What Are Shingles And What Causes Them

What Is The Prognosis Of Shingles

Generally speaking, shingles typically resolves within two to four weeks in most individuals. The prognosis is excellent for younger and healthy individuals who develop shingles, with very few experiencing any complications. However, in older individuals and in those with compromised immune systems, the prognosis is more guarded, as complications and more severe outbreaks of shingles occur more commonly in these groups.

Approximately 1%-4% of people who develop shingles require hospitalization for complications, and about 30% of those hospitalized have impaired immune systems. In the U.S., it is estimated that there are approximately 96 deaths per year directly related to the varicella-zoster virus, the vast majority of which occur in the elderly and in those who are immunocompromised.

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.

Is There A Vaccine For Shingles

There are two shingles vaccines currently available, Shingrix and Zostavax. Shingrix vaccine, a newer vaccine, is preferred over Zostavax for the prevention of shingles and its complications. Two doses of Shingrix given 2 to 6 months apart are recommended for healthy adults 50 years of age and older. Shingrix is also recommended for adults who have previously received Zostavax. A single dose of Zostavax may still be used to prevent shingles in certain cases for healthy adults 60 years and older.

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Can I Give Shingles To Others

No one can catch shingles from you. But the virus can be spread to a person who has never had chickenpox. The virus lives in the blisters that shingles causes. It can be spread until the blisters are completely healed. If you have blisters that have not crusted over yet, you should stay away from:

• Anyone who has never had chickenpox
• Babies under 12 months old
• Very sick people

Tell your doctor if you live with children who have not had chickenpox. They may need to be vaccinated.

Is That Rash By My Eye Really Shingles

Shingles tends to show up most frequently on the torso, just because of the laws of probability, notes Joseph Safdieh, MD, a professor of neurology at Weill Cornell Medicine in New York City. In that area of your body, there are 24 nerves that can host the virus, compared with the 10 in your lower back.

Often, its not what the rash looks like, but what it feels like before and after it shows up, that signals the condition. Up to several days before the shingles rash appears, pain, itching, or tingling often occurs in the area where it will develop.

In the days before the rash appears, a variety of other flu-like symptoms of shingles can occur. You may experience:

You may even experience the pain but not the rash. Because the pain of shingles originates in the nerves, it may have a different quality than any other pain you have experienced before.

Neuropathic pain is burning, says Dr. Safdieh. Its both numb and painful at the same time, and can be provoked by touching the skin. Your skin may be so sensitive that even sunlight can bring on a stabbing sensation.

Even if you arent sure you have shingles, you should still see a doctor right away, because immediate treatment can prevent complications like long-term nerve pain.

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For Older Adults: Shingles Vaccine

A different vaccine, the herpes zoster vaccine, is available for people aged 50 and older who have had chickenpox and therefore carry VZV. Experts also recommend this vaccine for those who have not had chickenpox or shingles.

In the U.S., of people born before 1980 already have this virus in their system. The herpes zoster vaccine can help prevent shingles in people who already have the virus.

The options available are Zostavax and a newer vaccine called Shingrix.

After two doses of Shingrix, a person will have more than 90% protection against shingles, falling to just above 85% after 4 years, according to the CDC.

Stay Away From Certain Groups Of People If You Have Shingles

You cannot spread shingles to others. But people who have not had chickenpox before could catch chickenpox from you.

This is because shingles is caused by the chickenpox virus.

Try to avoid:

• pregnant people who have not had chickenpox before
• people with a weakened immune system like someone having chemotherapy
• babies less than 1 month old unless you gave birth to them, as your baby should be protected from the virus by your immune system

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Why Doesnt Having Chickenpox Earlier In Life Provide Immunity Against Having Shingles Later

After having chickenpox, your body doesnt rid your system of the virus. Instead, the virus stays in a portion of the spinal nerve root called the dorsal root ganglion. In most people, the virus simply stays there quietly and doesnt cause problems. Scientists arent always sure why the virus gets active again, but they know stress can be a cause.

Age And Weak Immune System Increase Your Risk Of Getting Shingles

Although anyone who has had chickenpox can get shingles, your risk of developing shingles increases with age. Most people get shingles in their 50s or later in life.

Its rare to get shingles before 40 years of age. Scientists are still studying why this happens. Its likely that your immune system keeps the virus dormant. When the immune system starts to weaken, which may start in your 50s, the virus can wake up.

