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 Do You Prevent Shingles
Vaccination is a safe and effective way to protect against shingles in most people. The shingles vaccine should not be given to people who are immunocompromised.
For more information on shingles immunisation, see Shingles immunisation service.
Shingles is less contagious than chickenpox. The risk of spreading the disease is low if the rash is covered. When the rash has developed crusts, you are no longer infectious.
If you have shingles, you should:
- wash your hands often to prevent the virus from spreading.
Avoid contact with these people until the rash has developed crusts:
- pregnant women who have never had chickenpox or the chickenpox vaccine
- premature or low birthweight babies
- children who have not had chickenpox or the chickenpox vaccine
- people with weakened immune systems, such as people who:
- have had chemotherapy
- are taking other medicines that weaken their immune system
- have had a transplant
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When To Seek Care
Early shingles symptoms, such as pain or flu-like feelings, are not obvious signs of a shingles outbreak.
Once a rash appears, you should see your primary care physician or a dermatologist. A trained eye can often diagnose shingles by visually inspecting the rash.
If you have shingles, you may never experience the extreme pain that can often come with it. You may only feel itching and some minor discomfort.
Even without the painful symptoms of shingles, its recommended that you see a healthcare professional and start antiviral treatment within 72 hours of a rashs appearance.
Its especially important to seek prompt medical care if a rash forms near one or both eyes. Shingles in the eye may cause permanent vision loss.
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How To Treat And Prevent Shingles
Shingles is treated using antiviral medications, such as:
To manage shingles pain, you can also use numbing creams like lidocaine, or place a cool, wet washcloth on your skin.
It’s important to get treatment as quickly as possible because, “people with shingles can develop long-term pain or itch after the shingles resolves if the virus does too much damage,” Kim says.
To stop yourself from spreading varicella-zoster to anyone else, try to cover up your rash when possible and avoid directly touching it.
The best way to prevent shingles is to get a shingles vaccine. The newest vaccine, called Shingrix, is 85% to 90% effective at preventing shingles in people who have already had chickenpox. If you have never had chickenpox, you will need to get the chickenpox vaccine instead.
What Is Postherpetic Neuralgia
Postherpetic neuralgia is a complication of shingles infection . Shingles is caused by the reactivation of the varicella-zoster virus, which is the same virus that causes chickenpox.
Shingles causes a painful, blistering rash and other symptoms. The rash most commonly occurs in a band pattern on one side of your body, usually on your trunk . The rash turns into blisters. As the rash/blisters go away, pain may remain. When pain remains, the condition is called postherpetic neuralgia.
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How Long Will The Effects Last
The rash from shingles will heal in 1 to 3 weeks and the pain or irritation will usually go away in 3 to 5 weeks. When shingles occurs on the head or scalp, the symptoms usually go away eventually, but it may take many months.
If the virus damages a nerve, you may have pain, numbness, or tingling for months or even years after the rash is healed. This is called postherpetic neuralgia. This chronic condition is most likely to occur after a shingles outbreak in people over 50 years old. Taking antiviral medicine as soon as the shingles is diagnosed may help prevent this problem.
How Common Is Postherpetic Neuralgia
Varicella-zoster virus causes both chickenpox and shingles. About 99% of Americans over age 40 have had chickenpox. About one in three people in the U.S. develop shingles in their lifetime. Some 10 to 18% of people who get shingles will develop postherpetic neuralgia. Postherpetic neuralgia is the most common complication of shingles.
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Other Complications Of Shingles
If the shingles rash appears around the eye or forehead, it can cause eye infections and temporary or permanent loss of vision. If the shingles virus attacks the ear, people may develop hearing or balance problems. In rare cases, the shingles virus may attack the brain or spinal cord. These complications can often be prevented by beginning treatment for shingles as soon as possible.
Should I See A Doctor For Shingles
It is usually worth seeing a doctor to be certain about the diagnosis and to see if you need treatment or not. Ideally you should see a doctor as soon as possible after the rash appears.
The rash of shingles can be very painful. So even if the doctor doesn’t think you need an anti-shingles medicine, they may be able to give you stronger painkillers than those you can buy over the counter from the chemist.
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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.
Although Shingles Typically Lasts Three To Five Weeks The Pain Can Linger Learn The Timeline Of A Shingles Rash
Medically reviewed in March 2021
If you have shingles or are concerned about getting shingles, you may be wondering how long the rash will last.
Also called herpes zoster, shingles is a reactivation of the same virus that causes chicken pox. This reactivation causes a painful rash, which usually appears on one side of the torso, though it can occur in other areas of the body, including the face.
Shingles step-by-step Most cases of shingles will last from around three to five weeks. Here is a typical timeline of a shingles outbreak and recovery:
- To begin: You may feel numbness or itching on one side of your body. Burning or tingling pain is also common.
- Days 1 to 5: A red, painful rash appears.
- A few days after the rash appears: The rash becomes fluid-filled blisters.
- Days 7 to 10: The blisters dry up and crust over.
- Weeks 3 to 5: The scabs heal and clear up.
If at all possible, its best to see a healthcare provider as soon as symptoms begin. Within the first 72 hours of when the rash appears, your healthcare provider can prescribe an antiviral medication that you take by mouth. This can shorten the duration of your shingles outbreak, and lower the risk of long-term lingering pain, called post-herpetic neuralgia . Your healthcare provider can also prescribe other treatments to help ease the itching of a shingles rashsuch as wet compresses, calamine lotion, and colloidal oatmeal bathsas well as pain medications to relieve the pain associated with shingles.
