What Shingles Treatments Are Available
Treatment for shingles may include antiviral medications, such as acyclovir, famciclovir, or valacyclovir, which reduce the shingles rashs duration, decreasing the rashs severity, and lowers the risk of developing long-lasting nerve pain and other subsequent health problems. To treat pain-related symptoms from shingles, our dermatologist may also recommend that you take over-the-counter medications, including acetaminophen or ibuprofen. If you have severe pain, a corticosteroid, or another medication type that reduces inflammation, may be prescribed. To prevent shingles before it occurs, be sure to get the shingles vaccine.
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What Causes Shingles In Your Mouth
Shingles can affect the skin and mucosa, or tissues that line your body. This includes the inside of your mouth.
The cause of oral shingles is the same as shingles in general. The disease develops when your immune system becomes weakened. A compromised immune system is unable to control the virus, allowing it to multiply and cause shingles.
Several things can weaken your immune system and activate shingles, such as:
- emotional stress
Visit a doctor if you develop mouth lesions or mouth pain of any kind. You should also see a doctor if you have mouth lesions and:
- severe tooth or mouth pain
- unusual sensations, like tingling, burning, or prickling
- the mouth lesions are oozing or bleeding
If your doctor thinks you have oral shingles, theyll use several tests to make a diagnosis. This may include:
- Physical examination. Your doctor will check the lesions in your mouth for redness, blistering, and crusting. Theyll also examine your skin for other signs of shingles.
- Medical history. To determine your risk of developing shingles, your doctor will ask questions about your health. Theyll also want to know if youve had chickenpox before.
- Swab test. Your doctor may swab the blisters in your mouth. The swab will be sent to a laboratory, where technicians will analyze it for the varicella-zoster virus.
- Blood tests. A blood test is used to check your blood for signs of infection. This includes antibodies, which your body creates in response to shingles.
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.
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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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How To Prevent Transmission
You cant catch shingles, and you cant give shingles to someone else. But you can give others chickenpox.
After you have chickenpox, the varicella-zoster virus stays dormant in your body. If this virus reactivates, shingles occurs. Its possible to transmit this virus to others who arent immune while the shingles rash is still active. You are contagious to others until all areas of the rash are dried up and crusted over.
To catch the varicella-zoster virus from you, a person has to have direct contact with your rash blisters.
You can help prevent your transmission of the varicella-zoster virus by:
- keeping the rash loosely covered
- practicing frequent handwashing
- avoiding contact with people who may not have had chickenpox or who havent been vaccinated against chickenpox
Last medically reviewed on August 24, 2017
- Cohen KR, et al. . Presentation and management of herpes zoster in the geriatric population.
When Should People Seek Medical Care For Shingles
If people develop pain and/or a rash in a band on one side of the body or face, they should seek medical care is as soon as possible as treatments may reduce the pain and any possible further nerve or eye problems. If the rash occurs near the nose or eyes, they should seek emergency medical care. Individuals with a medical problem or taking medication that decreases their immune response should seek help immediately if they suspect they may be developing shingles.
Children should be vaccinated against chickenpox and older individuals should discuss the shingles vaccine with their doctors to reduce the risk of developing shingles.
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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.
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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Who Should Get Shingrix
Adults 50 years and older should get two doses of Shingrix, separated by 2 to 6 months. Adults 19 years and older who have or will have weakened immune systems because of disease or therapy should also get two doses of Shingrix. If needed, people with weakened immune systems can get the second dose 1 to 2 months after the first.
You should get Shingrix even if in the past you:
- Received varicella vaccine
There is no maximum age for getting Shingrix.
If you had shingles in the past, Shingrix can help prevent future occurrences of the disease. There is no specific length of time that you need to wait after having shingles before you can receive Shingrix, but generally you should make sure the shingles rash has gone away before getting vaccinated.
Chickenpox and shingles are related because they are caused by the same virus . After a person recovers from chickenpox, the virus stays dormant in the body. It can reactivate years later and cause shingles.
Shingrix is available in doctors offices and pharmacies.
If you have questions about Shingrix, talk with your healthcare provider.
