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How Do They Diagnose Shingles

What Are The Symptoms Of Shingles

Shingles: Signs, Symptoms and Treatment with Dr. Mark Shalauta | San Diego Health

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.

What Is Being Tested

Chickenpox and shingles are caused by an infection with the varicella zoster virus , a member of the herpes virus family. Varicella zoster virus tests detect either antibodies produced by the immune system in response to a VZV infection or detect the virus itself.

Tests for chickenpox and shingles may be performed to detect and diagnose a current or past infection with VZV. Most often, testing is not necessary to diagnosis an active infection because it can be made from clinical signs and symptoms, but in some people with atypical skin lesions, a diagnostic test helps to confirm the infection. In some people, especially organ transplant recipients and pregnant women, the tests may be used to diagnose a current infection or to determine whether or not they have developed immunity from prior infection or by vaccination.

Before the introduction and widespread use of a chickenpox vaccine in 1995, nearly everyone in the United States became infected by VZV by adulthood. While VZV is present in its latent form in many adults who were infected as children, according to the Centers for Disease Control and Prevention, the incidence of new cases of chickenpox has declined significantly. Two doses of the vaccine are about 98% effective in preventing the infection, and those who do become infected usually have milder symptoms.

What Shingles Symptoms Come Next

After about 1 to 5 days, a shingles rash will appear on one side of the body, often in a single characteristic band around one side of the torso or face.

The painful rash will then form itchy or burning blister-like sores filled with a clear fluid. The blisters will scab over in 7 to 10 days. Theyll gradually grow smaller before disappearing.

Shingles rash symptoms commonly last between 2 to 4 weeks.

Read Also: What Is The New Shingle Shot Called

How Is The Test Used

Laboratory tests are not routinely used to diagnose active cases of chickenpox and shingles, which are caused by the varicella zoster virus . These conditions are usually diagnosed based upon a persons signs and symptoms. Most adults have been infected with VZV, and children are now vaccinated therefore, general population screening is not done. However, testing for VZV or for the antibodies produced in response to VZV infection may be performed in certain cases. For example, it may sometimes be performed in pregnant women, in newborns, in people prior to organ transplantation, and in those with HIV/AIDS. Testing may be used to:

  • Determine if someone has been previously exposed to VZV either through past infection or vaccination and has developed immunity to the disease
  • Distinguish between an active or prior infection
  • Determine whether someone with severe or atypical symptoms has an active VZV infection or has another condition with similar symptoms

There are several methods of testing for VZV:

Antibody testingWhen someone is exposed to VZV, the persons immune system responds by producing antibodies to the virus. Laboratory tests can detect and measure the level of two classes of VZV antibodies in the blood: IgM and IgG.

Viral detectionViral detection involves finding VZV in a blood, fluid, or tissue sample. This can be done either by culturing the virus or by detecting the viruss genetic material .

Can You Get Shingles From The Covid

Shingles and HIV: What is the link?

There have been a few reports of shingles happening in people who were vaccinated against COVID-19. The varicella-zoster virus was reactivated in these people.

A note from Cleveland Clinic

If youve had chickenpox, youre at risk of developing shingles later in life. Shingles causes a rash that is contagious and painful. The disease can have serious complications. The best thing you can do to reduce your risk is to get the shingles vaccine. The vaccines are safe and effective.

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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.

  • First, a few days before the rash appears, you may feel pain in an area on your skin. The pain is described as itching, burning, stabbing or shooting. This usually happens before the rash comes.
  • Next, the raised rash appears as a band or a patch, usually on one side of your body. The rash usually appears around your waistline or on one side of your face, neck, or on the trunk , but not always. It can occur in other areas including your arms and legs.
  • Within three to four days, the rash develops into red, fluid-filled, painful, open blisters.
  • Usually, these blisters begin to dry out and crust over within about 10 days.
  • The scabs clear up about two to three weeks later.
  • Check If You Have Shingles

    The first signs of shingles can be:

    • a tingling or painful feeling in an area of skin
    • a headache or feeling generally unwell

    A rash will appear a few days later.

    Usually you get the shingles rash on your chest and tummy, but it can appear anywhere on your body including on your face, eyes and genitals.

    The rash appears as blotches on your skin, on 1 side of your body only. A rash on both the left and right of your body is unlikely to be shingles.

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    Treatment If Shingles Gets Worse

    In some cases, shingles causes long-term problems. Treatment depends on the specific complication.

    • Postherpetic neuralgia is persistent pain that lasts months or even years after the shingles rash heals. Certain medicines, such as anticonvulsants, antidepressants, and opioids, can relieve pain. Most cases of PHN get better within a year.
    • Disseminated zoster is a blistery rash over a large portion of the body. It may affect the heart, lungs, liver, pancreas, joints, and intestinal tract. Treatment may include both antiviral medicines to prevent the virus from multiplying and antibiotics to stop infection.
    • Herpes zoster ophthalmicus is a rash on the forehead, cheek, nose, and around one eye. It could threaten your sight. Get treatment from an ophthalmologist right away. Treatment may include rest, cool compresses, and antiviral medicines.
    • If the shingles virus affects the nerves originating in the brain , serious complications involving the face, eyes, nose, and brain can occur. Treatment depends on the nature and location of the complication.

    What Specialists Treat Shingles

    Shingles: What you need to know about causes, symptoms, and prevention.

