What You Need To Know About Shingles
Dr. Jerry Williams of Urgent Care 24/7 discusses what you need to know about Shingles.Shingles are caused by the varicella-zoster virus , the same virus that causes chickenpox. It can be extremely painful and it takes a toll on the elderly and immunocompromised.If your shingles outbreak becomes painful or reaches your face, seek immediate medical care as it can affect your vision.
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Who Should Not Get Shingrix
You should not get Shingrix if you:
- Have ever had a severe allergic reaction to any component of the vaccine or after a dose of Shingrix.
- Currently have shingles.
- Currently are pregnant. Women who are pregnant should wait to get Shingrix.
If you have a minor illness, such as a cold, you may get Shingrix. But if you have a moderate or severe illness, with or without fever, you should usually wait until you recover before getting the vaccine.
Shingles Can Be Prevented With A Vaccine
The first shingles vaccine was Zostavax, which was approved for use in 2006. In 2017, the Shingrix vaccine became available, and is now the preferred vaccine for preventing shingles. Its recommended that adults ages 50 years and up receive two doses of the Shingrix vaccine, which lowers the rates of shingles and postherpetic neuralgia by 90%.
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Can I Get Shingles From Another Person
No, you cannot get shingles from another person. However, the varicella zoster virus is contagious during the activestage to a person who has never had the chickenpox before. Unlike the chickenpox, it is not spread through saliva, coughing, or sneezing. Rather, it is spread by contact with fluid from a blister. It is only contagious after the blister develops and before the crust or scab forms. And thankfully, it is a lot less contagious than chickenpox.
Key Points About Shingles
- Shingles is a common viral infection of the nerves. It causes a painful rash or small blisters on an area of skin.
- Shingles is caused when the chickenpox virus is reactivated.
- It is more common in people with weakened immune systems, and in people over the age of 50.
- Shingles starts with skin sensitivity, tingling, itching, and/or pain followed by rash that looks like small, red spots that turn into blisters.
- The rash is typically affects just one area on one side of the body or face.
- Treatment that is started as soon as possible helps reduce the severity of the disease.
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When Should I See A Doctor Because Of The Side Effects I Experience From Shingrix
Shingrix causes a strong response in your immune system, so it may produce short-term side effects. These side effects can be uncomfortable, but they are expected and usually go away on their own in 2 or 3 days. You may choose to take over-the-counter pain medicine such as ibuprofen or acetaminophen. Contact your healthcare provider if the symptoms are not improving or if they are getting worse.
In clinical trials, Shingrix was not associated with serious adverse events. In fact, serious side effects from vaccines are extremely rare. For example, for every 1 million doses of a vaccine given, only one or two people might have a severe allergic reaction. Signs of an allergic reaction happen within minutes or hours after vaccination and include hives, swelling of the face and throat, difficulty breathing, a fast heartbeat, dizziness, or weakness. If you experience these or any other life-threatening symptoms, see a doctor right away.
What Exactly Is Shingles
The word shingles sounds grosser than it really is. Shingles is just another form of the chickenpox and is caused by the same virus, varicella zoster. Its also a very common diseaseone out of three people develop shingles in their lifetime. Thats because if youve had the chickenpox before, the virus remains in your body and can reactivate. Factors like age, medication, stress, and other diseases can wake the virus up. The virus then travels down down your nerves and sprouts a new infection.
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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.
How To Prepare For A Telehealth Visit For Shingles
If you think you may have shingles or you have already been diagnosed with shingles but have a question regarding its course or treatment, its a reasonable step to promptly schedule a telehealth visit with a board-certified dermatologist.
If you do not have a dermatologist or your dermatologist does not provide telehealth services, you can search online for one through the American Academy of Dermatology. You may also consider using an online telehealth company, such as TeleDoc or Doctors on Demand, to find a dermatologist.
If a teledermatology visit is not possible, seeing your primary care healthcare provider or an advanced nurse practitioner will also generally suffice. Shingles is a common skin ailment, so most primary healthcare professionals are very comfortable diagnosing and treating it.
