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.
What Are The Complications Associated With Shingles
Shingles is not usually dangerous to healthy individuals although it can cause great misery during an attack. Anyone with shingles on the upper half of their face, no matter how mild, should seek medical care at once because of the risk of damage to the eye. Very rarely, shingles can lead to pneumonia, hearing problems, blindness, brain inflammation or death. For about one person in five, severe pain can continue even after the rash clears up. This pain is called post-herpetic neuralgia. As people get older, they are more likely to develop post-herpetic neuralgia, and it is more likely to be severe.
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 pain doesnt lessen, other treatments such as nerve blocks or steroid injections near the area where the nerves exit the spine can be tried. Implantable nerve stimulator devices are an option for severe, ongoing pain that has not responded to other treatments.
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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 Is Shingles Treated
There is no cure for shingles, but antiviral medicine may relieve the symptoms and help prevent complications. See your doctor for a prescription of antiviral medicines as soon as possible after symptoms develop. Treatment should be started within 3 days of the shingles rash appearing.
If you are pregnant, talk to your doctor about whether antivirals are right for you.
Over-the counter medicines, such as paracetamol and non-steroidal anti-inflammatories, can be used for pain relief. If over-the-counter medicines are not controlling your pain, your doctor may prescribe other medicines.
There are several things you can do to help manage the condition. They include the following.
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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.
Can Shingles Be Harmful During Pregnancy
Journal of Obstetrics and Gynaecology
Still, pregnant women who develop chicken pox can experience complications, including varicella pneumonia, a condition that can be fatal.
If a pregnant woman develops a varicella rash from five days before to two days after delivery, the newborn will be at risk for neonatal varicella.
Pregnant women who have been exposed to the virus may be given a varicella-zoster immune globulin injection to reduce the risk of complications to both mother and baby.
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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.
What Everyone Should Know About The Shingles Vaccine
Shingles vaccination is the only way to protect against shingles and postherpetic neuralgia , the most common complication from shingles. CDC recommends that healthy adults 50 years and older get two doses of the shingles vaccine called Shingrix , separated by 2 to 6 months, to prevent shingles and the complications from the disease. Your doctor or pharmacist can give you Shingrix as a shot in your upper arm.
Shingrix provides strong protection against shingles and PHN. Two doses of Shingrix is more than 90% effective at preventing shingles and PHN. Protection stays above 85% for at least the first four years after you get vaccinated.
Most people who develop shingles have a tell-tale rash on one side of their body. But its possible to have shingles without a rash. This is known as zoster sine herpete or internal shingles. It is caused by the same virus, varicella-zoster virus , that causes shingles .
While it doesnt produce a painful, itching rash, internal shingles does cause other symptoms. Because it may not be recognized as a shingles infection, the frequency of ZSH infections may be higher than previously thought.
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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.
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.
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Who Should Not Get Shingrix
You should not get Shingrix if you:
- Have ever had a severe allergic reaction to any component of the vaccine or after a dose of Shingrix.
- Currently have shingles.
- Currently are pregnant. Women who are pregnant should wait to get Shingrix.
If you have a minor illness, such as a cold, you may get Shingrix. But if you have a moderate or severe illness, with or without fever, you should usually wait until you recover before getting the vaccine.
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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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.
How Can I Take Care Of Myself
- Take a pain-relief medicine such as acetaminophen. Take other medicine as prescribed by your healthcare provider.
- Put cool, moist washcloths on the rash.
- Rest in bed during the early stages if you have fever and other symptoms.
- Try not to let clothing or bed linens rub against the rash and irritate it.
- You develop worsening pain or fever.
- You develop a severe headache, stiff neck, hearing loss, or changes in your ability to think.
- The blisters show signs of bacterial infection, such as increasing pain or redness, or milky yellow drainage from the blister sites.
- The blisters are close to the eyes or you have pain in your eyes or trouble seeing.
- You have trouble walking.
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Shingles And Chickenpox Vaccination
The National Immunisation Program provides a free shingles vaccine, Zostavax® at 70 years of age . There is also a free catch-up program for 71 to 79 year olds until the end of 2021. The Zostavax® vaccine is available on prescription for people aged 50 to 69 years and from 80 years but it must be paid for by the patient.