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What Are The Symptoms
The first sign of shingles is often burning, sharp pain, tingling, or numbness in your skin on one side of your body or face. The most common site is the back or upper abdomen. You may have severe itching or aching. You also may feel tired and ill with fever, chills, headache, and upset stomach or belly pain.
One to 14 days after you start feeling pain, you will notice a rash of small blisters on reddened skin. Within a few days after they appear, the blisters will turn yellow, then dry and crust over. Over the next 2 weeks the crusts drop off, and the skin continues to heal over the next several days to weeks.
Because shingles usually follows nerve paths, the blisters are usually found in a line, often extending from the back or side around to the belly. The blisters are almost always on just one side of the body. Shingles usually doesn’t cross the midline of the body. The rash also may appear on one side of your face or scalp. The painful rash may be in the area of your ear or eye. When shingles occurs on the head or scalp, symptoms can include headaches and weakness of one side of the face, which causes that side of the face to look droopy. The symptoms usually go away eventually, but it may take many months.
In some cases the pain can last for weeks, months, or years, long after the rash heals. This is called postherpetic neuralgia.
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 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 Common Is Shingles
Shingles affects 1 out of every 3 people in the United States. More than 1 million cases of shingles are diagnosed every year. The risk of shingles increases as you get older, with about half the cases occurring in people over the age of 50. Shingles develops in about 10% of people who have had chickenpox at an earlier time in their life.
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The Stages Of Shingles Recovery
After the rash develops, which usually appears on only one side of the body, it forms blisters. You may feel like you have the flu or a mild fever. As you recover, you will typically go through these stages:
- Blisters begin to burst or weep about 5 days after they develop, and lasts from 7 to 10 days. You should take time off from work and other activities during this period, because you can spread the virus to others through the fluid in the blisters. Otherwise, you can return to work when you feel comfortable doing so.
- The blisters will scab over and begin to heal, which takes from 1 to 3 weeks, unless the rash is on your scalp in which case it can take several months.
- As they heal, the blisters become smaller and less painful, generally over a period of 3 to 5 weeks.
- About 10 to 15% of people with shingles will develop chronic nerve pain, which can be severe. Sensitivity to touch at the site of the rash is possible. The older you are, the more likely it is you will develop this disorder, called post-herpetic neuralgia, or PHN. The pain often lessens over time. Available treatments include anti-inflammatory injections, nerve blocks, certain tricyclic antidepressants, or capsaicin cream, which is made from chili peppers and can help ease nerve pain.
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.
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How Long Do Shingles Scabs Take To Heal
Shingles scabs will take about 2 to 4 weeks to heal. The exact time frame will be different for each person. It depends on several factors, including the severity of your rash and how soon you get treatment.
However, even after the scabs have cleared up, the pain and discomfort can last for several weeks or months.
According to the Centers for Disease Control and Prevention , about
Its important to contact a doctor within 72 hours of developing a shingles rash. The sooner you can get a proper diagnosis, the sooner you can start treatment for shingles.
Early treatment can help shorten the length of your infection and reduce the risk of possible complications.
To help ease the pain and sensitivity of the shingles rash and scabs, your doctor may prescribe oral gabapentin or pregabalin.
You should also contact a doctor if you experience any of the following:
- blisters or scabs that wont heal
- signs of a skin infection, like pus or swelling
- worsening or ongoing pain after the scabs heal
- persisting fatigue or fever after the rash heals
- new blisters or scabs
Is It Possible To Prevent Postherpetic Neuralgia
If shingles can be prevented, then PHN can be prevented. Fortunately, the vaccine Zostavax is about 70% effective in preventing shingles. The CDC recommends that everyone older than 60 years of age get the vaccine in 2011, the FDA approved the vaccine for people aged 50 and above. The CDC states, Zostavax should not be given to pregnant women, persons with a primary or acquired immunodeficiency, or to persons with a history of anaphylactic reaction to gelatin, neomycin, or any other component of the vaccine. Herpes zoster vaccine can be administered simultaneously with other indicated vaccines.
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Lasting Pain After Shingles
Pain that continues for a long time after a shingles rash has disappeared is called post-herpetic neuralgia. This is the most common complication of shingles. Its still not clear how it can be prevented or what the best treatment is.
Shingles typically causes a rash accompanied by pain in the affected area. The pain normally goes away when the rash goes away. This usually happens after two to four weeks. Pain that continues for longer is referred to as post-herpetic neuralgia. The word “post-herpetic” means “post-herpes” because the pain arises after infection by the herpes zoster virus. In very rare cases pain can come back after a shingles infection, even if it had already gone away and the rash has disappeared.
The main symptom of post-herpetic neuralgia is pain in the nerves . The skin is often overly sensitive and itchy as well. This can make it difficult or painful to wash yourself, turn over in bed, or hug someone. The pain and itching can be very severe and might keep you from sleeping.
Tingling Pain Or Numbness
During the first stage of shingles, before anything appears on your skin, a particular area of your body may begin to feel different. “When a shingles outbreak is starting, you may feel itching, burning, or pain,” Kim says. Often you will feel this on only one side of your body.
The initial signs of shingles may feel different for each person. In some cases, shingles can cause intense sensitivity, making it painful to even wear clothes over your skin, while in other cases, your skin may feel numb.
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