Shingles Symptoms: The Rash
The rash associated with herpes zoster begins as small blisters in a reddish background. New blisters form for the next few days, usually 3 to 5 days. Blisters emerge in a path of individual nerves in a specific ray-like distribution called a dermatomal pattern. Blisters tend to break out in a band-like pattern over an area of skin.
Timeline Of Shingles Symptoms
Shingles actually doesn’t occur without a prior chickenpox infection. VZV lies dormant in nerve roots after you recover where it can reactivate years later, returning as shingles. But though they share the same viral cause, the two conditions are distinct.
The first sign of shingles is usually a burning or stinging sensation in a band-like formation around the waist, chest, stomach, or back.
You may experience itching or become incredibly sensitive to even the softest touch. The weight of bed sheets on your skin may be uncomfortable. You may also experience fatigue, fever, and headache.
After a few days or even up to a couple of weeks, the telltale shingles rash will appear. This rash consists of fluid-filled blisters that worsen quickly. The blisters may look like chickenpox, but they are clustered together.
The shingles rash can vary in color, depending on your skin tone. On darker skin, the rash may be pink, grayish, dark brown, or even purple. On lighter skin, it will be red.
This is the stage at which VZV can be passed on to someone who has never had or been vaccinated against chickenpox.
Blisters typically scab over within a week to 10 days. Shingles typically takes three to five weeks to progress through all of its stages.
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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Who Is At Risk From Shingles
Anyone who has had chickenpox is at risk of getting shingles later in life. About one in three people who have not been immunised against chickenpox or shingles will get shingles in their lifetime.
Shingles usually affects older people. The older you are if you get shingles, the higher your risk of getting serious disease. People who have a weakened immune system are also at risk of getting more severe disease, even if they are young.
Who Should Not Get The Vaccine
Do not get the shingles vaccine if:
- You have a severe allergic reaction, such as anaphylaxis, to any ingredient of a vaccine or to a previous dose of Shingrix
- You have shingles now.
You are sick with an illness and a fever of 101Â°F or higher.
- You should also consider delaying the vaccine if you are pregnant or breastfeeding. Not enough is known about its safety for expectant and lactating women.
- You have had a negative test for varicella this would be uncommon for adults eligible for the vaccine, as most adults worldwide ages 50 and older have been exposed to the virus. You do not have to be tested before getting the vaccine.
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Early Symptoms Of Shingles
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What is shingles?
The same virus that causes chickenpox causes shingles. Its called the varicella zoster virus .
VZV stays dormant in your body even after you recover from chickenpox. The chickenpox virus can reactivate years or even decades later, but its not understood why.
When this happens, a person will develop shingles. Recognizing the early symptoms is important because it can be a painful condition with severe complications.
state that almost 1 in 3 people in the US will develop shingles in their lifetime. But some people are more likely to develop shingles than others.
It is that half of all cases of shingles occur in people aged 60 years and older.
Other groups prone to developing shingles include:
- people who have had organ transplants
- people experiencing a lot of stress
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Shingles Treatment: Home Remedies
Bathing is generally allowed, and the affected area can be washed with soap and water. Cool compresses and anti-itching lotions such as calamine lotion may also provide relief from symptoms. An aluminum acetate solution can be used to help dry up the blisters and oozing. Application of petroleum jelly can also aid in healing. Over-the-counter antihistamines, such as diphenhydramine and pain medicines can also help provide relief.
Wearing loose clothing can help 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 to avoid spread of the virus. People who do not have immunity to the virus may catch varicella by having direct contact with the lesions. In this way zoster is similar to cold sores, which are caused by a virus in the same family as varicella.
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Can You Still Develop Shingles If Youve Been Vaccinated For Chickenpox
Yes. Despite being vaccinated for chickenpox, you can still get shingles. No vaccine is 100% protective, and the effectiveness of vaccines lessens with time. However, people who get the chickenpox vaccine are significantly less likely to develop shingles later in life compared with people who never received the chickenpox vaccine. One recent 12-year study found that the number of shingles cases was 72% lower in children who had received the chickenpox vaccine compared with those who didnt.
How To Treat And Prevent Shingles
Shingles is treated using antiviral medications, such as:
To manage shingles pain, you can also use numbing creams like lidocaine, or place a cool, wet washcloth on your skin.
