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.
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.
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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What Are The Signs And Symptoms Of Shingles
Shingles causes a painful, blistering rash on your skin. If you get shingles, you may notice the following:
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Before the rash appears: For 1 to 2 days before the rash appears, you may have pain, burning, or tingling on an area of skin where the rash will develop. Some people say they felt an electrical sensation on their skin before getting the rash.
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Rash appears: A painful, blistering rash appears. It usually appears on one side of your body, often on the torso however, it can appear anywhere on your skin. Some people get more blisters after the rash appears, so it can seem that the rash is spreading.
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Rash starts to clear: As the rash clears, the blisters may crack open, bleed, and scab over. For most people, the rash will clear within 2 to 4 weeks.
Although the rash will clear on its own, treatment is important. Taking medication within 3 days of getting the shingles rash can:
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Reduce your risk of developing other health problems, such as long-lasting nerve pain, pneumonia, or hearing loss
Shingles rash on the face
If you have a shingles rash on your face, immediately seeing a doctor for treatment could save your eyesight.
What Are The Health Complications
The most common complication of shingles is postherpetic neuralgia . PHN causes severe pain even after the shingles rash clears.
People aged 60 years and older who dont seek treatment for shingles are more likely to develop PHN.
Shingles can also cause serious sight problems if it infects the structures of the eye.
Other rare complications include:
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How Do Dermatologists Diagnose Shingles
A dermatologist can often diagnose shingles by looking at the rash on your skin.
If there is any question about whether you have shingles, your dermatologist will scrape a bit of fluid from a blister. This will be sent to a lab where a doctor will look at the fluid under a high-powered microscope.
When you have shingles, the fluid contains the virus that causes shingles. Seeing the virus confirms that you have shingles.
Your dermatologist will also ask about your symptoms. Shingles tends to be painful.
When the shingles rash spreads to an eye, it can affect your eyesight
You can reduce this risk by seeing an ophthalmologist immediately.
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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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Does Stress Increase My Risk Of Shingles
Stress may increase your risk of shingles, however age is the most important risk factor for developing shingles, as most cases of shingles occur in adults 50 years and older.
Hidden Text
Im up for almost anything somebody wants to try, whether its something old or new, Im in. But not when I had shingles. I was out. Do anything you can not to get it.
Pat Knaust,former shingles sufferer and GSK spokesperson
How Long Does Shingles Last
Most cases of shingles last three to five weeks.
- The first sign is often burning or tingling pain sometimes it includes numbness or itching on one side of the body.
- Somewhere between one and five days after the tingling or burning feeling on the skin, a red rash will appear.
- A few days later, the rash will turn into fluid-filled blisters.
- About one week to 10 days after that, the blisters dry up and crust over.
- A couple of weeks later, the scabs clear up.
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Are There Natural Ways To Boost Your 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.
Other things you can do include:
- Eat a healthy diet.
- Aim for seven to nine hours of sleep each night.
- Dont smoke or use tobacco products.
These are all tips for an overall healthy lifestyle, not just for reducing your chance of getting shingles.
When To Contact A Doctor
Its important to visit your doctor as soon as possible if you suspect you have shingles, especially if youre somebody at an increased risk of developing it.
The American Academy of Dermatology recommends visiting a dermatologist or other healthcare professional within 3 days to prevent long-term complications.
Shingles typically clears up within a few weeks and does not commonly recur. If your symptoms have not lessened within 10 days, contact a doctor for a follow-up and reevaluation.
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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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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.
Can You Get Shingles If You Havent Had Chickenpox
No. You cant get shingles if youve never had chickenpox, but you can get chickenpox from someone who has shingles. If youve never had chickenpox and you come into direct contact with the oozing, blister-like rash of someone with shingles, the varicella-zoster virus can infect you and you would develop chickenpox.
Once youve had chickenpox, you could develop shingles at some point in your life. This is because the varicella-zoster virus never fully goes away after youve had chickenpox. It lies quietly inactive in your nerve tissue. Later in life, the virus may become active again and appears as shingles.
Can you get chickenpox more than once?
Its rare to get chickenpox twice in your life. Once youve had chickenpox, youre usually immune to it for the rest of your life. However, its not totally impossible. If you have a severely weakened immune system , you can get chickenpox a second time. If youve had chickenpox, you are more likely to get shingles at some point in your life than a repeat bout of chickenpox.
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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.
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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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.
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.
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How Is The Sample Collected For Testing
The sample required depends on whether testing is being done to determine the presence of antibodies or to detect the virus itself and on the health status of the person. Antibody testing requires a blood sample drawn from a vein in the arm. Viral detection may be done on a variety of samples, including a sample of vesicle fluid, blood, cerebrospinal fluid, other body fluid, or tissue.
What Is The Connection Between Chickenpox & Shingles
Chickenpox is a very contagious disease that causes a blister-like rash typically all over the body, itching, and fever. Before the chickenpox vaccine, nearly everyone in the United States got chickenpox. The chickenpox virus can reactivate, causing shingles. People with shingles may have pain, itching, tingling, and blisters in one area of the body that can last for weeks.
You may be among the 99% of people over the age of 50 years who is at risk for shingles, since the virus that causes chickenpox also causes shingles when it reactivates. One in three people will get shingles in their lifetime.
Chickenpox
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Is Shingles Contagious
Shingles is not contagious, but the virus that causes it, varicella-zoster, can be. Although the risk of transmission is low, a person can become infected with the varicella-zoster virus by making direct contact with the fluid inside a shingles blister.
According to the Centers for Disease Control and Prevention , the varicella-zoster virus can be transmitted from a person with shingles to a person who hasn’t had chicken pox before or has never had the chicken pox vaccine. If they become infected with the varicella-zoster virus, they’ll develop the chicken pox not shingles.
Once they then overcome chicken pox, the varicella-zoster virus will remain inactive in their bodies, which means they could later develop shingles.
Keeping your shingles rash covered and frequently washing your hands can help prevent transmission of the varicella-zoster virus.
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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