Symptoms And Complications Of Shingles
During the 2 or 3 days before shingles develops, most people have pain, a tingling sensation, or itching in a strip of skin on one side of the body. Clusters of small, fluid-filled blisters surrounded by a small red area then develop on the strip of skin. Typically, the blisters occur only on the limited area of skin supplied by the infected nerve fibers. Most often, blisters appear on the trunk, usually on only one side. However, a few blisters may also appear elsewhere on the body. Typically, blisters continue to form for about 3 to 5 days. The affected area is usually sensitive to any stimulus, including light touch, and may be very painful.
Shingles symptoms are usually less severe in children than in adults.
The blisters begin to dry and form a scab about 5 days after they appear. Until scabs appear, the blisters are contagious and contain varicella-zoster virus, which, if spread to susceptible people, can cause chickenpox. Having many blisters outside the affected dermatome or having blisters that persist for more than 2 weeks usually indicates that the immune system is not functioning normally.
Rarely, the affected skin becomes infected by bacteria. Scratching the blisters increases this risk. Bacterial infections increase the risk of scarring.
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.
Why Two Types Of Shingles
Most people are infected with VZV at some point. This type of virus stays in your body forever, but it lies dormant most of the time. When it reactivates, it causes shingles.
The infection affects a single nerve and the itching and pain are confined to the path of that nerve. That generally means symptoms in a stripe on one side of your body.
Typical shingles develops from an infection in a sensory nerve
In internal shingles, the infected nerve is deeper in the body, often in the digestive organs. It doesn’t cause a rash because those nerves don’t connect to your skin.
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Shingles Or Something Else
Small blisters that appear only on the lips or around the mouth may be cold sores, sometimes called fever blisters. They’re not shingles, but are instead caused by the herpes simplex virus. Itchy blisters that appear after hiking, gardening, or spending time outdoors could be a reaction to poison ivy, oak, or sumac. If you aren’t sure what’s causing your rash, see your healthcare provider.
What Problems Can Happen
Most cases of shingles heal on their own, with or without treatment, and won’t lead to any other problems. In rare cases, shingles can lead to complications, including:
- Ongoing pain : Damaged nerve fibers in the skin send confused messages to the brain, leading to pain. Pain can go on for a long time after the shingles rash is gone. This is the most common shingles complication.
- Vision problems: Shingles near or in an eye can lead to vision loss.
- Skin infections: A shingles rash can become infected with bacteria, leading to impetigo or cellulitis.
- Nervous system problems: Shingles on the face can involve different nerves that connect to the brain. This can lead to nerve-related problems such as facial paralysis, hearing problems, and problems with balance. In very rare cases, shingles can lead to encephalitis .
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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.
Key Points About Shingles
- Shingles is a common viral infection of the nerves. It causes a painful rash or small blisters on an area of skin.
- Shingles is caused when the chickenpox virus is reactivated.
- It is more common in people with weakened immune systems, and in people over the age of 50.
- Shingles starts with skin sensitivity, tingling, itching, and/or pain followed by rash that looks like small, red spots that turn into blisters.
- The rash is typically affects just one area on one side of the body or face.
- Treatment that is started as soon as possible helps reduce the severity of the disease.
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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.
Signs And Symptoms Of Shingles
Shingles may cause mild to severe pain, and the viral rash most commonly appears on the trunk, notes the CDC. Unlike chickenpox, the shingles rash usually occurs on one side of the body or face.
The first symptom of shingles is usually pain, itching, or tingling in the area where the shingles rash will later appear. This may happen several days before the rash erupts, leading to fluid-filled blisters like those of chicken pox. The blisters typically scab over in 7 to 10 days and clear up within two to four weeks, according to the CDC.
Other signs and symptoms of shingles may include:
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How Long Does Shingles Last
Shingles blisters usually scab over in 7-10 days and disappear completely in two to four weeks. In most healthy people, the blisters leave no scars, and the pain and itching go away after a few weeks or months. But people with weakened immune systems may develop shingles blisters that do not heal in a timely manner.
