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.
Can You Get Shingles In The Eye
Its most common to get the shingles rash on your chest, back or legs but you can get shingles on the face and eye, Rapuano says. About 15% of cases involve shingles in the eye area, he says.
However, theres a difference between having shingles around the eye and having shingles in the eye, which doctors refer to as eye involvement, Rapuano says. A patient can have shingles around the eye area without the eye itself being involved, he says.
About half of people who have shingles on the forehead or nose will also have eye involvement.
Ocular shingles typically occurs in one eye on the same side of the face as the rash. It typically occur after the shingles rash on the body has resolved, Rapuano says.
A patient who has had shingles on the face may feel like theyre healing well but then notice a symptom such as redness in the eye. When this happens, patients need to see an eye doctor right away, Rapuano says.
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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Burning Feeling And Red Rash
Between 1 and 5 days after you start to feel the tingling or numb feeling, a red rash will develop on the same area of your skin. Most often, the rash appears on one side of your torso, but it can show up anywhere on your body.
You may also have other symptoms along with the rash, such as:
When the rash starts, you should see a doctor for treatment as soon as possible. Starting antiviral medication treatment within 3 days of the rash first appearing can lower your risk of developing complications, like long-term pain.
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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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.
Do You Always Get The Typical Rash If You Have Shingles
Occasionally, some people dont get a rash. If you have any of the other symptoms of shingles , see your healthcare provider sooner rather than later. There are effective treatments you can take early for shingles. Even if you dont have shingles, seeing your healthcare provider will help you get your condition diagnosed and treated.
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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.
When Should You See A Healthcare Provider For Shingles
If you experience persistent pain or a widespread itchy rash on the body or face, you should reach out to your healthcare provider. The National Institute of Aging recommends that you see your healthcare provider no later than three days after the rash or skin pain has appeared.
Early diagnosis and treatment are vital to reducing your risk for complications, helping you to heal quicker and reduce the potential for scarring.
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What Increases The Risk Of Long
The risk of developing post-herpetic neuralgia increases with age. Four weeks after getting shingles,
- 27% of 55- to 59-year-olds and
- 73% of over 70-year-olds had nerve pain.
Women seem to be more likely to have longer-lasting nerve pain than men. Post-herpetic neuralgia is also more likely to develop if your eyes were affected by shingles.
Preventing Nerve Pain After Shingles
But if youre worried about PHN, dont despair. There are medications that can cut your risks of getting the condition. There are three antiviral drugs used: famciclovir , valacyclovir , and acyclovir . These medications need to be started within two to three days of the onset of shingles.
If you look at the clinical trials with any of these drugs in people over 50, says Dworkin, they cut the rate of pain at six months in half. Thats a very significant improvement. They are also very safe and have few side effects, he says.
But who needs the drugs? Dworkin says theres not a clear consensus yet.
There are some obvious cases. I think everyone would agree that someone who is over 50 and has severe symptoms should get preventative treatment, he tells WebMD.
But for younger people or those with fewer risk factors, the course is less clear.
Some people think that everyone who gets shingles should get preventative treatment with antiviral medicines, because the medicines are so safe and have such few side effects, he says.
Others argue that preventative treatment should only be given to those at greater risk. The main reason for this, Dworkin says, is cost.
A full course of treatment could cost anywhere between $100 and $160, he says. That can add up, and insurance companies might not want to pay if the risks are very, very low.
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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.
When Shingles Strikes Your Face
Dozens of muscles line your face, and they help you talk, eat, blink, and wink. All those movements start with nerve impulses, and any nerve band can get hit with a shingles outbreak.
Just one side of the face is touched by the issue, and the blisters will not spread. If you touch the bumps on one side of your face and then touch the other, you can’t spread the problem around. The virus sits within the nerves, far below the skin, and you can’t influence how the infection spreads.
Your shingles may appear on or around your eyelid, and that can make blinking difficult or painful. Sometimes, the tissues swell, and that makes it hard for you to open your eye.
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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.
What Do Shingles Scabs Look Like
Shingles scabs develop when your blisters dry up. The blisters that form on the rash usually start to scab within 7 to 10 days. These scabs are usually dry and flat and can be red, brown, or yellowish in color.
Since shingles blisters affect just one side of the body, the scabs will only appear on one side as well. This is different from most other skin conditions, which typically affect both sides of the body.
Other common skin disorders might cause peeling or white patches . Shingles scabs usually dont have these characteristics.
The following images show what shingles scabs look like:
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How Do Dermatologists Treat Shingles
An antiviral medication can:
Reduce the amount of time that you have a shingles rash
Lower your risk of developing long-lasting nerve pain and other health problems
One of three antiviral medications is usually prescribedacyclovir, famciclovir, or valacyclovir.
