How Is Postherpetic Neuralgia Diagnosed
Postherpetic neuralgia is usually diagnosed based on your symptoms, history of having shingles and physical exam. If youve had a recent case of shingles and have pain in the area where the shingles rash once was, you likely have PHN. Your provider may want to make sure your pain is not caused by something else, but in most cases, no other tests are needed.
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.
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.
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Urgent Advice: Get Advice From 111 As Soon As You Suspect Shingles
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.
How Common Is Shingles
Currently, around 2030% of people experience shingles at some point in their life.
The U.S. introduced a chickenpox vaccine in 1995, and the number of chickenpox cases has dropped by around 7685% since then. This means that, over time, the number of people with the VZV in their system is likely to decrease.
Shingles may become less prevalent as children who received the chickenpox vaccine grow into adulthood.
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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.
Questions To Ask Your Doctor
- Ive had chickenpox. Am I at risk of developing shingles?
- What is the best treatment for my shingles?
- The pain from shingles isnt going away. What can I do to make myself more comfortable?
- Im on treatment for shingles. When should I call my doctor if things dont get better?
- I have shingles and my children havent had the chickenpox vaccine. Should I get them vaccinated?
- Is the shingles vaccine right for me?
- Are there any risks associated with the shingles vaccine?
- Will my post-herpetic neuralgia ever go away?
- If Ive never had the chickenpox, should I still get the shingles vaccination?
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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 The Outlook For People With Recurring Shingles
Shingles usually clears up within two to six weeks.
In a small number of cases, the pain can remain once the rash has healed. This is called postherpetic neuralgia . Up to 2 percent of people who get shingles have PHN for five years or more. The risk increases with age.
Recurring shingles isnt preventable. You can reduce your risk by getting the shingles vaccine, even after youve had shingles.
A showed that people who had the shingles vaccine had 51 percent fewer cases of shingles. For people 50-59 years old, the shingles vaccine reduced the risk of shingles by 69.8 percent.
People who received the shingles vaccine generally had less severe cases of shingles. They also had
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If My Shingles Rash Is Mild Or Has Mostly Healed Do I Need To See A Doctor
Its a good idea to see a doctor whenever you have a case of shingles, no matter how mild.
Prompt antiviral treatment not only decreases the duration and severity of the rash but can also decrease the chance of developing post-herpetic neuralgia. Post-herpetic neuralgia is a complication of shingles characterized by long-term, debilitating pain.
If your rash has mostly healed, its still a good idea to see a doctor so they can monitor the rash for changes or complications, such as a bacterial skin infection that forms on top of your existing rash. This is known as a superimposed infection.
What Does The Shingles Vaccine Do
The shingles vaccine can prevent shingles. Every year, about 1 million people in the United States get shingles. Anyone whos had chickenpox can get shingles. Thats because the varicella-zoster virus lives silently in your nervous system after you’ve had chickenpox. The virus can reactivate later in your life if your immune system is weakened. Your risk of getting shingles goes up as you get older. In the United States, 1 in 3 people will get shingles in their lifetime.
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When Should I Contact A Doctor For Shingles Symptoms
As soon as you believe that you may be experiencing a shingles infection, let your doctor know. Starting treatment with an antiviral medication within 3 days of your rash appearing can help decrease the severity of your infection and prevent PHN.
Even if you have had the rash for longer than 3 days, contact your doctor for advice on how to proceed with treatment.
What Is The Treatment For Shingles And Recurring Shingles
The treatment for recurring shingles is the same as for shingles.
If you suspect that you have recurring shingles, see your doctor as soon as possible. Taking an antiviral drug like acyclovir , valacyclovir , or famciclovir can reduce the severity of shingles and reduce how long it lasts.
Your doctor may also prescribe medications to lessen your pain and help you sleep. These include the following:
- Skin patches with the painkiller lidocaine are available. You can wear them on the affected area for a specific length of time.
- Skin patches that have 8 percent capsaicin, an extract of chili peppers, are available. Some people cannot tolerate the burning sensation, even though the skin is numb before the patch is put on.
- Antiseizure drugs, such as gabapentin and pregabalin , reduce pain by reducing the nerve activity. They have side effects that may limit the amount of the drug that you can tolerate.
- Antidepressants such as duloxetine and nortriptyline can be useful, especially to relieve pain and allow you to sleep.
- Opioid painkillers can relieve pain, but they have side effects, such as dizziness and confusion, and they can become addictive.
You can also take cool baths with colloidal oatmeal to ease the itching, or apply cold compresses to the affected area. Rest and stress reduction are also important.
