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.
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.
How Is The Test Done
Antibody testing is done using a blood sample the sample is taken from a vein in the arm using a needle and then it is bottled, labelled and sent awayto the laboratory for analysis.
If the test is being carried out to test for the presence of the virus, several different tests may be carried out. Samples of blood, vesicle fluid,tissue or cerebrospinal fluid may be taken and analysed.
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Pcr Is The Most Useful Test
Laboratory testing may be useful in cases with less typical clinical presentations, such as in people with suppressed immune systems who may have disseminated herpes zoster . Polymerase chain reaction is the most useful test for confirming cases of suspected zoster sine herpete .
PCR can be used to detect VZV DNA rapidly and sensitively, and is now widely available. The ideal samples are swabs of unroofed vesicular lesions and scabs from crusted lesions you may also detect viral DNA in saliva during acute disease, but salvia samples are less reliable for herpes zoster than they are for varicella. Biopsy samples are also useful test samples in cases of disseminated disease. It is also possible to use PCR to distinguish between wild-type and vaccine strains of VZV.
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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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 Well Does Shingrix Work
Two doses of Shingrix provide strong protection against shingles and postherpetic neuralgia , the most common complication of shingles.
- In adults 50 to 69 years old with healthy immune systems, Shingrix was 97% effective in preventing shingles in adults 70 years and older, Shingrix was 91% effective.
- In adults 50 years and older, Shingrix was 91% effective in preventing PHN in adults 70 years and older, Shingrix was 89% effective.
- In adults with weakened immune systems, Shingrix was between 68% and 91% effective in preventing shingles, depending on their underlying immunocompromising condition.
In people 70 years and older who had healthy immune systems, Shingrix immunity remained high throughout 7 years following vaccination.
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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.
What Do The Results Mean
If you have symptoms and results show VZV antibodies or the virus itself, it’s likely you have chickenpox or shingles. Your diagnosis of either chickenpox or shingles will depend on your age and specific symptoms. If your results show antibodies or the virus itself and you don’t have symptoms, you either once had chickenpox or received the chickenpox vaccine.
If you are diagnosed with an infection and are in a high-risk group, your health care provider may prescribe antiviral medicines. Early treatment can prevent serious and painful complications.
Most healthy children and adults with chickenpox will recover from chickenpox within a week or two. Home treatment can help relieve symptoms. More serious cases may be treated with antiviral medicines. Shingles may also be treated with antiviral medicines as well as pain relievers.
If you have questions about your results or your child’s results, talk to your health care provider.
Learn more about laboratory tests, reference ranges, and understanding results.
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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.
How Are Shingles And Herpes Treated
Neither condition can be cured, but treatments are available.
Shingles is treated with both antiviral prescription medications that can speed up your healing and with medications that can help with your pain. Your exact treatment plan will depend on:
- how severe your case is
- your overall health
- the medications you already take
Antiviral options include:
Herpes is also treated with antiviral medication.
Antivirals can help you heal first and reduce your symptoms. Depending on your case and your overall health, you might take these medications during an outbreak or daily.
Options for herpes treatment include both acyclovir and valacyclovir.
Some other pain management options may include:
- numbing patches, gels, or creams you can apply to your skin
- codeine or other narcotic medications
- steroid injections
- anticonvulsants or antidepressants that can control pain
Talk with a doctor before using any of the treatments above. These treatments should not be used without guidance from a medical professional. A medical professional can help you avoid any unintended side effects, such as allergic reactions.
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What Does The Test Result Mean
Care must be taken when interpreting the results of VZV testing. The healthcare practitioner evaluates the results in conjunction with clinical findings. It can sometimes be difficult to distinguish between a latent and active VZV infection. This is possible for several reasons, including:
- A healthy person who has been infected with VZV will continue to harbor the virus after the symptoms disappear. The VZV can reactivate intermittently, shedding small amounts of virus into body fluids but not causing symptoms.
- An infant or immunocompromised person may not have a strong antibody response to the VZV infection their IgM and IgG levels may be lower than expected even though the person has an active case of VZV.
- The virus may not be present in sufficient number in the particular fluid or tissue tested to be detected.
Antibody detectionIf both VZV IgG and IgM are present in a symptomatic person, then it is likely that the person has either recently been exposed to VZV for the first time and has chickenpox or that the previous VZV infection has been reactivated and the person has shingles.
Viral detectionIf someone is symptomatic and the culture is positive for varicella zoster virus, then the person likely has an active VZV infection. If the culture is negative, then the person’s symptoms may be due to another cause or the VZV virus is not detectable in the sample tested.