To treat your symptoms, dermatologists typically recommend the following:
Pain: Medication that you can buy without a prescription can help, such as:
If you have severe pain, your dermatologist may prescribe a medication that reduces inflammation, such as a corticosteroid.
What Outcome Can I Expect If I Have Postherpetic Pain
Theres no standard treatment for the symptoms of postherpetic pain . Depending on the severity of your pain, you may start with over-the-counter products. If your pain is more severe, one or more prescription medications may be tried. PHN is difficult to treat. Achieving a complete symptom-free state was achieved in less than half the patients with PHN, according to one study.
PHN tends to happen in older individuals who may have other health conditions, which can complicate treatment and results. Pain can last weeks, months and even longer than a year. In some people, the pain can be debilitating. In most people, PHN lessens with time.
A note from Cleveland ClinicThe best way to not get postherpetic neuralgia is to prevent it from happening in the first place. Varicella-zoster virus causes both chickenpox and shingles. Vaccines are available to protect against developing both of these viral infections.
Once you develop chickenpox, the varicella-zoster virus remains in your body for life. If the virus reactivates and causes shingles, you have a few days around the rash outbreak to see your provider and get an antiviral medication, which can significantly lessen your symptoms. Still, if you develop PHN, your provider has many medications available to manage your symptoms.
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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.
Can You Prevent Shingles
Shingles are caused by an outbreak of the chickenpox virus. You have two avenues to follow that lead to prevention, including avoidance and vaccines.
If you’ve never been exposed to the chickenpox virus, prevention is critical. That means you should avoid:
- Anyone with active chickenpox. The puss inside the chickenpox holds the virus, and it’s very contagious. Steer clear of anyone who has been diagnosed. Chickenpox is considered to be more contagious than shingles.
- Anyone with shingles. You can get shingles from someone with an outbreak, although it’s rare. If you’ve never been exposed, do not take a chance.
If the outbreak is in the blister phase, the person is contagious. Once the blisters crust over, the person is no longer contagious. If the person keeps their rash and blisters covered, the risk of spreading the virus is low.
Some people are more susceptible to contracting the virus. This includes people with certain autoimmune conditions as well as those with other conditions that suppress the immune system. People who take certain immunosuppressive medications are also at a higher risk.
Adults 50 and older can use a vaccine for protection. Experts agree that the vaccine is not perfect, and some people who get it still get sick later. But it can reduce your risk of an outbreak. Your doctor can tell you whether you should get it and when.
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Who Is At Risk From Shingles
Anyone who has had chickenpox is at risk of getting shingles later in life. About one in three people who have not been immunised against chickenpox or shingles will get shingles in their lifetime.
Shingles usually affects older people. The older you are if you get shingles, the higher your risk of getting serious disease. People who have a weakened immune system are also at risk of getting more severe disease, even if they are young.
How Is Shingles Diagnosed
If you have symptoms of shingles, especially if they involve your face, see your doctor or ophthalmologist right away.
Doctors can usually diagnose a shingles rash by performing a physical exam. Your doctor can also take a scraping of your skin rash and send it to a lab for examination under a microscope.
Its particularly important to seek treatment if you have a compromised immune system. Early treatment can help cut down on your chances for serious complications.
Shingles will have to run its course, but quite a few treatment options are available. These include:
- antiviral drugs
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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.
What Is Postherpetic Neuralgia
Sometimes, particularly in older people, shingles pain persists long after the rash has healed. This is postherpetic neuralgia, defined as pain lasting three months after onset of the rash. Pain can be mild or severethe most severe cases can lead to insomnia, weight loss, depression, and disability. There may be other sensations, such as tingling, coldness, or loss of feeling. About 20 percent of people age 70 or greater who develop shingles may have long-lasting pain. Postherpetic neuralgia is not directly life-threatening and may get better over time.
About a dozen medications in four categories have been shown in clinical trials to provide some pain relief for postherpetic neuralgia. These include:
Tricyclic antidepressants : TCAs are often the first type of drug given to people suffering from postherpetic neuralgia. The TCA amitryptiline was commonly prescribed in the past, but although effective, it has a high rate of side effects. Desipramine and nortriptyline have fewer side effects and are therefore better choices for older adults, the most likely group to have postherpetic neuralgia.
Common side effects of TCAs include dry eyes and mouth, constipation, and impaired memory. People with heart arrhythmias , previous heart attacks, or narrow angle glaucoma should usually use a different class of drugs.
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