research linked it to autism. This connection has since been found to be untrue.

Is That Rash By My Eye Really Shingles

Shingles tends to show up most frequently on the torso, just because of the laws of probability, notes Joseph Safdieh, MD, a professor of neurology at Weill Cornell Medicine in New York City. In that area of your body, there are 24 nerves that can host the virus, compared with the 10 in your lower back.

Often, its not what the rash looks like, but what it feels like before and after it shows up, that signals the condition. Up to several days before the shingles rash appears, pain, itching, or tingling often occurs in the area where it will develop.

In the days before the rash appears, a variety of other flu-like symptoms of shingles can occur. You may experience:

You may even experience the pain but not the rash. Because the pain of shingles originates in the nerves, it may have a different quality than any other pain you have experienced before.

Neuropathic pain is burning, says Dr. Safdieh. Its both numb and painful at the same time, and can be provoked by touching the skin. Your skin may be so sensitive that even sunlight can bring on a stabbing sensation.

Even if you arent sure you have shingles, you should still see a doctor right away, because immediate treatment can prevent complications like long-term nerve pain.

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Will Shingles Go Away On Its Own

Shingles isn’t life-threatening, but it can be incredibly painful and, in some cases, complications can arise. While this rash typically goes away its own, prompt treatment can reduce your pain and help shingles go away faster.

“Several antivirals can be used to treat shingles. These drugs can help you heal more quickly and reduce your pain, but they are most effective when started within 72 hours of your rash appearing. This means it’s important to see your doctor as soon as you suspect shingles,” says Dr. Brown. “When it comes to the pain associated with shingles, most people are able to manage it using over-the-counter pain relievers. But, pain can be severe for some people. In these cases, your doctor can prescribe stronger pain medications.”

Beyond treating your immediate pain and rash, seeing your doctor is also important since serious complications can occur as a result of shingles, such as:

• Postherpetic neuralgia pain that lasts for months to years after the rash clears, with this pain being debilitating in some cases
• Skin infection occurs if the open sores of your rash become infected with bacteria, which can require antibiotics and delay healing
• Vision problems while rare, if your rash develops near your eye, the associated inflammation can damage your retina and, in some cases, result in vision loss

When To Seek Care

Early shingles symptoms, such as pain or flu-like feelings, are not obvious signs of a shingles outbreak.

Once a rash appears, you should see your primary care physician or a dermatologist. A trained eye can often diagnose shingles by visually inspecting the rash.

If you have shingles, you may never experience the extreme pain that can often come with it. You may only feel itching and some minor discomfort.

Even without the painful symptoms of shingles, its recommended that you see a healthcare professional and start antiviral treatment within 72 hours of a rashs appearance.

Its especially important to seek prompt medical care if a rash forms near one or both eyes. Shingles in the eye may cause permanent vision loss.

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How Long Is Shingles Contagious

Similar to chickenpox, shingles is a contagious illness. But, before we address how long you may be contagious, we need to talk about how shingles spreads which might actually surprise you.

“Shingles is indeed contagious, but it can only be spread to people who haven’t yet had chickenpox, or the chickenpox vaccine. In these cases, the shingles virus typically spreads via direct contact with the opened blisters of your rash. After being infected, a person doesn’t develop shingles, though he or she develops chickenpox,” explains Dr. Brown.

Since you can’t really know who is and who isn’t susceptible to chickenpox, it’s important to take safety measures if you have shingles.

“When you have shingles, you’re considered contagious until your open sores crust and scab over. This generally takes between 7 to 10 days,” says Dr. Brown. “Depending on where your rash develops on your body and where you work, you may be able to return to work before your shingles dry up.”

Before your rash dries up, Dr. Brown recommends the following to prevent spreading shingles to others:

• Make sure your rash is covered with gauze
• Limit interaction with other people if your shingles rash is on your face
• Consult with your doctor about returning to work if you work in a medical setting or nursing home, as well as if you interact with people frequently while at work

If You Get The Shingles Vaccine Does This Mean Youre 100% Protected From Getting Shingles

No. Just like most vaccines, getting vaccinated with a shingles vaccine doesnt provide 100% protection from disease. However, getting the shingles vaccine reduces your risk of developing shingles.

Even if you do develop shingles, youll be more likely to have a mild case. Also, youll be much less likely to develop postherpetic neuralgia, a painful condition that can follow a shingles outbreak.

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Burning Feeling And Red Rash

Between 1 and 5 days after you start to feel the tingling or numb feeling, a red rash will develop on the same area of your skin. Most often, the rash appears on one side of your torso, but it can show up anywhere on your body.

You may also have other symptoms along with the rash, such as:

When the rash starts, you should see a doctor for treatment as soon as possible. Starting antiviral medication treatment within 3 days of the rash first appearing can lower your risk of developing complications, like long-term pain.

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.

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Can Shingles Be Prevented Or Avoided

The best way to prevent shingles is through vaccination. Vaccinate your children for chickenpox. This vaccine reduces their risk for getting chickenpox. You cant get shingles unless youve had chickenpox first.

When you are older, get the shingles vaccine. It is recommended for adults 50 years of age and older. It can prevent shingles. People who have had shingles should get the vaccine to help stop the disease from reoccurring. Common side effects of the vaccine are headache, plus redness, swelling, itching, and soreness at the injection site.

The shingles vaccine is not recommended for anyone who:

• Has had an allergic reaction to gelatin or the antibiotic neomycin
• Has an allergy to any component of the shingles vaccine
• Has a weakened immune system due to conditions such as leukemia, HIV, or AIDS
• Is receiving treatment for cancer
• Is being treated with drugs that suppress their immune system, including high-dose steroids
• Is pregnant or might become pregnant within 4 weeks of getting the vaccine