Chickenpox And Shingles Tests
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- Varicella Zoster Virus by Culture
- VZV Antibodies IgG and IgM
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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.
Preventing The Virus Spreading
If you have the shingles rash, do not share towels or flannels, go swimming, or play contact sports. This will help prevent the virus being passed on to someone who has not had chickenpox.
You should also avoid work or school if your rash is weeping and cannot be covered.
Chickenpox can be particularly dangerous for certain groups of people. If you have shingles, avoid:
- women who are pregnant and have not had chickenpox before as they could catch it from you, which may harm their unborn baby
- people who have a weak immune system, such as someone with HIV or AIDS
- babies less than one month old, unless it is your own baby, in which case your baby should have antibodies to protect them from the virus
Once your blisters have dried and scabbed over, you are no longer contagious and will not need to avoid anyone.
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What Are The Possible Side Effects Of Shingrix
Studies show that Shingrix is safe. The vaccine helps your body create a strong defense against shingles. As a result, you are likely to have temporary side effects from getting the shots. The side effects might affect your ability to do normal daily activities for 2 to 3 days.
Most people got a sore arm with mild or moderate pain after getting Shingrix, and some also had redness and swelling where they got the shot. Some people felt tired, had muscle pain, a headache, shivering, fever, stomach pain, or nausea. Some people who got Shingrix experienced side effects that prevented them from doing regular activities. Symptoms went away on their own in about 2 to 3 days. Side effects were more common in younger people.
You might have a reaction to the first or second dose of Shingrix, or both doses. If you experience side effects, you may choose to take over-the-counter pain medicine such as ibuprofen or acetaminophen.
Guillain-Barré syndrome , a serious nervous system disorder, has been reported very rarely after Shingrix. There is also a very small increased risk of GBS after having shingles.
If you experience side effects from Shingrix, you should report them to the Vaccine Adverse Event Reporting System . Your doctor might file this report, or you can do it yourself through the VAERS websiteexternal icon, or by calling 1-800-822-7967.
If you have any questions about side effects from Shingrix, talk with your doctor.
What Are The Complications Of Shingles
Symptoms of shingles usually dont last longer than 3 to 5 weeks. However, complications can happen. The main complications that can result from shingles include:
- Postherpetic neuralgia . The most common complication of shingles is called postherpetic neuralgia . This continuous, chronic pain lasts even after the skin lesions have healed. The pain may be severe in the area where the blisters were present. The affected skin may be very sensitive to heat and cold. If you had severe pain during the active rash or have impaired senses, you are at increased risk for PHN. The elderly are also at greater risk. Early treatment of shingles may prevent PHN. Pain relievers and steroid treatment may be used to treat the pain and inflammation. Other treatments include antiviral drugs, antidepressants, anticonvulsants, and topical agents.
- Bacterial infection. A bacterial infection of the skin where the rash happens is another complication. Rarely, infections can lead to more problems, such as tissue death and scarring. When an infection happens near or on the eyes, a corneal infection can happen. This can lead to temporary or permanent blindness.
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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 Causes Shingles
The varicella zoster virus causes shingles and chickenpox. Anyone who has had chickenpox can later develop shingles even children. That’s because the virus stays dormant in the nervous system for the rest of a person’s life.
In many people, the virus never comes back. But in others, it flares up and causes shingles. It’s uncommon for someone to get shingles more than once.
People of all ages can get shingles, but most cases are in people over 50 years old.
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When To See A Doctor
A person should see a doctor if they are experiencing any early symptoms of shingles, especially if they have a history of shingles or are at a higher risk of developing an acute outbreak of the virus due to any of the risk factors above.
A person undergoing treatment for shingles should follow up with a doctor if:
- the symptoms get significantly worse after treatment
- the symptoms do not go away within a few weeks
- new or different symptoms appear in addition to the rash
- there are signs of secondary infection, such as high fever, an open wound, or red streaks coming out of a shingles lesion
People should also speak to a doctor if they have lasting nerve pain in the affected region after the rash of shingles disappears. This complication, called postherpetic neuralgia, affects
In many cases , a doctor will prescribe an antiviral medication, such as famciclovir, valacyclovir, or acyclovir. Pain-relieving medicine can also help ease symptoms. Calamine lotion, colloidal oatmeal compresses and baths, and cold compresses may ease the itching of shingles.
It is important to refrain from scratching the affected area as this can irritate the blisters and increase the risk of infection.
Some people develop a superimposed bacterial skin infection over their shingles lesions. This infection can be very painful, and it may spread if a person does not receive treatment. Individuals who develop this infection in addition to shingles may require antibiotic treatment or even hospitalization.
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.
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