What Is The Prognosis Of Shingles
Generally speaking, shingles typically resolves within two to four weeks in most individuals. The prognosis is excellent for younger and healthy individuals who develop shingles, with very few experiencing any complications. However, in older individuals and in those with compromised immune systems, the prognosis is more guarded, as complications and more severe outbreaks of shingles occur more commonly in these groups.
Approximately 1%-4% of people who develop shingles require hospitalization for complications, and about 30% of those hospitalized have impaired immune systems. In the U.S., it is estimated that there are approximately 96 deaths per year directly related to the varicella-zoster virus, the vast majority of which occur in the elderly and in those who are immunocompromised.
When Should I Seek Emergency Care For A Shingles Rash
While most cases of shingles are mild, several potential complications may require emergent care:
- Facial rash. A shingles rash on the face is concerning because eye involvement can lead to blindness. This requires an urgent assessment from an ophthalmologist.
- Loss of hearing or facial movement. Rarely, shingles can lead to hearing loss or facial nerve paralysis.
- Disseminated herpes zoster. This widespread shingles rash can also affect your organs. It requires hospitalization with intravenous antiviral treatment.
- Fever. Shingles in addition to fever can be concerning. It may mean you have a superimposed bacterial infection, which could require antibiotics and close observation.
- Confusion or seizures. Shingles in addition to confusion or seizures could indicate brain inflammation, which requires hospitalization for IV antiviral treatment and close monitoring.
Dr. Megan Soliman is an ABMS board certified internal medicine physician whose main focus in her clinical practice is patient advocacy. Her research interests include adverse effects of medications and herbal supplements. Soliman is enthusiastic about bread and butter medicine, which includes treating patients with the most common diseases. She also has a passion for reaching underserved communities, including both U.S. and international rural communities.
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 Is Shingles Treated
Specific treatment for shingles will be determined by your healthcare provider based on:
- Your age, overall health, and medical history
- How long the shingles have been present
- Extent of the condition
- Your tolerance for specific medicines, procedures, or therapies
- Expectations for the course of the condition
- Your opinion or preference
There is no cure for shingles. It simply has to run its course. Treatment focuses on pain relief. Painkillers may help relieve some of the pain. Antiviral drugs may help lessen some of the symptoms and reduce nerve damage. Other treatments may include:
- Creams or lotions to help relieve itching
- Cool compresses applied to affected skin areas
- Antiviral medicines
Home Remedies And Lifestyle
In addition to triggering an uncomfortable rash, shingles can cause symptoms that are similar to those of other viral infections.
While prescription and over-the-counter drugs can help, one of the most important things you can do while dealing with the illness is to take good care of yourself. If you’re caring for someone else who has shingles, “creature comforts” can be enormously soothing.
Verywell / Laura Porter
Integrate these basic tactics into even the busiest daily routine:
What Are Complications Of Shingles
Though shingles often resolve without any major problems, several potential complications can arise from shingles.
- Postherpetic neuralgia : This is the most common complication of shingles. PHN is characterized by persistent pain and discomfort in the area affected by shingles. The pain can last for months to several years after the rash has cleared up. This complication is thought to occur because of damage to the affected nerves. The pain can sometimes be severe and difficult to control, and the likelihood of developing postherpetic neuralgia increases with age.
- This chronic post-herpetic pain can sometimes lead to depression and disability.
- In people 60 years of age and older with shingles, postherpetic neuralgia will develop in approximately 15%-25% of cases. It rarely occurs in people under 40 years of age.
- Timely treatment with antiviral medication during a shingles outbreak may help reduce the incidence of developing postherpetic neuralgia.
- If postherpetic neuralgia develops, there are various treatment options available including topical creams such as capsaicin , topical anesthetic lidocaine patches , and antiseizure medications such as gabapentin , pregabalin , tricyclic antidepressant medications, and opioid pain medications.
- Intrathecal glucocorticoid injections may be useful for select patients with postherpetic neuralgia who do not respond to conventional medications and treatment measures.
When To Seek Medical Advice
Shingles is not usually serious, but you should see your GP as soon as possible if you recognise the symptoms. Early treatment may help reduce the severity of your symptoms and the risk of developing complications.