Zostavax® vaccine contains live attenuated varicella-zoster virus, containing 14 times more virus than childhood varicella vaccines and is contraindicated in immunocompromised people. Zostavax® vaccine should not to be used in people with compromised immune function due to the risk of disseminated disease from the vaccine virus.
- Safety advisory – Zostavax® vaccine for health professionals and consumers
Vaccination is still recommended for people who have had shingles infection in the past. It is recommended to wait at least a year after recovery.
The NIP provides a free chickenpox vaccine to children aged 18 months of age and as catch-up for children up to 20 years of age as part of the No Jab No Pay legislation. People aged 14 years and older require two doses of the chickenpox vaccine, one to two months apart. People from 20 years of age must purchase the vaccine privately.
Virus Reactivation And Symptoms
When the virus re-emerges, it typically reactivates in clusters of nerve cells in the peripheral nervous system called a sensory ganglion. The ganglia most likely to host varicella are those in the cervical, thoracic, and lumbar spine.
Varicella also often affects the trigeminal ganglion, which provides sensation to the face. As its name suggests, this particular clump of nerves has three branches. The one associated with eye function, the ophthalmic branch, is 20 times more likely than the other two to be affected.
Since the nervous system consists of tree-like branches of nerves, the blisters will follow the particular path of the nerves affected. That’s why a shingles rash often resembles a swath of blisters in a very specific area, rather than spread all over the body .
The area with the particular nerve cells in which the virus reawakens is where the shingles symptomsextreme pain and rashwill be concentrated.
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Along with the rash, symptoms of shingles may include:
For several days before the rash appears, you may have tingling, itching, or pain in the affected area.
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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.
Is The Zostavax Vaccine Still Being Used
Yes. The CDC, however, recommends Zostavax for adults age 60 and older, but not routinely for people aged 50 to 59. Zostavax is given as a single-dose shot versus the two-dose shot for Shingrix. Zostavax is less effective than Shingrix in preventing shingles and postherpetic neuralgia .
You can consider Zostavax if you are allergic to Shingrix or if Shingrix is unavailable because of supply shortage and you want some immediate protection from a possible case of shingles and/or postherpetic neuralgia. Because its a weakened live vaccine, it may be dangerous if you have cancer, HIV, or take steroids, chemotherapy or other medications that suppress your immune system. Ask your healthcare provider if the Zostavax vaccine is an option for you.
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Once You’ve Had Shingles Can It Come Back
Reoccurrence is relatively uncommon. Only a small percentage of patients may have a second episode, more commonly in women. “Three or more shingles episodes in the same person is considered extremely rare,” says Dr. Mohring. “In this case, it would prompt us to investigate other potential diseases that may be going on. Those with higher risk factors, especially weakened immune systems or autoimmune disease, are the most at risk for reoccurrence.”
Am I At Risk For Shingles
Everyone who has had chickenpox is at risk for developing shingles. Researchers do not fully understand what makes the virus become active and cause shingles. But some things make it more likely:
- Older age. The risk of developing shingles increases as you age. About half of all shingles cases are in adults age 60 or older. The chance of getting shingles becomes much greater by age 70.
- Trouble fighting infections. Your immune system is the part of your body that responds to infections. Age can affect your immune system. So can HIV, cancer, cancer treatments, too much sun, and organ transplant drugs. Even stress or a cold can weaken your immune system for a short time. These all can put you at risk for shingles.
Most people only have shingles one time. However, it is possible to have it more than once.
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Shingles On The Face: Symptoms Treatments And More
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Shingles on the face
Shingles, or zoster, is a common infection that occurs due to a herpes virus.
Shingles is a rash that usually appears on one side of the chest and back. It can also develop on one side of the face and around the eye.
The condition can be very painful and can sometimes have long-term side effects. No cure for shingles is available, but early treatment can lower your risk of serious complications.
second most common rash site is the face. It can spread from the ear to the nose and forehead. It can also spread around one eye, which can cause redness and swelling of the eye and surrounding area. The shingles rash occasionally develops in the mouth.
Many people feel a tingling or burning sensation days before the first red bumps appear.
The rash starts out as blisters filled with fluid, or lesions. Some people have a few clusters of blisters scattered about, and others have so many that it looks like a burn. The blisters eventually break, ooze, and crust over. After a few days, the scabs start to fall off.
Other symptoms of shingles are: