How Is It Treated
It is best to start treatment as soon as possible after you notice the rash. See your healthcare provider to discuss treatment with antiviral medicine, such as acyclovir. This medicine is most effective if you start taking it within the first 3 days of the rash. Antiviral medicine may speed your recovery and lessen the chance that the pain will last for a long time.
Your provider may also recommend or prescribe:
- medicine for pain
- antibacterial salves or lotions to help prevent bacterial infection of the blisters
Why Does Postherpetic Neuralgia Happen
Postherpetic neuralgia starts out with a very familiar illness: chickenpox. The virus that causes it is called varicella-zoster. Once chickenpox has run its course, the virus âhides outâ in your nervous system.
Doctors arenât sure exactly why, but sometimes the virus reactivates decades later and travels along pathways to your skin. A painful, blistering rash can erupt. Thatâs shingles.
In some cases, shingles can damage your nerves so that they canât send messages from your skin to your brain as they usually do. That scramble of signals can trigger the ongoing pain of neuralgia.
If the pain lasts more than a year, it can become permanent.
Spinal Cord Or Peripheral Nerve Stimulation
These are often used to treat several different types of neuropathic pain. Electrodes are placed underneath the skin along the affected peripheral nerves. Before using this technique, doctors will do a test using a wire electrode to get a sense of how the patient will respond.
After the electrodes have been placed above the peripheral nerve, a weak electrical current is sent to the nerve. By stimulating a sensory pathway that doesnt cause pain, experts believe that this electrical signal to the brain can trick the brain into turning off the painful signal, bringing relief to the patient.
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What Can I Take To Feel Better
Your doctor has a host of ways to treat your pain after shingles, including a variety of medications. They include:
Anticonvulsants: These medications were developed to control seizures, but they can also help reduce the pain of postherpetic neuralgia. Examples are:
Talk to your doctor or pharmacist about side effects of any new prescription or over-the-counter medication.
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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How Is Postherpetic Neuralgia Treated
If shingles is caught within the first three days of its outbreak, your healthcare provider may prescribe the antiviral medication acyclovir , valacyclovir or famciclovir . These medications help the rash/blisters heal faster, keep new sores from forming, decrease pain and itching and reduce length of pain after sores have healed.
If your shingles outbreak is not caught early, your healthcare providers has many options to manage your postherpetic neuralgia symptoms.
If your pain is mild, your healthcare provider may recommend:
- Acetaminophen or NSAIDs such as ibuprofen .
- Creams and patches include lidocaine and capsaicin .
If your pain is more severe, your healthcare may prescribe:
- Antiseizure drugs gabapentin and pregabalin .
- Antidepressants, such as escitalopram , quetiapine or amitriptyline.
- Botulinum toxin injections in the area where you are having pain.
Theres no clear-cut superior treatment for PHN. Your provider may need to try more than one medication or prescribe the use of several medications at the same time. You and your provider will discuss options and what makes sense to try for you. Contact your provider if your pain is not lessening after taking your medicine. Take all your medications exactly as prescribed.
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 Of Shingles
Usually, shingles develops on just one side of the body or face, and in a small area. The most common place for shingles to occur is in a band around one side of the waistline.
Most people with shingles have one or more of the following symptoms:
- Fluid-filled blisters
- Tingling, itching, or numbness of the skin
- Chills, fever, headache, or upset stomach
For some people, the symptoms of shingles are mild. They might just have some itching. For others, shingles can cause intense pain that can be felt from the gentlest touch or breeze. Its important to talk with your doctor if you notice any shingles symptoms.
If you notice blisters on your face, see your doctor right away because this is an urgent problem. Blisters near or in the eye can cause lasting eye damage and blindness. Hearing loss, a brief paralysis of the face, or, very rarely, inflammation of the brain can also occur.
How Does It Occur
If you have had chickenpox, you are at risk for later developing shingles. After you recover from chickenpox, the chickenpox virus stays in your body. It moves to the roots of your nerve cells and becomes inactive . Later, if the virus becomes active again, shingles is the name given to the symptoms it causes.
What exactly causes the virus to become active is not known. A weakened immune system seems to allow reactivation of the virus. This may occur with normal aging, immune-suppressing medicines, or another illness, or after major surgery. It can also happen as a complication of cancer or AIDS or treatment of these illnesses. Chronic use of steroid drugs may trigger shingles. The virus may also become active again after the skin is injured or sunburned. Emotional stress seems to be a common trigger as well.
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What You Can Do About Nerve Pain That Lingers After Shingles
Chronic pain that continues after a case of shingles is called postherpetic neuralgia . It is estimated that about 20% of patients will experience this type of nerve pain as a complication of shingles.
Those who have had chickenpox are at risk of developing shingles later in life. People who develop PHN are generally age 60 and older. Although there is no cure for PHN, there are several methods of pain management that can ease symptoms. Fortunately, the type of pain that arises from postherpetic neuralgia improves over time.
Neuralgia affects the nerves, causing structural and functional damage. It can feel like a stabbing or burning pain that radiates along the affected nerve.
Neuropathic pain is not caused by an external injury or stimuli but originates from inside the nervous system. When the herpes-varicella zoster virus is reactivated in the form of shingles, scar tissue forms alongside nerves, creating pressure, and sending pain signals to the brain.
Best Treatments For Lasting Shingles Pain
Postherpetic Neuralgia Pain: What Works, What Doesn’t
Doctors call it postherpetic neuralgia or PHN. It’s caused by nerve damage left behind by a case of shingles. Shingles itself comes from reactivation of a chickenpox virus, varicella zoster. The virus travels down nerve fibers to cause a painful skin rash.