Its important to get treatment as quickly as possible because, people with shingles can develop long-term pain or itch after the shingles resolves if the virus does too much damage, Kim says.
To stop yourself from spreading varicella-zoster to anyone else, try to cover up your rash when possible and avoid directly touching it.
The best way to prevent shingles is to get a shingles vaccine. The newest vaccine, called Shingrix, is 85% to 90% effective at preventing shingles in people who have already had chickenpox. If you have never had chickenpox, you will need to get the chickenpox vaccine instead.
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Summary: What Does Shingles Look Like
Now that youve seen the shingles pictures above, review the key points about what to expect from the shingles rash.
- Shingles is the reactivation of chickenpox.
- The first shingles symptom is usually pain followed a few days later by a red rash across the torso.
- The red rash eventually develops fluid-filled blisters. While you have blisters, youre contagious.
- The blisters will pop and crust over.
- This shingles rash can be spread to any part of the body.
- You should seek immediate medical attention if you develop shingles on your eyes, forehead, face, or ears.
Are Viral Rashes Contagious
While some viral rashes are contagious, others are not. Those that are contagious are usually spread during certain stages of the infection, often before symptoms appear.
Getting an accurate diagnosis for a skin rash is the best way to know whether you have a contagious viral rash. In addition, the information can help you reduce the spread of the virus to family members and other close contacts.
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Skin Allergies: Causes & Symptoms Of The Reaction
Skin allergies and stress are two common causes of skin rashes, but an allergic skin reaction can look very similar to the shingles rashmaking the two skin conditions difficult to differentiate. To spot the difference, its important to ask your resident or the elderly loved one in question about any recent changes in his or her routine. An allergic skin reaction can be caused by medication, exposure to an outdoor skin allergen , or exposure to new cosmetics . These allergic reactions can look like sporadic or irregularly shaped red sores on the skin. This flat or raised irritation can be itchy and bumpy, and even lead to blisters. However, unlike shingles, allergic skin rashes like this will often clear up on their ownwith most gone around two weeks after exposure.
Can Eye Shingles Cause Blindness
Even with proper treatment, some eye shingles patients still develop eye disorders such as corneal scarring, glaucoma or retinal disease.
For example, eye shingles can cause:
A corneal dendrite which may lead to a scar
In the most severe cases of eye shingles, a patient may need a corneal transplant.
Eye shingles is not contagious. It cannot be spread to another person.
However, a person who has shingles-related rash anywhere on their body can transmit chickenpox virus to someone who hasnt already had chickenpox or been vaccinated for the condition.
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Is Shingles Contagious
Yes, but not in the way you may think. Your shingles rash will not trigger an outbreak of shingles in another person, but it can sometimes cause chickenpox in a child. People who’ve never had chickenpox, or the vaccine to prevent it, can pick up the virus by direct contact with the open sores of shingles. So keep a shingles rash covered and avoid contact with infants, as well as pregnant women who have never had chickenpox or the varicella vaccine and people who may have weak immune systems such as chemotherapy patients.
S Of The Shingles Rash
If you have a rash of blisters on your skin or a rash that looks like any shown below, see your doctor immediately for a diagnosis. If you have shingles, its important to get treatment, preferably within 2 to 3 days.
If youve had the rash for longer than 2 to 3 days, its still important to see your doctor.
A typical shingles rash
Doctors often refer to this rash as the shingles band because it looks like a band that appears on one area of your body, as shown here.
A rash on one side of the body
A key that you have shingles is that the rash only develops on one side of your body.
Close-up of a shingles rash
The shingles rash often causes a cluster of tiny blisters. You may notice that the skin beneath the blisters is red and inflamed, as shown here.
The rash will also feel painful.
Blistering shingles rash on a mans chest
Although the rash can begin in one area, you may notice that a few scattered blisters develop in other areas, as shown here.
Shingles rash on the palm of a mans hand
While shingles tends to develop on your body or face, it can appear anywhere on your skin.
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How To Tests For The Virus
Once you have a symptom, see your doctor to test your blood, cerebrospinal fluid, or saliva to identify if the presence of VZV antibodies exists. An antibody test would indicate that you have been exposed to varicella-zoster because your immune system makes proteins to fight the virus. Your doctor will look for these proteins, which are called antibodies. The doctor can confirm a diagnosis of shingles without a rash present. However, these tests can be inconclusive. Your doctor will review your medical history to provide clues that suggest you have shingles without a rash.