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What Are The Symptoms Of Postherpetic Neuralgia
Common postherpetic neuralgia symptoms include:
- Burning, sharp, jagging or aching pain in the area where the shingles rash appeared.
- Itchiness or numbness at or near the area of the former rash.
- Pain that is constant or comes and goes. Pain typically lasts, on average, for three months after the rash has healed, but can last for more than a year or longer.
- Pain at affected skin area can be brought on even with a light touch .
- Pain gets worse at night or in heat or cold temperatures.
Stay Away From Certain Groups Of People If You Have Shingles
You cannot spread shingles to others. But people who have not had chickenpox before could catch chickenpox from you.
This is because shingles is caused by the chickenpox virus.
Try to avoid:
- pregnant people who have not had chickenpox before
- people with a weakened immune system like someone having chemotherapy
- babies less than 1 month old unless you gave birth to them, as your baby should be protected from the virus by your immune system
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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.
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.
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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.
What Are The Risk Factors For Recurring Shingles
People dont know what causes recurring shingles, but certain factors increase your chances of getting shingles again.
People with weakened immune systems are more likely to get shingles again. One study determined that the rate of shingles recurrence was among people with compromised immune systems. This is about 2.4 times higher than for those who didnt have compromised immune systems.
You may have a compromised immune system if you:
- are getting chemotherapy or radiation therapy
- have organ transplants
- are taking high doses of corticosteroids like prednisone
Additional risk factors include:
- longer-lasting and more severe pain with the first case of shingles
- pain for 30 days or more with the first case of shingles
- being over the age of 50
Having one or more blood relatives with shingles may also increase your risk of getting shingles.
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What Is The Shingles Vaccine
The shingles vaccine can protect you against shingles and postherpetic neuralgia , which is the most common complication of shingles. Shingles is a painful rash caused by the varicella-zoster virus, the same virus that causes chickenpox. The rash usually develops on one side of your body or face. It starts with red bumps and then the bumps turn into fluid-filled blisters.
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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Can Postherpetic Neuralgia Be Prevented
The Food and Drug Administration has approved a shingles vaccine, which can reduce your chance of getting shingles and PHN. The recombinant herpes-zoster vaccine is recommended to prevent shingles in adults ages 50 and older. The vaccination is given in two doses, two to six months apart. The two-dose vaccine is 90% effective at preventing shingles and PHN. Protection lasts at least for four years after you get vaccinated.
If you have never had chickenpox or have children who have never had chickenpox, getting the chickenpox vaccine can help prevent getting this infection in the first place. If you never get chickenpox, you will not have the varicella-zoster virus in your body and will not get shingles or PHN.
What Can I Do For The Pain
To help with the pain of shingles, your doctor might have you take an over-the-counter pain medicine. This could include acetaminophen or ibuprofen .
Applying a medicated anti-itch lotion to the blisters might reduce the pain and itching. Placing cool compresses soaked in water mixed with white vinegar on the blisters and sores might also help.
If shingles causes severe pain, your doctor might prescribe a stronger pain medicine.
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Focus On Prevention Doctors Say
Prevention is the best way to avoid a shingles episode.
There is a vaccine that prevents the onset of shingles in people exposed to chickenpox. The CDC recommends that people age 60 and older get one dose of the vaccine. Vaccines are readily available at a doctors office and drug stores. In 2011, the Food and Drug Administration extended the vaccine use for people aged 50 to 59.
Wigand-Bolling said the vaccine reduces the incidence of shingles by 51% and the neuralgia associated with shingles by 67%. The doctor said the vaccine is injected and once vaccinated a person is protected for life.
Unless contraindicated because of pregnancy or being an organ transplant recipient or on chemotherapy, everyone over age 50 should be vaccinated, Wigand-Bolling said. I would recommend getting vaccinated to patients who may not have had chicken pox, or those who dont remember having chicken pox.
More than 90% of those identified in the study at increased risk of stroke and heart attack after a shingles episode hadn’t been vaccinated for shingles. The people in the study who had the vaccine still got shingles, it’s worth noting.
Who Should Get The Shingrix Vaccine
The Shringrix vaccine is recommended in healthy adults age 50 and older. There is no maximum age. You should get the vaccine even if:
- Youve had shingles.
- Youre not sure if youd had chickenpox .
- Youve already had the Zostavax vaccine. This vaccine for shingles is no longer available in the U.S. Ask your healthcare provider about the best time to get the Shingrix vaccine.
If you currently have shingles, you need to wait until the shingles rash has gone away. Talk with your provider about the proper time to begin vaccination with Shingrix.
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