You should also see your GP if you are pregnant or have a weakened immune system and you think you have been exposed to someone with chickenpox or shingles and haven’t had chickenpox before.
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Are There Shingles Home Remedies
People who have shingles symptoms and signs should see their doctor as soon as possible, because antiviral medication is effective only if given early. Individuals with facial, nose, or eye symptoms and signs should seek medical care immediately.
- Do not scratch the skin where the rash is located. This may increase the risk of secondary bacterial infection and scarring. Over-the-counter antihistamines and topical creams can relieve the itching.
- After diagnosis and appropriate treatment, apply cool tap-water compresses to weeping blisters for 20 minutes several times a day to soothe and help dry the blisters. This also aids in removing the scabs and decreases the potential for bacterial infection. Tap-water compresses must be stopped once the blisters have dried, so the surrounding skin does not become too dry and itchy. Remember that weeping blisters contain the virus and are contagious to individuals who are susceptible to the chickenpox virus.
- Keep the area clean with mild soap and water. Application of petroleum jelly can aid in healing. Wear loose clothing to avoid extra pain from clothing rubbing against the rash. Avoid close skin-to-skin contact with others who have not had chickenpox, are ill, or who have a weakened immune system.
Shingles Chickenpox And Pregnancy
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.
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What Specialists Treat Shingles
Primary care physicians, including internal medicine specialists, family medicine specialists and/or specialists in infectious diseases, can appropriately treat some patients. An emergency medicine physician may start the initial care. However, if there is a chance the eye may be involved, an ophthalmologist should be consulted. If a person is pregnant and gets shingles, they should consult with their ob-gyn physician immediately. For long-term or chronic pain involved in postherpetic neuralgia, a neurologist and/or pain specialists may be involved in the care of the patient.
What Are Shingles Symptoms
Common symptoms of shingles are pain and a rash in a belt-like form that stops at the midline of the body affecting only one side. Symptoms of shingles progress from burning and itching sensations to severe pain at the location of the rash. Early shingles symptoms may include burning, tingling, or a numb sensation on the skin accompanied by headache, upset stomach, and chills.
Later stages include painful fluid-filled blisters that cause severe pain, fever, and severe itching.
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Liquid Dimethyl Sulfoxide And Idoxuridine
Idoxuridine is an antiviral medication approved in Europe for treating shingles.
One 2015 publication suggested frequent application of 5 to 40 percent idoxuridine dissolved in DMSO may speed up the healing time of shingles. However, in the United States, idoxuridine is only FDA-approved to treat keratitis, a herpes simplex virus infection of the cornea of your eye.
What Are The Symptoms Of Shingles
Early symptoms of shingles may include:
Other signs and symptoms that appear a few days after the early symptoms include:
- An itching, tingling or burning feeling in an area of your skin.
- Redness on your skin in the affected area.
- Raised rash in a small area of your skin.
- Fluid-filled blisters that break open then scab over.
- Mild to severe pain in the area of skin affected.
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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.
Consider Using Creams Lotions Or Patches
Shingles can be very painful. If you need help managing pain, your doctor might prescribe a topical pain-relieving cream or patch. These contain lidocaine or other nerve block medication for the skin.
A medicated anti-itch cream that includes an antihistamine, such as diphenhydramine , might also help you find some relief.
After the rash has scabbed over, you can try using creams or lotions to soothe any remaining symptoms. Look for products that contain:
- colloidal oatmeal
Your doctor may also recommend an oral over-the-counter pain reliever such as a nonsteroidal anti-inflammatory drug or acetaminophen . Always follow the dosage instructions on the label or take according to your doctors instructions.
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Avoid Scratching The Blisters
It might be tempting to scratch or pick at the blisters, especially if theyre causing you discomfort. Know that theyll eventually crust over and fall off if you leave them alone.
Scratching at blisters or scabs can lead to infection and scarring. Cleaning and covering them regularly with a new sterile bandage can help reduce the likelihood that youll pick at the rash.
Keeping the rash clean is one part of the process. The other is to make sure you bandage it properly, especially if the rash is still weeping .
When dealing with a painful shingles rash, your best bet is to use bandages that are:
When youre switching the dressing, allow the skin to dry before covering it with a new bandage.