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Can Shingles Be Prevented
There are 2 vaccines available to reduce the likelihood of developing shingles, Zostavax and Shingrix. If you are over 50, you can talk to your doctor about whether you need it. It is recommended for everyone over 60 and is given free of charge in Australia to people aged 70 to 79.
Vaccination will not guarantee that you will not get shingles, but it will reduce your chance of developing the condition. The vaccine used to protect against shingles is not the same as the vaccine used to protect against chickenpox. Read more about the chickenpox vaccine here.
Risk Factors For Developing Shingles
- If youre age 50 or older. Shingles is most common in people over the age of 50, and it is so common, some experts estimate that half the people age 80 and older will have had shingles.
- If you have certain diseases. Diseases that weaken your immune system can increase your risk.
- If you take certain medications. Includes drugs that prevent rejection of transplanted organs, and prolonged use of steroids such as prednisone.
- If youre undergoing cancer treatments. They can lower your resistance to diseases like shingles.
- If you have a weakened immune system. If you have trouble fighting infections, your risk for getting shingles is higher.
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Shingles Is Baused By The Same Virus That Causes Chicken Pox
Both chicken pox and shingles are caused by the Varicella-Zoster Virus . The initial infection presents as chicken pox, with small blisters that usually appear all over the body. When chicken pox resolves, VZV goes dormant, lying along one nerve pathway . Later, VZV re-activates as shingles, causing vesicles that only appear on one side of the body, along one nerve pathway.
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Doctors Of Osteopathic Medicine
A Doctor of Osteopathic Medicine focuses on medicine geared to treat the whole person. A DO emphasizes the importance of preventing medical conditions and maintaining long-term physical well-being.
People may seek DO care because they want to work on overall wellness rather than treat a single condition. Individuals with shingles may choose a DO because they need help with a range of symptoms.
One technique that a DO might suggest for someone with shingles is known as myofascial release . This involves stretching and releasing different parts of the body to rebalance tissues.
Shingles can cause pain due to uncomfortable rashes. Balancing tissue function through myofascial release may provide relief in some cases.
A DO may also use:
- facilitated positional relief
- balanced ligamentous tension
- reciprocal inhibition
Shingles can cause pain and discomfort throughout the body. An experienced DO may be able to increase a persons comfort by restoring tissue balance and connectivity.
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Prevent Shingles Or Another Shingles Outbreak:
- A vaccine may be given to help prevent shingles. You can get the vaccine even if you already had shingles. The vaccine comes in 2 forms. A 2-dose vaccine is usually given to adults 50 years or older. A 1-dose vaccine may be given to adults 60 years or older.
- The vaccine can help prevent a future outbreak. If you do get shingles again, the vaccine can keep it from becoming severe. Ask your healthcare provider about other vaccines you may need.
What Are Symptoms Of Shingles
The most common symptom is a painful rash on one side of the body or face. Others may include:
- Pain or tingling before the rash develops
Less common symptoms or complications can include:
- Skin infections that develop from blisters
- Pain that can last after the rash disappears
- Scars from healed blisters
- Shingles can affect the eye, causing painful inflammation
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Who Should Get Shingrix
Adults 50 years and older should get two doses of Shingrix, separated by 2 to 6 months. Adults 19 years and older who have or will have weakened immune systems because of disease or therapy should also get two doses of Shingrix. If needed, people with weakened immune systems can get the second dose 1 to 2 months after the first.
You should get Shingrix even if in the past you:
- Received varicella vaccine
There is no maximum age for getting Shingrix.
If you had shingles in the past, Shingrix can help prevent future occurrences of the disease. There is no specific length of time that you need to wait after having shingles before you can receive Shingrix, but generally you should make sure the shingles rash has gone away before getting vaccinated.
Chickenpox and shingles are related because they are caused by the same virus . After a person recovers from chickenpox, the virus stays dormant in the body. It can reactivate years later and cause shingles.
Shingrix is available in doctors offices and pharmacies.
If you have questions about Shingrix, talk with your healthcare provider.
* A shingles vaccine called zoster vaccine live is no longer available for use in the United States, as of November 18, 2020. If you had Zostavax in the past, you should still get Shingrix. Talk to your healthcare provider to determine the best time to get Shingrix.
