What Triggers A Shingles Outbreak And Who Is Most At Risk
According to Dr. Gurland, we just dont know why outbreaks happen some researchers have linked shingles with periods of excess stress, but most people who get stressed dont get shingles.
However, shingles is more common in patients whose immune systems arent functioning normally due to cancer, medications, other infections, and other health conditions. While you dont need an immune deficiency to get shingles, said Dr. Gurland, a significant minority of patients who have it also have a suppressed immune system. The risk also increases with age , although Dr. Gurland has seen very young patients develop the disease as it doesnt discriminate.
Systemic Disease Produced By Vzv Reactivation Without Rash
reported a case of fatal hepatic necrosis caused by VZV in a 64-year-old woman. She had undergone splenectomy 14 months before the fatal hepatitis. The postmortem diagnosis was based on characteristic pathological changes in the liver, the detection of herpesvirus virions in liver by electron microscopy, and serologic evidence of recent VZV infection. A report of fulminant fatal disseminated VZV infection without rash occurred in an 8-year girl undergoing chemotherapy for leukemia virus was present in blood, lungs, liver, kidneys, and bone marrow . Although the nervous system was spared in both patients, these cases confirm the existence of disseminated VZV infection of multiple organs in the absence of rash.
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Whats The Difference Between Shingles And Chickenpox
How does the same virus produce two different diseases? Essentially, the bodys immune response changes between the first varicella-zoster infection contracted from another person and the second infection from the dormant virus that remains within your body. The different immune responses lead to different symptoms, contagiousness, and treatment options.
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Complications Of Shingles Without Rash
Complications from shingles can be very severe, particularly if the outbreak goes untreated.
- Postherpetic Neuralgia-This condition is caused when the nerve fibers become confused after their interaction with the shingles virus. Postherpetic neuralgia will cause the nerves to send exaggerated feelings of pain from the skin to the brain, even after the shingles outbreak has healed.
- Neurological Problems-Nerves can become permanently damaged after suffering from a shingles outbreak. Facial paralysis, hearing problems, balance problems or inflammation of the brain are all possible side effects.
- Vision Loss-If a shingles outbreak occurs around the eye it can cause a severe infection. This may cause vision damage or permanent vision loss.
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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Higher Intensity Of Pain With Internal Shingles
While both regular shingles and internal shingles can cause preherpetic neuralgia, this condition has been found to be more severe in the latter case.
One study found that at the onset of symptoms, after one month, and after three months, internal shingles patients had consistently more severe and persistent pain. Overall, however, preherpetic neuralgia occurs much more frequently in regular herpes zoster patients.
What Are The Symptoms
Shingles symptoms happen in stages. At first you may have a headache or be sensitive to light. You may also feel like you have the flu.
Later, you may feel itching, tingling, or pain in a certain area. Thatâs where a band, strip, or small area of rash may occur a few days later. The rash turns into clusters of blisters. The blisters fill with fluid and then crust over. It takes 2 to 4 weeks for the blisters to heal, and they may leave scars. Some people only get a mild rash. And some do not get a rash at all.
Itâs possible that you could also feel dizzy or weak. Or you could have pain or a rash on your face, changes in your vision, changes in how well you can think, or a rash that spreads. A rash or blisters on your face, especially near an eye or on the tip of your nose, can be a warning of eye problems.
if you think you may have shingles. Itâs best to get early treatment. Medicine can help your symptoms get better sooner. And if you have shingles near your eye or nose, see your doctor right away. Shingles that gets into the eye can cause permanent eye damage.
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Shingles Without The Rash
For about two weeks I was experiencing pain on my right side, around my rib area to under my breast bone. It was an odd pain, nothing like I’ve had before, it felt as though someone punched me really hard. I thought it was just a muscle strain from so much coughing as I had pneumonia, but the pain didn’t go away when the cough did, the pain got worse, and it was constant and would not respond to over the counter pain meds. It got to the point I was crying from the pain. All I can describe it as if someone beat the s**t out of me and left me there, or a car ran over my side. I had no burning, no tingling, no rash. It is a scary pain.
Nonetheless I was still diagnosed with shingles, and given anti virals and pain meds. Within a week I felt a lot better, now the pain is mostly gone, thank God.
Shingles also makes you feel lightheaded, faint, weak, unwell in yourself, not right. Before I got the pain I had a few days of feeling really weak and not right and thought I was going to pass out. Funny that as I remember a day before I got Chicken Pox, years ago, I felt really off.
Terrible thing to get. Now fearing getting it again so will look into a vaccine.
Hope this helps some people – if this is you, go to your doctor, the anti virals really work fast and the pain meds make it bearable. Paracetamol is not enough for this. Neither is co-codamol. You need either a med that dulls the nerve endings, or an opiate
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Who Should Be Vaccinated With Shingrix
The Shingrix vaccine is recommended for those 50 years of age and older who are in good health.
You should get the Shingrix vaccine even if:
- You have had shingles already.
- You have been previously vaccinated with Zostavax .
- You do not know for sure if youve ever had chickenpox.
Ask your healthcare provider, who knows your entire health history, if getting this vaccine is right for you.
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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.
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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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 Is Internal Shingles Treated
Even though shingles is a virus, this is a case where there are antiviral medications available by prescription. Thats why its important to see your doctor right away if you suspect you have shingles. Early treatment may reduce the risk of complications, like PHN. Serious complications require hospitalization.
Common antiviral medications for shingles include:
Depending on the location and severity of the shingles infection, steroids may also help. Anti-inflammatory medications like ibuprofen and pain-relieving medication such as acetaminophen or other prescription pain medication can help in easing pain experienced from shingles.
