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.
Psoriasis Forms Red Patches On The Skin
Psoriasis is an autoimmune disease that is easy to confuse with the shingles rash. As with the shingles virus, psoriasis forms red patches on the skin, according to Johns Hopkins Medicine. One type of psoriasis pustular can lead to the development of blisters. Areas of skin affected by psoriasis often develop into silvery scales on the scalp, elbows, knees, and lower back. Treatment can help control the condition.
Stage : Rash Outbreak
The second stage of shingles is an eruption of the rash itself, typically 34 days after you first experience the tingling and burning sensation.
The rash typically appears as a band or strap. It includes fluid-filled blisters and lasts 24 weeks. The rash at this stage can be painful.
Some people experience a minor rash or skin irritation. For other people, the rash can cover a larger area. Flu-like symptoms may also occur at this stage.
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What Are The Symptoms Of Shingles
Shingles often starts with a burning, tingling, or painful sensation along one side of the torso or head. Within one to five days, a rash will appear. Within a few days, the rash will turn into fluid-filled blisters. The blisters will start to dry up about a week later, and will begin to disappear over the next several weeks. Some people only experience mild itching, but others have intense pain.
If you think you may have shingles, see your doctor as soon as possible, especially if you see blisters on your face or near your eye. Shingles can cause hearing or vision loss, especially if you dont get treatment for it.
No matter where your rash appears, you should seek medical treatment quickly. Your doctor can make a diagnosis and prescribe treatments to help the blisters dry up and heal. This can reduce the duration of the outbreak and your discomfort.
No cure is available for shingles, but most people who have an outbreak get it only once.
Doing the following at home may help you to feel more comfortable:
- Get lots of rest.
- Use cool washcloths on your rash.
- Take oatmeal baths.
- Keep your stress to a minimum.
You should keep the rash covered and wash your hands often to reduce the risk of spreading the infection. Shingles isnt contagious, but you can give someone chickenpox while you have it.
Signs And Symptoms Of Shingles
Shingles may cause mild to severe pain, and the viral rash most commonly appears on the trunk, notes the CDC. Unlike chickenpox, the shingles rash usually occurs on one side of the body or face.
The first symptom of shingles is usually pain, itching, or tingling in the area where the shingles rash will later appear. This may happen several days before the rash erupts, leading to fluid-filled blisters like those of chicken pox. The blisters typically scab over in 7 to 10 days and clear up within two to four weeks, according to the CDC.
Other signs and symptoms of shingles may include:
Self-care for shingles at home includes:
- applying calamine lotion or other creams to soothe the skin and relieve pain
- cleaning the rash area gently to prevent bacterial infection
- placing cool compresses on blisters to lessen pain and help the blisters heal
- drinking plenty of water and other healthy liquids
- reducing stress as much as possible, such as walking every day and eating nutritious food
- resting, contact your doctor if pain is making it difficult to sleep
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What Are The Health Complications
The most common complication of shingles is postherpetic neuralgia . PHN causes severe pain even after the shingles rash clears.
People aged 60 years and older who dont seek treatment for shingles are more likely to develop PHN.
Shingles can also cause serious sight problems if it infects the structures of the eye.
Other rare complications include:
How Do Dermatologists Diagnose Shingles
A dermatologist can often diagnose shingles by looking at the rash on your skin.
If there is any question about whether you have shingles, your dermatologist will scrape a bit of fluid from a blister. This will be sent to a lab where a doctor will look at the fluid under a high-powered microscope.
When you have shingles, the fluid contains the virus that causes shingles. Seeing the virus confirms that you have shingles.
Your dermatologist will also ask about your symptoms. Shingles tends to be painful.
When the shingles rash spreads to an eye, it can affect your eyesight
You can reduce this risk by seeing an ophthalmologist immediately.
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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.
Shingles Complications: Postherpetic Neuralgia
Postherpetic neuralgia is the most common complication of shingles. This is defined as persistence of the nerve pain associated with shingles beyond one month, even after the rash is gone. It occurs from irritation of the sensory nerves by the virus. The pain of PHN can be severe and debilitating. Up to 15% of people with shingles develop PHN. Typically, this occurs in people over 50 years of age. Treatment of shingles with antiviral drugs can reduce the duration and occurrence of postherpetic neuralgia.