How Shingles Can Get Into The Eyes
After the symptoms of chickenpox have cleared up, the virus lies dormant in the body. More specifically, the virus remains in the nerves. At any time, the virus can reactivate and cause shingles to develop.
When the virus reactivates in a nerve called the trigeminal nerve, it can cause shingles of the eye. The trigeminal nerve carries signals between the brain and several areas of the face, including the eye.
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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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Emergency Care Discharge Instructions
Instruction summary
If you have been diagnosed with shingles, you likely had chicken pox when you were a child. The virus that caused chicken pox never actually leaves the body it hides, or “sleeps” inside the spinal cord. For most people, the virus stays quiet inside the spinal cord and never reactivates or “wakes up.” However, for 1 in 5 people , the virus does reactivate. It travels down one of the nerves from the spinal cord, causing the rash to appear along the path of that nerve. This usually causes a burning pain to the area, then a skin rash appears a few days later.
You may have been prescribed a medication to manage the pain. Strong pain medications such as Tylenol #3 or Percocet can make you drowsy, so do not drive or operate heavy machinery when taking either of them. These medications usually also cause constipation, so take an over-the-counter medicine for constipation, such as Metamucil or Docusate, at the same time as taking these medications.
For a small number of patients, the pain lasts more than a month . This is called post-herpetic neuralgia. See your family doctor if this is the case for you.
If you have been prescribed an anti-viral medication, start it as soon as possible and complete the entire course .
Remember that you are contagious while you have the skin rash. The risk is that you can give another person chicken pox if they havent had chicken pox before however, you cant give them shingles.
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Dont Shrug Off Shingles
- By Matthew Solan, Executive Editor, Harvard Men’s Health Watch
ARCHIVED CONTENT: As a service to our readers, Harvard Health Publishing provides access to our library of archived content. Please note the date each article was posted or last reviewed. No content on this site, regardless of date, should ever be used as a substitute for direct medical advice from your doctor or other qualified clinician.
If you had chickenpox as a kid, there is a good chance you may develop shingles later in life. In fact, one in three is predicted to get shingles during their lifetime, says Dr. Anne Louise Oaklander, director of the Nerve Unit at Harvard-affiliated Massachusetts General Hospital.
The same varicella-zoster virus that causes chickenpox also causes shingles. After the telltale spots of chickenpox vanish, the virus lies dormant in your nerve cells near the spinal cord and brain. When your immunity weakens from normal aging or from illnesses or medications, the virus can re-emerge. It then travels along a nerve to trigger a rash in the skin connected to that nerve. The rash often appears on only one side of your body. The most common locations are the chest, back, or stomach, or above one eye.
Improve Your Shingles Outcome
The shingles vaccine is only used as a prevention strategy, and it cannot treat someone who currently has the disease. Early treatment is crucial, so contact a doctor promptly if symptoms of shingles are seen. Talk to your doctor to learn about the different treatment options. Sometimes extreme pain will send a shingles sufferer to the ER. Give yourself the benefit of the doubt and seek medical advice, especially if you have never had shingles.
Works Cited
Mayo Clinic. Shingles. Mayo Clinic, Mayo Foundation for Medical Education and Research, 6 Oct. 2020, .
Ratini, Melinda. Shingles : Symptoms, Causes, Contagiousness, Vaccine, Diagnosis, and Treatment. WebMD, WebMD, 16 Nov. 2019, .
Higuera, Valencia. Healthline.com, 3 Jan. 2019, www.healthline.com/health/shingles-natural-treatment.
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There Are Several Signs And Symptoms To Look For
Pain is the most common symptom of shingles. It usually starts as a burning sensation along the affected dermatome, and often becomes a deeper nerve pain once the rash appears. The rash begins as small red bumps that develop into vesicles and take up to two weeks to disappear.
Less than 20% of patients with shingles will also experience systemic symptoms, including fever, body aches and malaise.
What Are The Symptoms Of Shingles
The risk of getting shingles rises as you age, making it most common in people over age 50. Many people experience pain, itching or tingling on their skin several days before a painful rash appears. Other symptoms include:
- Skin that is sensitive to the touch
Many people describe the discomfort as a shooting or burning pain, while others experience numbness and tingling. Some experience all the symptoms.
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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.