Another way of diagnosing shingles is a history of pain on one side of your body, together with the telltale rash and blisters. Your doctor may decide to take a culture or tissue scraping of the blisters for examination in the laboratory.
Is This Shingles Without A Rash Worried
About 5 weeks ago I injured my back, dont remember doing it but it felt like a pulled muscle. I thought nothing of it but then 2 weeks ago I got tender skin on patches of my back and around to my chest. I thought maybe it was a trapped nerve but the back pain is now just about gone. The skin pain is still there, also my right lymph node is enlarged and the skin around it is also tender. The skin on my back and around to my chest feels like it is tender too , like mild.sunburn or goosebumps, it is on my left side. I went to the doctor but he said theres no rash then its not shingles. He sort of put it down to nerve pain but im not convinced. The last few days I feel a bit tired too. There is no rash whatsoever but the skin pain is very painful at times especially on the groin where the lymph node is.
1 like, 9 replies
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Who’s At Risk For Shingles
Anyone who has ever had chickenpox can get shingles, but the risk increases with age. People older than age 60 are up to 10 times more likely to get shingles than younger people. Other factors that increase your risk include:
- Some cancer medicines
- A weak immune system from illnesses such as cancer or HIV
A quarter of adults will develop shingles at some point, and most are otherwise healthy.
Hives And The Shingles Rash Are Often Confused
Hives are another type of allergic reaction that can be confused with the shingles rash. Hives are red, itchy bumps and swollen areas of varying sizes that can appear anywhere on the body. The allergic reaction that prompts hives can come from exposure to certain medications, foods, latex, or a viral infection. A quarter of Americans will experience hives at least once in their lives, while one in three Americans over 60 will get the shingles virus. Hives will clear up on their own, but the process can take months.
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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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Who Should Avoid The Shingles Vaccine
Some people should not receive the shingles vaccine, including pregnant women and those with significantly suppressed immune systems.
The shingles vaccine should not be given to pregnant women. It is recommended that a woman wait three months before trying to become pregnant after she has received the shingles vaccine.
People With Weakened Immune Systems
People with weakened immune systems due to immune-suppressing medications, HIV disease, cancer treatment, or organ transplants should not receive the shingles vaccine because it contains live, weakened virus particles.
People Under Age 60
There is not enough information available to determine whether Zostavax may be generally beneficial in people younger than 60 years of age.
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How Is Shingles Treated
Treatment is most effective when initiated within 72 hours of the appearance of the rash. Antiviral drugs can help recover faster and reduce the risk of complications.
Shingles rash and blisters can cause severe pain and may not reduce with over-the-counter pain medication. Treatment of pain includes:
- Antiseizure medicines
- Medicated lotions to reduce pain and itching
- Over-the-counter pain killers such as paracetamol or ibuprofen
- Prescription painkillers such as codeine for intense pain
Is A Vaccine Available To Prevent Shingles
Two vaccines are available in the United States to reduce your chance of developing shingles and postherpetic neuralgia. One vaccine, Zostavax®, has been available since 2006. The second vaccine, Shingrix®, has been available since 2017. Shingrix is recommended as the preferred vaccine by the Advisory Committee on Immunization Practices, a group of medical and public health experts.
Shingrix is given as a two-dose shot in your upper arm. You should receive the second dose two to six months after receiving the first. Shingrix has been shown to be more than 90% effective in preventing shingles and postherpetic neuralgia. Its effectiveness remains above 85% for at least four years after receiving the vaccine.
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Zoster Sine Herpete Is A Rare Form Of Shingles That Doesn’t Cause A Rash
Most people with shingles have a telltale rash on one side of their body, but it is possible to have shingles without a rash. It’s called zoster sine herpete or internal shingles. It’s caused by the same virus, varicella-zoster virus , that causes chickenpox and typical shingles .
Internal shingles still causes pain and itchingjust without the rashalong with other symptoms. Because healthcare providers may not recognize it as a shingles infection, ZSH infections may be more common than previously thought.
This article explores the differences in symptoms, the additional complications ZSH can cause, how it’s diagnosed and treated, and how you can cope with it.
Getty Images / Oscar Wong