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What Can You Do To Avoid Stress
Reducing or eliminating stress from your life may not guarantee that you wont get shingles, but it will make you healthier. Experimenting with different techniques for stress can help you find what works for you. Try these techniques to reduce stress:
- Identify and avoid the things that trigger your stress. Consider keeping a journal of your moods and possible triggers.
- Wind down before sleep. Reading a book, turning off the computer, and creating a bedtime routine may help.
- Turn mealtimes into social rituals with people you like, complete with conversation, soft music, and healthy, well-prepared food.
- Spend time with your pet or someone elses pet if you like animals.
- Turn off your phone.
- Spend time in nature or taking quiet walks in peaceful surroundings.
- Practice meditation.
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.
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Where Can I Find More Information About Research On Shingles
In addition to the NINDS, several other NIH organizations support research relevant to understanding, treating, or preventing shingles and its complications, including the National Institute of Allergy and Infectious Diseases and the National Institute on Aging .
- NIH RePORTER is a searchable database of current and previously funded research supported by NIH and some other federal agencies. RePORTER also includes links to research results such as patents and publications citing support from these projects.
- PubMed allows users to search millions of journal article abstracts in biomedical research fields. The full text of many articles describing research funded by NIH and other sources is also freely available through PubMedCentral
How Are Chickenpox And Shingles Different
When a person, usually a child, who has not received the chickenpox vaccine is exposed to VZV, he or she usually develops chickenpox, a highly contagious disease that can be spread by breathing as well as by contact with the rash. The infection begins in the upper respiratory tract where the virus incubates for 15 days or more. VZV then spreads to the bloodstream and migrates to the skin, giving rise to the familiar chickenpox rash.
In contrast, you cant catch shingles from someone else. You must already have been exposed to chickenpox and harbor the virus in your nervous system to develop shingles. When reactivated, the virus travels down nerves to the skin, causing the painful shingles rash. In shingles, the virus does not normally spread to the bloodstream or lungs, so the virus is not shed in air.
But a person with a shingles rashwhich contains active virus particlescan pass the virus to someone who has never had chickenpox or who has not been vaccinated. In this case, the person will develop chickenpox, not shingles. A person must come into direct contact with the open sores of the shingles rash. Merely being in the same room with someone who has shingles will not cause chickenpox. Children who develop chicken pox generally fully recover however, adults who develop chicken pox can become seriously ill.
Likewise, a person with chickenpox cannot give shingles to someone elsebut they can pass the virus to someone who has never had chickenpox.
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When To Call Your Doctor
Contact your doctor as soon as you notice skin sensations, and certainly once the rash develops.
There is no cure for shingles. However, antiviral medications can help the blisters heal faster and lower the risk of severe pain.
Antiviral treatment should begin within 72 hours of the rash developing. Treatment can reduce the severity of your infection and lower your risk of developing the long-term complication PHN.
Rash or blisters on the face requires urgent medical care. Notify your doctor right away. Shingles on the face or near the eyes or ears can cause:
What Is Postherpetic Neuralgia
Sometimes, particularly in older people, shingles pain persists long after the rash has healed. This is postherpetic neuralgia, defined as pain lasting three months after onset of the rash. Pain can be mild or severethe most severe cases can lead to insomnia, weight loss, depression, and disability. There may be other sensations, such as tingling, coldness, or loss of feeling. About 20 percent of people age 70 or greater who develop shingles may have long-lasting pain. Postherpetic neuralgia is not directly life-threatening and may get better over time.
About a dozen medications in four categories have been shown in clinical trials to provide some pain relief for postherpetic neuralgia. These include:
Tricyclic antidepressants : TCAs are often the first type of drug given to people suffering from postherpetic neuralgia. The TCA amitryptiline was commonly prescribed in the past, but although effective, it has a high rate of side effects. Desipramine and nortriptyline have fewer side effects and are therefore better choices for older adults, the most likely group to have postherpetic neuralgia.
Common side effects of TCAs include dry eyes and mouth, constipation, and impaired memory. People with heart arrhythmias , previous heart attacks, or narrow angle glaucoma should usually use a different class of drugs.
