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.
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
Oral Pain Relief Medicines
e.g. paracetamol , aspirin ibuprofen
e.g. paracetamol, ibuprofen diclofenac , naproxen
- paracetamol, aspirin and non-steroidal anti-inflammatories , which include ibuprofen, diclofenac and naproxen, relieve pain and reduce fever
- paracetamol is a safe choice for most people, but it is important not to take more than recommended. Paracetamol is an ingredient in many cold and flu remedies, so be careful not to double dose
- the maximum daily dose of paracetamol for an adult is 4 g , and no more than 1 g every 4 hours.
- aspirin and NSAIDs are not suitable for everyone. Children under 16 years old must not take aspirin because it can cause Reyes syndrome, which is a serious condition. It should also be avoided by adolescents under 16 years old who have a viral illness
- check with your pharmacist before taking aspirin or NSAIDs if you:
- have a history of stomach problems, such as ulcers or indigestion
- have asthma some asthmatics find their condition is made worse by these types of medicines
- have kidney problems or a heart condition
- take other medications
- have bleeding or bruising problems
- have an allergy to aspirin or NSAIDs
- are pregnant or breastfeeding
- are elderly you may be at more risk of side effects
- are due to have any type of surgery within the next couple of days
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Shingles And Your Eyes
If the shingles rash breaks out on the face, near the eye, the vision may be affected. An ophthalmologist should be consulted right away when pain or other symptoms of shingles affect the eye or the area near the eye.
Shingles painand other symptoms from an outbreak of herpes zosterusually lasts between three to five weeks. Most people experience shingles once, but in some instances, people will continue to experience pain. When this happens, its called postherpetic neuralgia .
Who Gets Postherpetic Neuralgia
About 1 out of 5 people who have shingles will have these sharp, ongoing pains afterward. Certain things can increase your chances of getting it:
- Age: Most people who get postherpetic neuralgia are older than 60.
- Gender: Women seem to get it more than men.
- Early symptoms: People who have numbness, tingling, or itching before a shingles rash even appears tend to get the lingering pain later.
- Pain at the start: If you had severe pain or a rash during the beginning of your outbreak, you have a greater chance of the neuralgia later.
- Other health problems: People with ongoing conditions that can weaken the immune system, like HIV and cancer, seem more likely to get it.
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Go With Gabapentin For Phn
If you do have the lasting nerve pain of PHN, some doctors will prescribe anti-seizure medications, including Neurontin or Lyrica . Even though they were developed as anti-seizure medicines, they can help modulate the nerve pain until the nerves can heal, Dr. Auwaerter explains. These treatments can reduce pain signaling from the nerves to the brain by calming your neurotransmitters for a short time. They are FDA-approved as an effective treatment for PHN. Like antivirals, they require frequent daily dosing, usually three times per day.
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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.”
Preventing The Virus Spreading
If you have the shingles rash, do not share towels or flannels, go swimming, or play contact sports. This will help prevent the virus being passed on to someone who has not had chickenpox.
You should also avoid work or school if your rash is weeping and cannot be covered.
Chickenpox can be particularly dangerous for certain groups of people. If you have shingles, avoid:
- women who are pregnant and have not had chickenpox before as they could catch it from you, which may harm their unborn baby
- people who have a weak immune system, such as someone with HIV or AIDS
- babies less than one month old, unless it is your own baby, in which case your baby should have antibodies to protect them from the virus
Once your blisters have dried and scabbed over, you are no longer contagious and will not need to avoid anyone.
See Your Pharmacist Or Medical Professional
- see your doctor as soon as possible if you think you have shingles
- early treatment with antiviral tablets can reduce symptoms and complications, which is especially important if the rash is on your face, neck or scalp. The complications from shingles here can be more serious, including damage to your sight
- see your doctor again if the pain does not go away after initial treatment, particularly if it is interfering with your sleep or making you feel depressed
- see your doctor if the rash is not healing, especially if there is swelling or pus sometimes the rash can become infected with bacteria
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Shingles And Nerve Paths
Shingles is caused by a reactivation of the virus that causes chickenpox. Only people whove had chickenpox or chickenpox vaccines can develop shingles. Having a chickenpox vaccine can lead to shingles because the vaccine contains the virus that causes chickenpox.
Shingles isnt contagious, but people who have not had chickenpox can develop chickenpox if they come in contact with open blisters of somebody with shingles.
After your body fights off a chickenpox infection, the herpes zoster virus remains dormant in your cranial nerves and spinal ganglia until it becomes reactivated. Spinal ganglia are nerve cells that connect your spinal cord to nerves in your body and limbs.
The virus reactivates when your immune system is no longer able to suppress it. Reactivation most commonly occurs in older adults because the immune system tends to get weaker with age, as well as in people with suppressed immune systems.
Once the virus is active, it usually spreads down sensory nerve fibers that lead from your spinal cord to your skin. These nerves carry sensory information like feelings of pain, itchiness, or pressure from your skin to your spinal cord and brain.
Once the virus gets to the end of these sensory nerves, it reaches your skin and usually leads to a rash. This rash often shows up in one or two nearby areas of skin called dermatomes.
A dermatome is an area of your skin where the sensation is supplied by one spinal nerve.
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.
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Antidepressants May Offer Surprising Relief
Antidepressants may have been invented for depression, but they are also known to modulate peripheral nerves, Dr. Auwaerter says, thereby dulling PHN pain. Your physician may suggest Pamelor or Aventyl or Elavil . Dr. Auwaerter adds that these medications can sometimes cause side effects like fatigue and sluggishnessthough PHN patients usually only need a low dose, which is unlikely to cause major adverse effects.