Why Doesnt Having Chickenpox Earlier In Life Provide Immunity Against Having Shingles Later
After having chickenpox, your body doesnt rid your system of the virus. Instead, the virus stays in a portion of the spinal nerve root called the dorsal root ganglion. In most people, the virus simply stays there quietly and doesnt cause problems. Scientists arent always sure why the virus gets active again, but they know stress can be a cause.
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Who Should Be Vaccinated With Shingrix
The Shingrix vaccine is recommended for those 50 years of age and older who are in good health.
You should get the Shingrix vaccine even if:
- Youve had shingles already.
- Youve been previously vaccinated with Zostavax . If youve been vaccinated with Zostavax, wait at least eight weeks before getting vaccinated with Shingrix.
- You dont know for sure if youve ever had chickenpox.
Ask your healthcare provider, who knows your entire health history if getting this vaccine is right for you.
When You Should See Your Doctor
Go to your doctor as soon as you see the rash, as treatment is most effective if its started early.
Your doctor may prescribe antiviral medicine, which may help you recover faster and will reduce the chance that the pain will last for a long time.
Your doctor may also give you medicine for pain relief.
See your doctor again if:
- you get any blisters on your face
- your fever or pain gets worse
- your neck gets stiff, you cant hear properly or you feel less able to think clearly
- you develop new symptoms such as drooping or weakness to one side of your face
- the blisters show signs of infection or if you see milky yellow drainage from the blister sites.
Call Healthline if you are unsure what you should do.
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What Are The Complications Of Shingles
After the shingles rash has disappeared, you might continue to have nerve pain in that same area. Postherpetic neuralgia can last for months or years and become quite severe.
More than 10% of people who get shingles develop postherpetic neuralgia. Researchers dont know why some people get postherpetic neuralgia and others dont. It may be that nerves become more sensitive or that the virus may be invading and damaging the central nervous system.
Other complications include:
- Other types of nerve issues like numbness or itching.
- A bacterial infection of the shingles rash.
- Eye and ear inflammation if the rash is near these organs.
Can Shingles Cause Chronic Pain
In some people, the pain of shingles may linger for months or even years after the rash has healed. This pain, due to damaged nerves in and beneath the skin, is known as postherpetic neuralgia. Others feel a chronic itch in the area where the rash once was. In severe cases, the pain or itching may be bad enough to cause insomnia, weight loss, or depression.
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How Can You Prevent Spreading The Virus
You cant give shingles to someone else, but the varicella-zoster virus is very contagious. If you have shingles and you expose someone else who has not had chickenpox or the chickenpox vaccine, you can give them the virus. Theyll get chickenpox, not shingles, but this puts them at risk for shingles later on.
Youre contagious when your blisters are oozing, or after they break and before they crust over. Do the following to avoid spreading the virus to others:
- Keep your rash covered, especially when the blisters are active.
- Try not to touch, rub, or scratch your rash.
- Wash your hands thoroughly and often.
Avoid contact with people whove never had chickenpox or the chickenpox vaccine, especially:
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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Hives Can Cause Itchy Red Bumps
Hives are red or skin-colored bumps that can cause mild to severe itching, according to the ACAAI. They typically appear suddenly and disappear quickly. Pressing the middle of a red bump will make it turn white, which is known as blanching. Hives can be caused by a number of triggers, including allergies, cold or hot weather, and infections.
How Can You Care For Yourself At Home
- Be safe with medicines. Take your medicines exactly as prescribed. Call your doctor if you think you are having a problem with your medicine. Antiviral medicine helps you get better faster.
- Try not to scratch or pick at the blisters. They will crust over and fall off on their own if you leave them alone.
- Put cool, wet cloths on the area to relieve pain and itching. You can also use calamine lotion. Try not to use so much lotion that it cakes and is hard to get off.
- Put cornstarch or baking soda on the sores to help dry them out so they heal faster.
- Do not use thick ointment, such as petroleum jelly, on the sores. This will keep them from drying and healing.
- To help remove loose crusts, soak them in tap water. This can help decrease oozing, and dry and soothe the skin.
- Take an over-the-counter pain medicine, such as acetaminophen , ibuprofen , or naproxen . Read and follow all instructions on the label.