* A shingles vaccine called zoster vaccine live is no longer available for use in the United States, as of November 18, 2020. If you had Zostavax in the past, you should still get Shingrix. Talk to your healthcare provider to determine the best time to get Shingrix.
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.
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If You Have More Than One Area Of Blisters What Can You Expect If You Go To The Hospital
Its important to note that most people with shingles dont need to be in a hospital, but if you do:
- Youll be in a contact isolation room.
- The door will be kept closed.
- A sign on your door will remind people who have never had chickenpox or the vaccine not to enter.
- The sign will also remind staff to wear gowns and gloves when entering the room.
How Is Shingles Diagnosed
Your healthcare provider will do a complete physical exam and ask about your medical history, specifically about whether you have ever had chickenpox.
Your healthcare provider will likely know right away that it is shingles based on the unique rash. The rash usually appears one area on one side of the body or face. It appears as red spots, small fluid- or pus-filled vesicles, or scabs.
The healthcare provider may also take skin scrapings for testing.
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How Long Does The Shingles Vaccine Last
Currently, Shingrix is the vaccine on the market that can help decrease your risk of shingles. It also decreases your risk of PHN.
The Centers for Disease Control and Prevention reports that Shringrix is more than 90% effective at protecting adults ages 50 years and older who have healthy immune systems. This immunity lasts for a minimum of 7 years after the vaccination.
Adults who have weakened immune systems benefit from 6891% effectiveness of Shingrix in preventing shingles and PHN.
The CDC recommends that the following people get the Shingrix vaccine:
- adults over age 50 years, even if they have already had shingles
- adults over age 19 years with weakened immune systems
Contact your doctor if you wish to discuss getting the shingles vaccine.
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.
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Can Other People Catch Shingles
This one is confusing! You can catch chickenpox from other people, but you can’t catch shingles from other people. You only get shingles from a reactivation of your own chickenpox infection in the past.
So if you have shingles, and you come into contact with somebody else, they cannot ‘catch’ your shingles. But if they have never had chickenpox, it is possible that they could catch chickenpox from you.
To put it another way, no, you don’t ‘catch’ shingles. It comes from a virus hiding out in your own body, not from someone else. But if you have shingles, you may be infectious, as it is possible for people to catch chickenpox from you.
Only people who have never had chickenpox are likely to be at risk of catching chickenpox from your shingles. People who have had chickenpox should be immune from catching it again. If the rash is in a covered area of skin, the risk of anyone with whom you are not in close contact catching chickenpox is very low.
Is Shingles Contagious
If you are in contact with someone who has shingles, you will not get the symptoms of shingles yourself. However, direct contact with fluid from a shingles rash can still spread the varicella-zoster virus, which can cause chickenpox in people who have not had chickenpox before or the chickenpox vaccine. The risk of spreading the virus is low if the shingles rash is kept covered.
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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.
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.
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Can You Still Develop Shingles If Youve Been Vaccinated For Chickenpox
Yes. Despite being vaccinated for chickenpox, you can still get shingles. No vaccine is 100% protective, and the effectiveness of vaccines lessens with time. However, people who get the chickenpox vaccine are significantly less likely to develop shingles later in life compared with people who never received the chickenpox vaccine. One recent 12-year study found that the number of shingles cases was 72% lower in children who had received the chickenpox vaccine compared with those who didnt.
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.
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Steroid Medication For Shingles
Steroids help to reduce swelling . A short course of steroid tablets may be considered in addition to antiviral medication. This may help to reduce pain and speed healing of the rash. However, the use of steroids in shingles is controversial. Your doctor will advise you. Steroids do not prevent PHN.
What Should You Expect If You Get Shingles
Shingles can be a very painful condition. If you think you have the symptoms of shingles, see your healthcare provider right away. Starting antiviral medications early can ease your discomfort and end symptoms earlier.
A better approach to shingles is to take action and do what you can to lessen your risk of getting it. If you’ve never had shingles in the past, talk to your healthcare provider about getting the shingles vaccine. If youve never had chickenpox, talk with your healthcare provider about getting the chickenpox vaccine.
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