    Primary care physicians, including internal medicine specialists, family medicine specialists and/or specialists in infectious diseases, can appropriately treat some patients. An emergency medicine physician may start the initial care. However, if there is a chance the eye may be involved, an ophthalmologist should be consulted. If a person is pregnant and gets shingles, they should consult with their ob-gyn physician immediately. For long-term or chronic pain involved in postherpetic neuralgia, a neurologist and/or pain specialists may be involved in the care of the patient.

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    How Is Internal Shingles Treated

    Even though shingles is a virus, this is a case where there are antiviral medications available by prescription. Thats why its important to see your doctor right away if you suspect you have shingles. Early treatment may reduce the risk of complications, like PHN. Serious complications require hospitalization.

    Common antiviral medications for shingles include:

    Depending on the location and severity of the shingles infection, steroids may also help. Anti-inflammatory medications like ibuprofen and pain-relieving medication such as acetaminophen or other prescription pain medication can help in easing pain experienced from shingles.

    Shingles On Your Face

    Shingles usually occurs on one side of your back or chest, but you can also get a rash on one side of your face.

    If the rash is close to or in your ear, it can cause an infection that could lead to:

    • loss of hearing
    • issues with your balance
    • weakness in your facial muscles

    Shingles inside your mouth can be very painful. It may be difficult to eat and may affect your sense of taste.

    A shingles rash on your scalp can cause sensitivity when you comb or brush your hair. Without treatment, shingles on the scalp can lead to permanent bald patches.

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    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.

    Urgent Advice: Get Advice From 111 As Soon As You Suspect Shingles

    Shingles and Shingrix, Everything People Need to Know

    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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    How Shingles Spreads

    The varicella-zoster virus can typically spread from a person with shingles to someone who has never had chickenpox. If a person has had chickenpox, they usually have antibodies against the virus in their body.

    Shingles causes open, oozing blisters. The varicella-zoster virus can spread through contact with shingles blisters that havent scabbed over yet. If you havent had chickenpox, you can acquire the varicella-zoster virus from exposure to the virus through someone elses open shingles blisters. This could lead to chickenpox.

    The virus doesnt spread after the blisters have formed crusty scabs. Once the blisters scab, they can no longer pass on the virus. The virus also doesnt spread when the blisters are well covered.

    You cant get shingles through contact with the saliva or nasal secretions of someone who has shingles, except in rare cases. That means you usually cant get shingles if someone who has it coughs or sneezes on you.

    National Institute on Aging says that it only reactivates in around one-third of them, so only one in three people with the virus will have shingles. Experts do not know why some people develop it, and others dont.

    However, the chance of this happening increases as a person gets older. Around half of all cases occur after the age of 60 years, and the risk increases significantly from 70 onward.

    You might also have a higher risk if you:

    Even a common cold can affect the immune system and trigger shingles in some people.

    What Is The Outlook

    If you have a particularly severe case of shingles, it could take months to go away. It can also become a long-term problem for some people. If you have postherpetic neuralgia, you may need to see your doctor more often.

    Complications that involve the eye or ear may require ongoing care, especially if you have lingering vision or hearing problems.

    Most people have shingles only once, but it can recur. This is more likely to happen if you have a weakened immune system.

    If you havent had any major complications, your symptoms should clear up within a matter of weeks with few, if any, lasting effects.

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    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.

    How Do Dermatologists Treat Shingles

    How to treat shingles

    An antiviral medication can:

    • Reduce the amount of time that you have a shingles rash

    • Lower your risk of developing long-lasting nerve pain and other health problems

    One of three antiviral medications is usually prescribedacyclovir, famciclovir, or valacyclovir.

    To treat your symptoms, dermatologists typically recommend the following:

    Pain: Medication that you can buy without a prescription can help, such as:

    If you have severe pain, your dermatologist may prescribe a medication that reduces inflammation, such as a corticosteroid.

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    When To Get Tested

    When you have atypical and/or severe symptoms and your health care practitioner wants to distinguish between a VZV infection and another cause when a healthcare practitioner wants to check whether or not you are immune to VZV sometimes prior to an organ transplant or when a child, pregnant woman, or a person with a weakened immune system has been exposed to someone with chickenpox

    Early Symptoms Of Shingles

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    What is shingles?

    The same virus that causes chickenpox causes shingles. Its called the varicella zoster virus .

    VZV stays dormant in your body even after you recover from chickenpox. The chickenpox virus can reactivate years or even decades later, but its not understood why.

    When this happens, a person will develop shingles. Recognizing the early symptoms is important because it can be a painful condition with severe complications.

    state that almost 1 in 3 people in the US will develop shingles in their lifetime. But some people are more likely to develop shingles than others.

    It is that half of all cases of shingles occur in people aged 60 years and older.

    Other groups prone to developing shingles include:

    • people who have had organ transplants
    • people experiencing a lot of stress

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    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.

    What Are The Signs & Symptoms Of Shingles

    How Shingles Is Treated

    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.

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    Why Does Shingles Appear Mostly On One Side Or In One Area Of Your Body

    The virus travels in specific nerves, so you will often see shingles occur in a band on one side of your body. This band corresponds to the area where the nerve transmits signals. The shingles rash stays somewhat localized to an area. It doesnt spread over your whole body. Your torso is a common area, as is your face.

    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.

    ImageGetty Images

    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.

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