Age increases your risk of getting shingles

Many people who had chickenpox dont remember having it and are unaware that they can get shingles.

Anyone who has a weakened immune system also has an increased risk of getting shingles. This includes people who have:

• Some cancers, such as leukemia or lymphoma

• Human immunodeficiency virus

• To take medication that suppresses the immune system, such as people living with an organ transplant, severe psoriasis, or advanced psoriatic arthritis

• To receive certain cancer treatments, such as chemotherapy

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Can Shingles Be Harmful During Pregnancy

While its rare for pregnant women to develop shingles, if they do, most experts agree that its unlikely to cause harm to the fetus.

Still, pregnant women who develop chicken pox could experience complications, with 10 to 14 percent of those infected developing varicella pneumonia, a condition that can be fatal.

If a pregnant woman gets chicken pox during her first trimester or early in her second, theres a 0.4 to 2 percent risk that her infant will be born with congenital varicella syndrome , which can result in abnormalities in the brain and limbs.

Pregnant women who have been exposed to the virus may be given a varicella zoster immune globulin injection to reduce their risk of complications.

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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.

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Are There Any Home Remedies For Shingles

Care for the skin rash can be provided at home, and this can offer some symptom relief.

• Topical calamine lotion can be applied to the rash in order to decrease itching.
• Cool wet compresses against the painful rash can sometimes be soothing, and for some individuals, a compress with aluminum acetate solution may also be helpful.
• For some, colloidal oatmeal baths may also provide relief from the itching.
• It is important to maintain good personal hygiene, avoid scratching the rash, wear loose-fitting clothes, and try to keep the affected area clean in order to prevent secondary bacterial infection of the skin.
• The rash should be covered to decrease the risk of transmissibility should you come into contact with susceptible individuals.

Antiviral Medicines For Shingles

Antiviral medicines used to treat shingles include aciclovir, famciclovir and valaciclovir. An antiviral medicine does not kill the virus but works by stopping the virus from multiplying. So, it may limit the severity of symptoms of the shingles episode.

An antiviral medicine is most useful when started in the early stages of shingles . However, in some cases your doctor may still advise you have an antiviral medicine even if the rash is more than 72 hours old particularly in elderly people with severe shingles, or if shingles affects an eye.

Antiviral medicines are not advised routinely for everybody with shingles. As a general rule, the following groups of people who develop shingles will normally be advised to take an antiviral medicine:

• If you are over the age of 50. The older you are, the more risk there is of severe shingles or complications developing and the more likely you are to benefit from treatment.
• If you are of any age and have any of the following:
• Shingles that affects the eye or ear.
• A poorly functioning immune system .
• Shingles that affects any parts of the body apart from the trunk .
• Moderate or severe pain.

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Who Is At Risk For Getting Shingles

People who have had chickenpox who are more likely to develop shingles include those:

• With a weakened immune system .
• Over the age of 50.
• Who have been ill.
• Who have experienced trauma.
• Who are under stress.

The chickenpox virus doesnt leave your body after you have chickenpox. Instead, the virus stays in a portion of your spinal nerve root called the dorsal root ganglion. For the majority of people, the virus stays there quietly and doesn’t cause problems. Researchers aren’t always sure why the virus gets reactivated, but this typically occurs at times of stress.

What Are The Symptoms Of Shingles

Early symptoms of shingles may include:

Other signs and symptoms that appear a few days after the early symptoms include:

• An itching, tingling or burning feeling in an area of your skin.
• Redness on your skin in the affected area.
• Raised rash in a small area of your skin.
• Fluid-filled blisters that break open then scab over.
• Mild to severe pain in the area of skin affected.

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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.

Is Shingles Contagious

Yes. You can spread the varicella zoster virus to people whoâve never had chickenpox and havenât been vaccinated.

Youâre contagious until all of the sores have crusted over. Until then, avoid pregnant women who may not have had chickenpox or the vaccine, people with weak immune systems, and newborns.

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When To Call A Doctor

if you:

• Have a rash or blisters on your face, especially near an eye or on the tip of your nose. This can be a warning of eye problems. Treatment can help prevent permanent eye damage.
• Think you have shingles. Early treatment with antiviral medicines may help reduce pain and prevent complications of shingles, such as disseminated zoster or postherpetic neuralgia .