How Is Shingles Prevented
The best protection against shingles is vaccination. Chickenpox vaccine should prevent you from getting the virus, and so decrease the risk of both chickenpox and shingles. Shingles vaccine reduces the risk of getting shingles and its complications you may still get shingles, but the symptoms are usually less severe and post-herpetic neuralgia is less likely. In New Zealand there are 2 brands of vaccines that protect against shingles Shingrix and Zostavax. These vaccines differ in the way they work, their cost and how they are given. Read more about the differences between Shingrix and Zostavax.
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Are There Treatments I Can Put On My Skin
You might find relief with topical treatments. You can talk to your doctor about:
Creams: Some of these contain capsaicin, the ingredient in cayenne pepper that gives it a kick. Examples are Capsin and Zostrix. You can buy this over the counter but make sure your doctor knows if you plan on using these.
Patches: Capsaicin is also in Qutenza, which is applied via a patch for one hour every 3 months. You need to visit the doctorâs office for this.
Coping With Shingles Pain
If you have shingles, you may be wondering how to cope with the pain:
- Be sure to get plenty of sleep and eat a healthy diet to help boost your immune system.
- Wear comfortable, loose clothing with natural fiber .
- Establish or maintain a regular exercise routine.
- Utilize home remedies to help soothe pain from blisters.
- Engage in activities that help take your mind off of the pain.
- Establish a routine to help manage stress.
- Seek out support when needed from family and friends as well as professional supportive services.
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What Does Postherpetic Neuralgia Feel Like
You usually have pain on one side of your body, where you had the blisters. The feeling is described as shooting, sharp, or stabbing. Other signs you have neuralgia include:
- It hurts to be touched: Sometimes, you canât bear clothing rubbing on your skin. You might feel discomfort from a light breeze.
- Long-lasting pain: This condition can last 3 months or longer after the shingles rash has healed. In some people, itâs permanent. For most, it gets better over time.
- Other sensations: Sometimes, you might feel burning, itching, tingling, or aching along with the shooting feelings. Some people feel numb or get headaches.
- You may also get a fever and generally feel worn-out.
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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Do Nerve Block Injections Require Any Preparation
Your doctor will give you instructions before the nerve block procedure, which you must follow.
These may include:
- Stop taking blood-thinning drugs, like Aspirin, at least 10 days before the injection. Remember, you should always inform your doctor if you are taking this type of medication.
- Avoid taking anti-inflammatory medicines, such as ibuprofen, 24 hours before the nerve block.
- Ask someone to take you home after the procedure.
- On the day of the Injection, you must be free of infections, such as the flu. Let your doctor know if you have any symptoms so you can reschedule the procedure.
Remember to stick to this and other recommendations your doctor gives you. This is very important for the success of the treatment and to avoid potential complications.
Which Groups To Avoid If You Have Shingles
Pregnant women who have not had chickenpox should avoid people with shingles. See the separate leaflet called Chickenpox Contact in Pregnancy for more details. Also, if you have a poor immune system , you should avoid people with shingles. These general rules are to be on the safe side, as it is direct contact with the rash that usually passes on the virus.
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Mayo Clinic Minute: Learn More About Eye Shingles
Shingles is caused by the varicella-zoster virus the same virus that causes chickenpox. If you’ve had chickenpox, the virus can lie dormant in your body’s nerve tissue for years when suddenly it’s triggered by stress or a weakened immune system, and manifests as shingles. A shingles vaccine called Shingrix is recommended for anyone over 50. It helps prevent the disease and reduces the severity of symptoms.
Ophthalmic shingles is one particular version of the disease that can have some serious side effects that ultimately can cause permanent damage to your vision.
Journalists: Broadcast-quality video is in the downloads at the end of this post. Please “Courtesy: Mayo Clinic News Network.” Read the script.
You’re probably familiar with shingles, a viral infection that causes a painful rash usually on the body’s torso. But did you know that shingles also can affect the eye?
“Shingles around the eye typically involves the skin of the forehead and the skin of the upper lid. It can also involve the side of the nose or the tip of the nose,” says Dr. Keith Baratz, a Mayo Clinic ophthalmologist.
The virus lies dormant for years, but, when triggered by stress or a weakened immune system, it travels along nerve pathways to the skin and usually affects only one side of the face.
“You can almost draw a line right down the middle of the forehead when you get the rash,” says Dr. Baratz.
The Rash It Must Be Shingles
Tuesday evening I took a shower and this rash had blossomed around my waist and butt. The most uncomfortable outbreak was around my couch and between my legs, not to mention it just looked awful. I was the perfect candidate to have a flare up of the herpes zoster virus also known as Shingles when it manifests itself as a rash. I was over 50, had chicken pox as a child, and had not had the Zostavax vaccine to prevent Shingles.
As the rash developed on my left side, the internal back pain subsided. On the right side of my body I had four large welts like super-sized mosquito bites. Those welts really itched. Sleeping was still uncomfortable, but the pain wasnt as bad. I also didnt feel quite as achy. Unlike a rash that is itchy, similar to numerous episodes with poison oak, this Shingles rash is painful, like bad sunburn in my case. I sprayed some Solarcain sunburn spray to alleviate the pain. Unfortunately, since the rash around my back, waist, and butt, just sitting to work seems to irritate it. But the spray seems to have helped.
Another trick to reduce the pain and some of the mild itching was hydrocortisone cream. I would slather on the hydrocortisone cream and I could get through the night without itching too bad, but I still felt achy.
Shingles Vaccine Side Effects
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