Key Points About Shingles
- Shingles is a common viral infection of the nerves. It causes a painful rash or small blisters on an area of skin.
- Shingles is caused when the chickenpox virus is reactivated.
- It is more common in people with weakened immune systems, and in people over the age of 50.
- Shingles starts with skin sensitivity, tingling, itching, and/or pain followed by rash that looks like small, red spots that turn into blisters.
- The rash is typically affects just one area on one side of the body or face.
- Treatment that is started as soon as possible helps reduce the severity of the disease.
What Are The Complications Of Postherpetic Neuralgia
PHN itself is a complication of shingles. A serious complication of PHN is addiction to pain medications. Some patients may have an inability to live a normal lifestyle because of constant pain, while others have sleep and activities limited or even prohibited by touching the affected area, including just having contact with their own clothing. Patients taking opioids may become very constipated. In a few cases of PHN, muscle weakness can be an additional complication.
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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Skin Care And Itch Relief For Shingles
To relieve itching and discomfort, try:
- A cool, wet compresses on the affected skin
- Soothing baths and lotions, such as colloidal oatmeal bath, starch baths, or calamine lotion
- Zostrix, a cream that contains capsaicin
- Antihistamines to reduce itching
Keep your skin clean. Throw away bandages you use to cover your skin sores. Throw away or wash in hot water clothing that has contact with your skin sores. Wash your sheets and towels in hot water.
While your skin sores are still open and oozing, avoid all contact with anyone who has never had chickenpox, especially pregnant women.
For Some Pain From Shingles May Linger And Become Long
Dear Mayo Clinic:
I have been diagnosed with shingles of the trigeminal nerve affecting my face. How do I reduce the pain in my head and eye after having shingles?
Answer:For most people, the pain from a case of shingles usually fades as the rash disappears. But for some, the pain may linger and become a long-term condition. A variety of treatments may lessen this pain, but the condition can be challenging to treat.
Shingles is a localized form of chickenpox. Once you’ve had chickenpox, the varicella-zoster virus that caused it remains in your body for the rest of your life. As you grow older, the virus can reactivate. Sometimes this occurs when your body is stressed because of another infection or due to medications that suppress your immune system, for example. The result is shingles. Because you have some immunity against the virus, rather than getting a full body rash, the rash occurs in areas of skin supplied by the nerve where the virus is reactivated.
Shingles typically involves a bandlike rash on the chest, abdomen or face that is usually quite painful. Most people recover from shingles in a few weeks without other problems, but a small number continue to have severe pain in the same distribution that was irritated when the virus returned. Pain that lasts for three months or more is called postherpetic neuralgia.
If medications aren’t enough, procedures such as nerve blocks or steroid injections may help lessen postherpetic neuralgia.
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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?
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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Are There Other Ways To Ease The Pain
Most people with postherpetic neuralgia use medication to control their symptoms. But there are other ways to control the pain, too. They include:
TENS : You use a device that shoots tiny electrical currents into the area of pain on the skin. This helps block the pain.
Cold packs: Try a gel-filled one to numb the area unless cooler objects make your neuralgia worse.
Comfortable clothes: Go for looser fits and fabrics such as cotton and silk.
Dr Ellie Cannon: How Long Will It Be Before I’m Free From The Pain Of Shingles
17:01 EDT, 25 July 2020 | Updated:
I had shingles a few months ago and was given tablets. The blisters have gone but I still have pain across the side of my ribs where they were. Will it go away?
Something I noticed, during lockdown was a larger-than-usual number of my patients getting shingles.
Its a nasty condition caused by the same virus as chickenpox, which lives, dormant, in our bodies after we first get it as youngsters.
It can, for a variety of reasons, become reactivated.
Most people will suffer for a few weeks but for some it may go on as long as a year and it is hard to say why it persists, writes Dr Ellie Cannon
No one knows for sure why it happens but its thought its linked to a lowered immunity.
Stress, sun exposure, illnesses or medicines that suppress the immune system, and simply older age, are also thought to raise the risk.
The virus varicella zoster lives in the nerves and so the blisters usually appear along a line the nerve supplies.
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How Bad Is Shingles Pain
Pain. Eventually, most people with shingles experience a localised “band” of pain in the affected area. The pain can be a constant, dull or burning sensation and its intensity can vary from mild to severe. You may have sharp stabbing pains from time to time, and the affected area of skin will usually be tender.
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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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.
Have Shingles Get Treatment Take Action
If you have shingles, it’s important to talk to your doctor about your risk for developing PHN. Ask whether preventative treatment with antiviral drugs makes sense. If your doctor says it’s not necessary, ask why.
The full implications of the psychological risk factors for PHN aren’t clear yet, says Dworkin. But he suggests that people with shingles should try to stay active and connected.
“If psychological distress is a risk factor for PHN,” he says, “then we think that people who have shingles might benefit from getting out and not being isolated and homebound.”
You might make an effort to stay connected to family and friends and not to dwell on your symptoms. Also, keep in mind that even if you do develop PHN, there are treatments that can help.
“We have about a half dozen types of drugs that are used as first-line treatments for PHN,” says Dworkin. They include lidocaine patch , pregabalin , gabapentin , capsaicin , carbamazepine , tricyclic antidepressants, and painkillers.
The most important thing is to get prompt medical attention if you think you might have shingles.
“If you have a one-sided rash — especially if you’re over 50 — see your doctor right away,” says Dworkin. “It could be shingles. And we know that prompt treatment can dramatically reduce the likelihood of developing long-term pain.”
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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
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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Shingles Symptoms Before Rash
Shingles develops in two stages. The first is called the prodromal period.
Shingles is a reactivation of the varicella virus, which is what causes chickenpox. After an initial infection, the virus lays dormant in the body. Once reactivated, which can happen years down the line, shingles results.
Often, the earliest signs this is occurring are similar to what you’d expect at the start of any infection. These symptoms sometimes occur at times when you’re feeling stressed or run down. They are also systemic, meaning they affect the whole body.
You may assume you’re just overtired or coming down with a cold when you actually have shingles.
Can I Prevent Shingles
- are over the age of 50 years
- have previously had chickenpox
- do not remember whether or not you have had chickenpox
Contact your doctor to discuss getting the shingles vaccine.
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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.
When Should I Get The Shingles Vaccine
The current shingles vaccine is a safe, easy, and more effective way to prevent shingles than the previous vaccine. In fact, it is over 90% effective at preventing shingles. Most adults age 50 and older should get vaccinated with the shingles vaccine, which is given in two doses. You can get the shingles vaccine at your doctors office and at some pharmacies.
You should get the shingles vaccine if you:
- Have already had chickenpox, the chickenpox vaccine, or shingles
- Received the prior shingles vaccine called Zostavax
- Dont remember having had chickenpox
Medicare Part D and private health insurance plans may cover some or all of the cost. Check with Medicare or your health plan to find out if it is covered.
You should not get vaccinated if you:
- Currently have shingles
- Are sick or have a fever
- Had an allergic reaction to a previous dose of the shingles vaccine
If you are unsure about the above criteria or have other health concerns, talk with your doctor before getting the vaccine.
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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.
Rebooting The Nervous System
Its like restarting a computer, Dr. Rosenquist says. When its running slowly or acting weird, you restart it. We are trying to turn that nerve off. When it comes back on, hopefully, it will send an appropriate transmission as opposed to a pain transmission.
Treatmentoptions for PHN patients include:
Patientswith refractory PHN rarely need opioid pain medication. However,you should be evaluated by a physician. We cant make a blanket statement abouttreatment. It is individualized, she says.
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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.
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.
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