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What Happens During Chickenpox And Shingles Testing
You will need to provide a sample of blood from your vein or from the fluid in one of your blisters. Blood tests check for antibodies to the VZV. Blister tests check for the virus itself.
For a blood test from a vein, a health care professional will take a blood sample from a vein in your arm, using a small needle. After the needle is inserted, a small amount of blood will be collected into a test tube or vial. You may feel a little sting when the needle goes in or out.
For a blister test, a health care provider will gently press a cotton swab on a blister to collect a sample of fluid for testing.
Both types of tests are quick, usually taking less than five minutes.
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Can Shingles Be Prevented Or Avoided
The best way to prevent shingles is through vaccination. Vaccinate your children for chickenpox. This vaccine reduces their risk for getting chickenpox. You cant get shingles unless youve had chickenpox first.
When you are older, get the shingles vaccine. It is recommended for adults 50 years of age and older. It can prevent shingles. People who have had shingles should get the vaccine to help stop the disease from reoccurring. Common side effects of the vaccine are headache, plus redness, swelling, itching, and soreness at the injection site.
The shingles vaccine is not recommended for anyone who:
- Has had an allergic reaction to gelatin or the antibiotic neomycin
- Has an allergy to any component of the shingles vaccine
- Has a weakened immune system due to conditions such as leukemia, HIV, or AIDS
- Is receiving treatment for cancer
- Is being treated with drugs that suppress their immune system, including high-dose steroids
- Is pregnant or might become pregnant within 4 weeks of getting the vaccine
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How Do People Get Shingles
People get shingles when the virus that causes chicken pox, varicella zoster, is reactivated in their body. The varicella zoster virus doesn’t leave the body, even after a person has recovered from chicken pox. It can flare up again, causing shingles, often many years after a person has had chicken pox. The virus tends to reactivate when a person’s immune system is weakened because of another health problem.
Diagnoses And Treatment Of Shingles Without Rash
If you note that you are suffering from symptoms typically associated with shingles but without any rash it is important to tell your doctor right away. While you may not develop a rash, patients will still feel the tingling, burning sensation associated with the virus moving from the nerves to the skin. This sensation will typically only be on one side of the body. If you have had the chickenpox virus you will need to talk with your doctor to confirm your diagnosis. Because there are no blisters to check, your doctor may perform a blood test to check for the shingles virus. This will also help them rule out other conditions that cause similar symptoms.
Once it is determined that you are suffering a shingles outbreak, your doctor will determine what level of care is appropriate. Many patients can be treated with medications like Valacyclovir or Acyclovir and home remedies such as cool baths and cool/wet compresses. In severe cases patients may need to stay in the hospital for treatment.
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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.
Diagnosis And Treatment For Shingles Without Rash
Shingles is difficult to diagnose primarily due to absence of rash although there is pain. This is because many other ailments have pain as a symptom. In such cases often blood test for detecting varicella zoster virus is helpful. An immunoglobulin test such as IgM antibodies for varicella zoster virus is also beneficial for diagnosing the condition. There are many other tests such as polymerase chain reaction test to detect the virus.
Treatment of shingles without rash is similar to that of typical shingles that develop with rash. The first line of treatment is oral antiviral drugs. It is aimed to reduce the severity of pain, prevent complications and shorten the course of illness.
Besides anti viral medicines, homeopathic drugs are also beneficial for shortening and alleviating the disease. Homeopathic drugs such as Ars alb, Apis, Kali Mur etc are effective in dealing with shingles with or without rash.
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Hows Shingles Without A Rash Diagnosed
Shingles without a rash isnt common, but it may be more common than previously thought because it often goes undiagnosed. Shingles without a rash is difficult to diagnose based on your symptoms alone.
Your doctor may test your blood, cerebrospinal fluid, or saliva to identify the presence of VZV antibodies. This will allow them to confirm a diagnosis of shingles without a rash. However, these tests are often inconclusive.
Your medical history may provide clues that suggest you have shingles without a rash. Your doctor may ask if youve had a recent operation or if youre under increased stress.
Once your doctor suspects you have VZV, theyll use antiviral medicines such as acyclovir to treat the shingles. They may also prescribe drugs for the pain.
Other treatment will vary based on the location and severity of symptoms.
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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What Are The Risks Associated With Shingles
Some people experience pain around the rash site for a month or morepain that is severe enough to interfere with daily activities.
Scratching the rash can also cause a secondary infection if harmful bacteria get into the sores.
Shingles on the face can involve the eyes, which is serious because it can cause scarring and blindness.
The occurrence and severity of shingles and its complications increase with age.
How Long Does A Shingles Outbreak Last
It can take three to five weeks from the time you begin to feel symptoms until the rash totally disappears.
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Are There Natural Ways To Boost Your Immune System To Help Lessen The Chances Of Developing Shingles
Stress is a risk factor for developing shingles, so limiting your stress can be helpful. Try meditation, yoga or other relaxation methods.
Other things you can do include:
- Eat a healthy diet.
- Aim for seven to nine hours of sleep each night.
- Dont smoke or use tobacco products.
These are all tips for an overall healthy lifestyle, not just for reducing your chance of getting shingles.
How Is Postherpetic Neuralgia Treated
Treatments include lotions or creams and/or other medications not specifically used for pain, such as antidepressants or drugs for epilepsy. Regular pain relievers are not usually effective for this type of pain.
If your pain doesnt lessen, you might try therapies like nerve blocks or steroid injections near the area where the nerves exit the spine. Your provider might suggest an implantable nerve stimulator device for severe, ongoing pain that hasnt responded to other treatments.
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