If you still feel intense pain for more than 1 month after the skin heals, see your doctor to find out if you have PHN. Getting your pain under control right away may prevent nerve damage that may cause pain that lasts for months or years.

What Are Risk Factors For Shingles

A weakened immune system might wake up the virus. After youâve had chickenpox, youâre more likely to get shingles if you:

• Are 50 or older
• Are under a lot of stress
• Have cancer, HIV, or another disease that lowers your bodyâs defenses
• Have had a serious physical injury
• Take long-term steroids or other medicines that can weaken your immune system

But many people who get shingles donât fit into any of these categories.

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What Happens If You Dont Fix Lifted Shingles

Lifted shingles do more than impact your propertys appeal. If you fail to fix your shingles, heres what you should expect:

• Water Leaks. You will inevitably have to deal with water leaks if your roofs shingles have been lifted for a long time. It will create an opening for the rainwater, which will enter your home and cause damage to your floors, furniture, and more.
• Mold Growth. Once the water has made its way indoors, it could turn your home into a breeding ground for mold, bacteria, and more if it is left untreated. In turn, this can put your health at risk. Mold exposure can cause respiratory concerns, particularly for people with pre-existing medical conditions.
• Blown-Off Shingles. Shingles may go through the lifting stage before they get completely blown off the roof. Dont wait for this to happen, and instead, partner with a professional roofer that can address your roof concerns promptly.
• Damage to the Rest of the Roof. A single damaged shingle is only the beginning. Soon, youll discover that the rest of the shingles have been lifted by the wind, as well. The moment you notice that the shingles were bent by the wind, get in touch with a professional roofer as soon as possible.

What Is The Outcome For Someone Who Has Shingles

Most people get shingles once, but its possible to get it again.

If you have a healthy immune system, the blisters tend to clear in 7 to 10 days. The rash tends to go away completely within 2 to 4 weeks. The pain may last longer, but usually stops in 1 or 2 months.

For some people, the pain will last longer than the rash. When it does, its called postherpetic neuralgia , which can come and go or be constant. PHN can last for months, years, or the rest of your life. Treatment can help reduce the amount of pain you feel.

Be sure to tell your doctor if you continue to have pain. Treatment can help you feel more comfortable.

For anyone who has a shingles rash, the right self-care can help ease your discomfort. Youll find out what dermatologists recommend at, Shingles: Self-care.

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ReferencesCenters for Disease Control and Prevention . About shingles. Page last reviewed 10/17/2017. Last accessed 4/1/2019.

Dooling KL, Guo A, et al. Recommendations of the Advisory Committee on Immunization Practices for Use of Herpes Zoster Vaccines. Morb Mortal Wkly Rep 2018 67:103-8.

Madkan V, Sra K, et al. Human herpes viruses. In: Bolognia JL, et al. Dermatology. . Mosby Elsevier, Spain, 2008: 1204-8.

Straus SE, Oxman MN. Varicella and herpes zoster. In: Wolff K, Goldsmith LA, et al. Fitzpatricks Dermatology in General Medicine . McGraw Hill Medical, New York, 2008: 1885-98.

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What Do Lifted Shingles Look Like

Shingles are supposed to withstand strong winds. However, if they werent installed correctly, or if theyre old and worn, the wind can cause them to lift. When a shingle is lifted, its edges will be a bit upturned and the space beneath the shingle will be noticeable.

The easiest way to tell your roof has lifted shingles is if the shingles are no longer lying flat. This is something you can visually see from the ground level.

If You Get The Shingles Vaccine Does This Mean Youre 100% Protected From Getting Shingles

No. Just like most vaccines, getting vaccinated with a shingles vaccine doesnt provide 100% protection from disease. However, getting the shingles vaccine reduces your risk of developing shingles.

Even if you do develop shingles, youll be more likely to have a mild case. Also, youll be much less likely to develop postherpetic neuralgia, a painful condition that can follow a shingles outbreak.

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What Are The Complications Associated With Shingles

Shingles is not usually dangerous to healthy individuals although it can cause great misery during an attack. Anyone with shingles on the upper half of their face, no matter how mild, should seek medical care at once because of the risk of damage to the eye. Very rarely, shingles can lead to pneumonia, hearing problems, blindness, brain inflammation or death. For about one person in five, severe pain can continue even after the rash clears up. This pain is called post-herpetic neuralgia. As people get older, they are more likely to develop post-herpetic neuralgia, and it is more likely to be severe.