- Avoid close contact with people until the blisters have healed. It is very important for you to avoid contact with anyone who has never had chickenpox or the chickenpox vaccine. Pregnant women, young babies, and anyone else who has a hard time fighting infection is especially at risk.
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Psoriasis Forms Red Patches On The Skin
Psoriasis is an autoimmune disease that is easy to confuse with the shingles rash. As with the shingles virus, psoriasis forms red patches on the skin, according to Johns Hopkins Medicine. One type of psoriasis pustular can lead to the development of blisters. Areas of skin affected by psoriasis often develop into silvery scales on the scalp, elbows, knees, and lower back. Treatment can help control the condition.
Shingles Risk Factors: Who Gets It
The simple answer is anyone who has had chicken pox. As the same virus lies dormant in your nerve cells, there are several factors that will cause it to reappear, this time as shingles.
1. Age Factor
While the most common period is between 50 and 60 years of age, there are reports stating that half of people older than 80 will experience shingles.
2. Disease Factor
If your immune system is weakened by having another condition, such as HIV, AIDS, or lymphoma, your risk for an outbreak of shingles is greater.
3. Treatment Factor
The cancer treatments of radiation and chemotherapy can lower your ability to fight disease and can trigger the shingles virus.
4. Medication Factor
Particular prescribed medications such as steroids and those used for organ transplant recipients can increase the risk.
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Varicella In Vaccinated Persons
Breakthrough varicella on the abdomen of a vaccinated child.
Breakthrough varicella is infection with wild-type varicella-zoster virus occurring in a vaccinated person more than 42 days after varicella vaccination. Breakthrough varicella is usually mild. Patients typically are afebrile or have low fever and develop fewer than 50 skin lesions. They usually have a shorter illness compared to unvaccinated people who get varicella. The rash is more likely to be predominantly maculopapular rather than vesicular. However, 25% to 30% of people vaccinated with one dose who get breakthrough varicella will have clinical features similar to unvaccinated people with varicella.
Since the clinical features of breakthrough varicella are often mild, it can be difficult to make a diagnosis on clinical presentation alone. Laboratory testing is increasingly important for confirming varicella and appropriately managing the patients and their contacts. Breakthrough varicella occurs less frequently among those who have received two doses of vaccine compared with those who have received only one dose disease may be even milder among two-dose vaccine recipients, although the information about this is limited.
Treat Your Body And Mind
You can get worn down mentally when youâre in constant pain. Stress can make it seem even worse. Self-care starts with treating your rash, but donât stop there. Your mind and emotional state need to be cared for as well.
5. Stick with good habits: Your bodyâs working hard to fight the varicella-zoster virus that causes shingles. To give it the right support, you can:
- Eat nutritious food and have regular meals. Ask someone to make a run to the grocery store for fresh fruit and such if youâre not up for it.
- Try to get a good nightâs sleep and rest anytime you need to.
- Do gentle exercises, such as walking or stretching. Light activity can help take your mind off the pain. Keep it simple though, and check with your doctor if youâre trying something new.
6. Distract yourself: Sometimes, the best thing you can do is to put your focus elsewhere. Here are a few things to try:
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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.
How To Prevent Shingles
The only method to prevent shingles is vaccination. It should be noted this does not guarantee you will not get shingles. The vaccine is intended to help prevent the condition, but if you have an outbreak, the vaccine will lessen the duration and severity of the symptoms. It is not intended for those with a weak immune system as it is a live vaccination.
The injection is administered in the upper arm with possible side effects of redness, pain, swelling, and itching at the entry site. There have been reports of headaches and a rash in some people after the vaccination.
The varicella zoster vaccine, or Zostavax, is approved by the Food and Drug Administration for people 50 and older. The Centers for Disease Control and Prevention recommends people over the age of 60 have the shingles vaccine.
For those individuals who have never had the chicken pox disease, it is recommended to have the varicella vaccine, Varivax. It is the same injection given to children to prevent the disease. As with all vaccinations, it does not guarantee you will not have the targeted disease. The vaccine will help with reducing the symptoms and duration should you contract chicken pox.
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