In addition to keeping the rash protected, bandaging also prevents you from passing the varicella-zoster virus to another person. Be sure to keep bandages on any areas of the rash that havent scabbed over yet.
While shingles isnt contagious, the virus that causes it can be passed to anyone who hasnt had chickenpox or the chickenpox vaccine. If they come into skin-to-skin contact with the fluid that oozes from a shingles blister, they could end up with chickenpox, according to
If My Shingles Rash Is Mild Or Has Mostly Healed Do I Need To See A Doctor
Its a good idea to see a doctor whenever you have a case of shingles, no matter how mild.
Prompt antiviral treatment not only decreases the duration and severity of the rash but can also decrease the chance of developing post-herpetic neuralgia. Post-herpetic neuralgia is a complication of shingles characterized by long-term, debilitating pain.
If your rash has mostly healed, its still a good idea to see a doctor so they can monitor the rash for changes or complications, such as a bacterial skin infection that forms on top of your existing rash. This is known as a superimposed infection.
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When Should I See My Doctor
See your doctor as soon as possible if you are experiencing any symptoms of shingles. Starting treatment with antiviral medicines within 3 days of the rash appearing should reduce the severity of symptoms and the risk of further complications, including post-herpetic neuralgia.
See your doctor straight away if you have symptoms of shingles and are experiencing the following:
- symptoms that affect your eye area
- a temperature of 38°C or higher
You should also see your doctor if you are pregnant, or have a weakened immune system due to medicine that suppresses the immune system, or a condition that weakens your immune system.
Is Shingles Prevention Possible Is There A Shingles Vaccine
Prevention of shingles in people who have contracted chickenpox is difficult, since the factors that trigger reactivation are not yet defined. However, if a person is never infected with the virus, shingles will not develop. Furthermore, there are at least two methods that are currently used to reduce the incidence of shingles.
First, the VZV vaccine, otherwise known as the chickenpox vaccine, may decrease the incidence of shingles by enhancing the immune system’s ability to fight off VZV or keep this virus inactive. This vaccine is usually administered to children, but the immunity may decline in about 15-20 years. The single-dose vaccine dose is given to babies 12-18 months of age. Most vaccine side effects, if they occur, are mild and range from a rash, skin redness, and swelling to small chickenpox lesions, usually at the injection site. Boosters of this vaccine for use in adults are now being investigated and may help prevent shingles in the future.
Shingrix is the vaccine the CDC currently recommends as the preferred shingles vaccine. Two doses about 2-6 months apart are more than 90% effective in preventing shingles and PHN, and it is recommended for use in people 50 and over. Side effects of Shingrix may occur and last about 2-3 days and may include redness and swelling at the inoculation site. Some individuals may experience muscle pain, headache, shivering, fever, stomach pain, and nausea.
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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:
- Youve had shingles already.
- Youve been previously vaccinated with Zostavax . If youve been vaccinated with Zostavax, wait at least eight weeks before getting vaccinated with Shingrix.
- You dont 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.
Why Does Shingles Appear Mostly On One Side Or In One Area Of Your Body
The virus travels in specific nerves, so you will often see shingles occur in a band on one side of your body. This band corresponds to the area where the nerve transmits signals. The shingles rash stays somewhat localized to an area. It doesnt spread over your whole body. Your torso is a common area, as is your face.
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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.
What Is The Best Medication For Shingles
Your healthcare provider will determine the best medication for your case of shingles based on your symptoms, medical history, and response to shingles treatment. Heres an overview of the popular shingles medications that your doctor may prescribe.
|Best medication for shingles
|One 0.65 ml injection in the upper arm
|Irritation of the injection site or chickenpox-like rash near the injection site or headache
Dosage is determined by your healthcare provider based on your medical condition, response to treatment, age, and weight.
Other possible side effects exist. This is not a complete list.
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How Is Shingles Diagnosed And Treated
If you think you might have shingles, talk to your doctor as soon as possible. Its important to see your doctor no later than three days after the rash starts. The doctor will confirm whether you have shingles and can make a treatment plan. Most cases can be diagnosed from a visual examination. If you have a condition that weakens the immune system, your doctor may order a shingles test. Although there is no cure for shingles, early treatment with antiviral medications can help the blisters clear up faster and limit severe pain. Shingles can often be treated at home.