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What Shingles Symptoms Come Next
After about 1 to 5 days, a shingles rash will appear on one side of the body, often in a single characteristic band around one side of the torso or face.
The painful rash will then form itchy or burning blister-like sores filled with a clear fluid. The blisters will scab over in 7 to 10 days. Theyll gradually grow smaller before disappearing.
Shingles rash symptoms commonly last between 2 to 4 weeks.
Chickenpox Is Caused By The Same Virus
The same virus, varicella zoster virus, causes both chickenpox and shingles.
Chickenpox typically causes an itchy rash that spreads over the entire body, as opposed to just one side of the body or face like shingles. More than 99 percent of Americans born on or before 1980 have had chickenpox, per the CDC. If you dont know if you had chickenpox, check with your family doctor, who can review your records.
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What Are The Symptoms And Signs Of Shingles
The first symptom of shingles is often burning or tingling pain, or itch, generally in a band-like distribution on one side of the body, i.e., around the waist, chest, stomach, or back. Shingles pain can be mild or intense. Some people have mostly itching some feel severe pain from the gentlest touch, such as the weight of bed linens or clothing. A few people may have general symptoms of a viral infection, like fatigue, fever, and headache.
After several days or up to two weeks after the first symptoms are felt, a rash of fluid-filled blisters appears. These are similar to chickenpox but occur in a cluster rather than scattered over the body. The number of vesicles is variable. Some rashes merge and produce an area that looks like a burn. Other people may have just a few small scattered lesions. The clusters most often appear in a band called a dermatome, which contains nerves that branch out from the virus-affected nerve root exiting the spine. The second most common location is on one side of the face around the eye and on the forehead. However, shingles can involve any part of the body, including internal organs.
Recent studies have shown that subtle cases of shingles with only a few blisters, or none, are more common than previously thought. These cases may remain unrecognized.
How Do You Get Shingles
Chickenpox is the root cause of shingles. Anyone whos had chickenpox can develop shingles. Its common knowledge that chickenpox is contagious, but is shingles contagious? Its possible to spread VZV through aerosolized secretions from chickenpox or shingles. When people breathe in those secretions, they can be infected with the active virus. People also transmit VZV through direct physical contact with the fluid in chickenpox or shingles blisters.
Those whove had chickenpox could develop shingles if exposed to blister liquid from shingles. Those who havent had chickenpox could get chickenpox, which can be severe for infected adults. Theres a risk of death for every person infected with chickenpox, but the mortality rate is higher for infected adults. Adults may also suffer other medical complications from chickenpox, such as stroke. Adults infected with chickenpox would be susceptible to developing shingles later if the virus was reactivated or exposed to VZV.
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Ringworm Causes An Itchy Red Circular Rash
Ringworm is a skin infection that, despite its name, is caused by a fungus, whereas the shingles rash is caused by a virus, according to the CDC. Ringworm can cause a red, itchy, circular rash on your skin. It may also cause scaly, cracked skin and hair loss. The rash can appear on any part of your body, and it spreads easily through skin-to-skin contact or contact with an item contaminated with the fungus, like dirty clothes or a shower floor. Some forms of ringworm can be treated with over-the-counter medication, while others must be treated with prescription antifungal medication.
What Are Other Complications Of Shingles
Complications of zoster are more frequent in people with lesions in or around the eyes, forehead, and nose , or around the ear and on the face . People with shingles in or near the eye should see an ophthalmologist immediately, as they can suffer painful eye infections and, in some cases, temporary or permanent vision loss. Symptoms can include redness and swelling involving just the white of the eye , the clear front of the eye , or internal parts of the eye. If the cornea is involved, treatment to avert permanent scarring is important to preventing lasting vision loss. The disease can cause damage to or death of the nerve cells that react to light .
Shingles infections within or near the ear can cause hearing or balance problems as well as weakness of the muscles on the affected side of the face. These problems can be long-lasting or permanent.
In rare cases, shingles can spread into the brain or spinal cord and cause serious complications such as stroke or meningitis .
The varicella zoster virus also may involve blood vessels or provoke an immune reaction irritating the surface of blood vessels . People with shingles have slightly increased risk of stroke, greatest in the first few weeks after vesicle eruption, but lasting for several months. The risk of stroke is highest in people with eye zoster, perhaps as much as five percent.
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