When the rash goes away, the pain usually goes with it. But for 12% to 15% of people the pain remains. If your shingles pain lasts eight to 12 weeks after the rash goes away, you’re part of an “unfortunate minority,” says pain researcher Andrew S.C. Rice, MD, of Imperial College, London.
“Among people with PHN, some have their pain resolve in the first year to 18 months after the shingles rash goes away,” Rice tells WebMD. “But if they have pain longer than that, it is not going to go away on its own. In either case, a person must deal with the pain.”
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What Are The Three Stages Of Shingles
The stages of shingles are the early lesion, the vesicular stage, and the late stage.
The early lesion is the first sign of shingles and appears as a patch of red skin that may be sensitive to touch.
The vesicular stage is the next and is marked by the appearance of small red bumps on the skin, which are slightly cloudy and may have a yellowish tinge to them.
The late-stage is the last stage of shingles and is characterized by a rash of painful blisters, which crust over and eventually scab over.
How Long Does Postherpetic Neuralgia Last
Postherpetic neuralgia can last for weeks, months, or in some people, years after the shingles rash goes away. In most people, shingles pain goes away in one to three months. However, in one in five people, pain lasts more than one year.
The pain from PHN can be so severe in some people that it disrupts their life. Researchers dont know why some people have severe or long-lasting pain and others do not.
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Vaccine Prevention For Shingles And Postherpetic Neuralgia
In 2006, a vaccine to prevent shingles came onto the market. Called Zostavax, the vaccine cuts the likelihood of getting shingles after chickenpox by about half, dramatically reducing the number of people who might get nerve pain after shingles.
Based on these results, the CDC recommends Zostavax to all adults age 60 and older. Rumbaugh goes further: He suggests you get vaccinated at any age if you have had shingles. His clinical experience suggests the vaccine helps reduce postherpetic neuralgia even after infection with the varicella zoster virus.
Get Shingles Treatment Online
Speak to a board-certified doctor securely from your phone or computer and get medication for shingles in 15 minutes. Shingles, also known as herpes zoster, is a viral infection that causes a painful rash. Although shingles can appear anywhere on the body, it most often is a single stripe of blisters that wraps around the left or right side of your torso. With our same-day treatment service, you can meet with a top online doctor, get diagnosed, and receive the medication you need.
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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.
Avoid The Pain Of Shingles
Anyone who has recovered from chickenpox can develop shingles
Shingles is a painful infection. Some people have the virus hiding in their nerve tissue, and if conditions are right, the virus “awakens.” This may cause a few blisters on the skin or a big rash that is only on one side of the body. The rash may be on the chest and back, at the waist, on the upper arm, or the side of the face and scalp. In healthy people, the rash goes away in 2 to 4 weeks.
Shingles is not likely to spread, but it may cause chickenpox. The same virus that causes chickenpox causes shingles. However, not everyone who had chickenpox will develop shingles.
What are the risk factors for shingles?
Anyone who has had chickenpox can develop shingles. But your risk is greater if you:
Are age 50 or older
Have an illness that weakens your immune system, such as HIV infection
Have cancer, especially leukemia or lymphoma
Take medicines that suppress your immune system, such as steroids or those given after an organ transplant
Can shingles be prevented?
A vaccine reduces your risk of getting shingles. Half as many people get shingles after being vaccinated. Among those who are treated and then develop shingles, only one third develop after-shingles pain. If you’re older you when you’re vaccinated and you get shingles, your outbreak will be less severe.
How do you know when shingles is coming on?
What is the treatment for shingles?
What causes after-shingles pain?
How serious is after-shingles pain?
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Causes Of Shingles Pain
Causes of Shingles Pain
The main cause of shingles pain is a viral infection of the nerve root. If you ever had chickenpox, the virus will remain dormant in your body for the rest of your life. As you grow older, your immune system becomes weaker and suppressed from medications or other procedures such as chemotherapy. When your immune system gets weak, the virus can reactivate, causing shingles pain.
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.
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What Are Some Common Treatments For Shingles
The CDC recommends that adults 50 years or older receive two doses of the shingles vaccine. Additionally, several antiviral medicines like acyclovir, valacyclovir, and famciclovir are available to treat shingles and shorten the length and severity of the illness. These medicines are most effective when taken immediately after the rash appears.
Can I Give Shingles To Others
No one can catch shingles from you. But the virus can be spread to a person who has never had chickenpox. The virus lives in the blisters that shingles causes. It can be spread until the blisters are completely healed. If you have blisters that have not crusted over yet, you should stay away from:
- Anyone who has never had chickenpox
- Babies under 12 months old
- Very sick people
Tell your doctor if you live with children who have not had chickenpox. They may need to be vaccinated.
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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.
What Does A Mild Case Of Shingles Look Like
Not everyone with shingles will develop a blistering rash. A mild case of shingles may include a red rash without blisters. The shingles rash and blisters are distinct characteristics of the illness. Mild cases of shingles do not usually cause headaches, fever, or fatigue.
Whether mild or severe, pain is the most common symptom of shingles. Most people describe a deep burning, throbbing, or stabbing sensation. The pain usually subsides within 30 days.
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Who Is At Risk Of Getting Shingles
Shingles typically affects older people, but it can also occur in healthy younger persons and even in children. Those whose immune systems have been weakened by cancer, HIV infection, AIDS, or treatment with certain medicines are also at increased risk of getting shingles.
- Anyone who has had chickenpox is at risk of getting shingles later in life. About 1 in 3 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.
- Women have a higher risk of getting shingles than men.
- Most people who develop shingles have only 1 episode during their lifetime. However, you can have shingles more than once.
An attack of shingles during pregnancy will not harm the unborn baby. The mother is already carrying the varicella zoster virus before developing shingles and there is no increase in the risk of passing it on to the fetus if shingles develops. However, an attack of chickenpox during pregnancy can be serious and requires urgent medical attention.