Should I Go To Urgent Care For Shingles

Know The Bathing Dos And Donts

Using the right water temperature while bathing or showering can make a big difference in how your skin feels and heals. Ideally, you should bathe with cool or lukewarm water and avoid very hot water.

You can also apply a cool, wet compress to the rash and blisters. The AAD recommends you soak a clean washcloth in cold water and place the cloth on top of the affected area several times a day. Leave it on for 5 to 10 minutes.

You should avoid rubbing washcloths, sponges, or exfoliants on the area.

You can also add colloidal oatmeal or cornstarch to your baths to provide some much-needed itch relief. Just be sure to dry your skin gently after getting out of the bath. Then, follow up with a layer of calamine lotion to soothe your skin, or keep it dry and cover with a bandage if its still weeping.

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.

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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Prevent Shingles With Vaccination

The Centers for Disease Control and Prevention recommends that almost all people ages 60 and older be vaccinated against shingles, whether or not they had chicken pox in their youth or have had shingles before, says Dr. Oaklander.

The vaccination that prevents chickenpox in children was used to develop a similar vaccine that protects against shingles. It reduces the risk of getting shingles by about half, and shingles rashes that still develop are slightly less likely to cause postherpetic pain, or other serious complications, says Dr. Oaklander.

People with especially weak immune systems, such as those with cancer or anyone undergoing immunosuppressive treatments, should avoid Zostavax since the vaccine contains a weakened form of the live virus. Because Zostavax has only been available since 2006, it is still not yet clear if a single vaccination offers lifelong protection, but at this time, no booster is recommended.

A new shingles vaccine called HZ/su also may be helpful for older adults. A study published in The New England Journal of Medicine found that the vaccine was 97.2% effective among those ages 50 and older, and 97.9% effective for those ages 70 and older. And since HZ/su is not made from a live, weakened virus, it is safe to give to people with weak immune systems. This vaccine still needs to undergo further testing before it can be submitted for FDA approval, which may happen as early as this year.

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What Is The Prognosis For Shingles What Are Possible Shingles Complications

Many cases of shingles go away by themselves, with or without treatment. The rash and pain should be gone in two to three weeks. However, shingles may last longer and be more likely to recur if the person is older, especially older than 50 years of age, or if they have a serious medical problem.

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Take Your Shingles Shot

If you are in your 50s, its time to talk with your physician about the shingles vaccine.

Shingles is a viral infection caused by the varicella zoster virusthe same virus responsible for chicken pox. If youve had chicken pox, the virus remains dormant in your body long after the tell-tale spots are gone, and you can develop shingles at any point during your lifetime.

Like chicken pox, shingles causes a rash. This rash usually consists of red bumps that morph into painful, fluid-filled blisters, according to the American Academy of Family Physicians. In addition to the rash, you may have a fever and localized itching, pain or tingling sensations that may develop even before the rash.

Shingles usually causes no long-term complications, but there are exceptions. Some people develop a condition called post-herpetic neuralgia, which can cause persistent pain. The older you are when shingles develops, the greater your risk of post-herpetic neuralgia.

A Layer of Protection

The Centers for Disease Control and Prevention reports that the one-dose shingles vaccine can reduce your likelihood of developing the disease by 51 percent and, if you do develop shingles, reduces your chances of post-herpetic neuralgia by 67 percent. For this reason, experts recommend all adults age 60 and older get vaccinated.

A Matter of the Heart?

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 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.

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.

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What Does A Shingles Rash Look Like

At the onset, a shingles rash usually appears as a single red band on one side of the body or the face. Unfortunately, the rash gets worse before it gets better. Within a few days, the red area turns into fluid-filled blisters, which will scab over about a week later. The scabs usually clear up within a couple of weeks.

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.

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Prevent The Spread Of The Shingles Virus:

The virus can be passed to a person who has never had chickenpox. This usually happens if the other person comes in contact with your open sores. This person may get chickenpox, but not shingles. You are contagious until your blisters scab over. Stay away from people who have not had chickenpox or the chickenpox vaccine. Avoid pregnant women, newborns, and people with weak immune systems. They have a higher risk of infection.

• Wash your hands often. Wash your hands several times each day. Wash after you use the bathroom, change a child’s diaper, and before you prepare or eat food. Use soap and water every time. Rub your soapy hands together, lacing your fingers. Wash the front and back of your hands, and in between your fingers. Use the fingers of one hand to scrub under the fingernails of the other hand. Wash for at least 20 seconds. Rinse with warm, running water for several seconds. Then dry your hands with a clean towel or paper towel. Use hand sanitizer that contains alcohol if soap and water are not available. Do not touch your eyes, nose, or mouth without washing your hands first.
• Cover a sneeze or cough. Use a tissue that covers your mouth and nose. Throw the tissue away in a trash can right away. Use the bend of your arm if a tissue is not available. Wash your hands well with soap and water or use a hand sanitizer.

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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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.

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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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, it’s 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.

What Is The Connection Between Chickenpox & Shingles

Chickenpox is a very contagious disease that causes a blister-like rash typically all over the body, itching, and fever. Before the chickenpox vaccine, nearly everyone in the United States got chickenpox. The chickenpox virus can reactivate, causing shingles. People with shingles may have pain, itching, tingling, and blisters in one area of the body that can last for weeks.

You may be among the 99% of people over the age of 50 years who is at risk for shingles, since the virus that causes chickenpox also causes shingles when it reactivates. One in three people will get shingles in their lifetime.

Chickenpox

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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.

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