Check If You Have Shingles
The first signs of shingles can be:
- a tingling or painful feeling in an area of skin
- a headache or feeling generally unwell
A rash will appear a few days later.
Usually you get the shingles rash on your chest and tummy, but it can appear anywhere on your body including on your face, eyes and genitals.
The rash appears as blotches on your skin, on 1 side of your body only. A rash on both the left and right of your body is unlikely to be shingles.
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.
Why Does Shingles Appear Mostly On One Side Or In One Area Of The Body
The virus travels in specific nerves, so you will often see shingles occur in a band on one side of the body. This band corresponds to the area where the nerve transmits signals. The shingles rash stays somewhat localized to an area it does not spread over your whole body. The torso is a common area, as is the face.
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How Does It Occur
If you have had chickenpox, you are at risk for later developing shingles. After you recover from chickenpox, the chickenpox virus stays in your body. It moves to the roots of your nerve cells and becomes inactive . Later, if the virus becomes active again, shingles is the name given to the symptoms it causes.
What exactly causes the virus to become active is not known. A weakened immune system seems to allow reactivation of the virus. This may occur with normal aging, immune-suppressing medicines, or another illness, or after major surgery. It can also happen as a complication of cancer or AIDS or treatment of these illnesses. Chronic use of steroid drugs may trigger shingles. The virus may also become active again after the skin is injured or sunburned. Emotional stress seems to be a common trigger as well.
When To Seek Medical Advice
Shingles is not usually serious, but you should see your GP as soon as possible if you recognise the symptoms. Early treatment may help reduce the severity of your symptoms and the risk of developing complications.
You should also see your GP if you are pregnant or have a weakened immune system and you think you have been exposed to someone with chickenpox or shingles and haven’t had chickenpox before.
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Shingles And Chickenpox Vaccination
The National Immunisation Program provides a free shingles vaccine, Zostavax® at 70 years of age . There is also a free catch-up program for 71 to 79 year olds until the end of 2021. The Zostavax® vaccine is available on prescription for people aged 50 to 69 years and from 80 years but it must be paid for by the patient.
Zostavax® vaccine contains live attenuated varicella-zoster virus, containing 14 times more virus than childhood varicella vaccines and is contraindicated in immunocompromised people. Zostavax® vaccine should not to be used in people with compromised immune function due to the risk of disseminated disease from the vaccine virus.
- Safety advisory – Zostavax® vaccine for health professionals and consumers
Vaccination is still recommended for people who have had shingles infection in the past. It is recommended to wait at least a year after recovery.
The NIP provides a free chickenpox vaccine to children aged 18 months of age and as catch-up for children up to 20 years of age as part of the No Jab No Pay legislation. People aged 14 years and older require two doses of the chickenpox vaccine, one to two months apart. People from 20 years of age must purchase the vaccine privately.
Shingles Rash In The Eyes
Ophthalmic shingles, or herpes zoster ophthalmicus , is when the shingles rash is in and/or around the eye. It is a severe variant that affects 20% of people with the infection.
If you develop a shingles rash near your eye, contact your healthcare provider right away.
lauraag / Getty Images
HZO usually appears within two to four weeks after a shingles rash starts. People who have a compromised immune system, such as those with HIV/AIDS, are at higher risk for developing this.
All parts of the eye can be affected. For example:
- You can develop blisters around the eye that may cause the eyelids and surrounding area to swell.
- The corneaâthe transparent part over the front of the eyeâcan be affected, causing calcification .
- Blood vessels in the eye could become more pronounced blood flow to the eye could be impacted.
To reduce your risk of long-term eye complications, contact your healthcare provider right away if you have a shingles rash on your face.
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What If I Have Shingles And A Poor Immune System
If you have a poor immune system and develop shingles then see your doctor straightaway. You will normally be given antiviral medication whatever your age and will be monitored for complications. People with a poor immune system include:
- People taking high-dose steroids. per day for more than one week in the previous three months. Or, children who have taken steroids within the previous three months, equivalent to prednisolone 2 mg/kg per day for at least one week, or 1 mg/kg per day for one month.)
- People on lower doses of steroids in combination with other immunosuppressant medicines.
- People taking anti-arthritis medications which can affect the bone marrow.
- People being treated with chemotherapy or generalised radiotherapy, or who have had these treatments within the previous six months.
- People who have had an organ transplant and are on immunosuppressive treatment.
- People who have had a bone marrow transplant and who are still immunosuppressed.
- People with an impaired immune system.
- People who are immunosuppressed with HIV infection.
What Types Of Health Care Professionals Treat Shingles
Shingles are most commonly diagnosed and treated by a primary care physician or an emergency medicine physician.
- For certain individuals who develop complications of shingles, a specialist in ophthalmology, neurology, or infectious disease may also be involved.
- Select patients with postherpetic neuralgia may require the care of a pain specialist.
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Do You Always Get The Typical Rash If You Have Shingles
Occasionally, some people dont get a rash. If you have any of the other symptoms of shingles , see your healthcare provider sooner rather than later. There are effective treatments you can take early for shingles. Even if you dont have shingles, seeing your healthcare provider will help you get your condition diagnosed and treated.
Shingles Or Something Else
Small blisters that appear only on the lips or around the mouth may be cold sores, sometimes called fever blisters. They’re not shingles, but are instead caused by the herpes simplex virus. Itchy blisters that appear after hiking, gardening, or spending time outdoors could be a reaction to poison ivy, oak, or sumac. If you aren’t sure what’s causing your rash, see your healthcare provider.
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Why Does Shingles Appear Mostly On One Side Or In One Area Of Your Body
The virus travels in specific nerves, so you will often see shingles occur in a band on one side of your body. This band corresponds to the area where the nerve transmits signals. The shingles rash stays somewhat localized to an area. It doesnt spread over your whole body. Your torso is a common area, as is your face.
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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Month Two To Three: Lingering Itch
The lasting itch one can experience once the shingles rash clears is called postherpetic itch and it most commonly develops on the face and on skin thats already suffered sensory loss. Translations: Your skin is likely already feeling numb there. And since individuals are more likely to scratch numb skin too long and too vigorously, its important to turn to your healthcare provider for advice. He or she will likely suggest topical local anesthetics to help quell the urge to itch.
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 may 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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Is The Zostavax Vaccine Still Being Used
Yes. It is still recommended for preventing shingles and postherpetic neuralgia in healthy people age 50 and older. Zostavax is given as a single-dose shot versus the two-dose shot for Shingrix. Zostavax is less effective than Shingrix in preventing shingles and postherpetic neuralgia .
Zostavax can be considered if you are allergic to Shingrix or if Shingrix is unavailable due to supply shortage and you want some immediate protection from a possible case of shingles and/or postherpetic neuralgia. Because it is a weakened live vaccine, it may be dangerous if you have cancer, HIV, or take steroids, chemotherapy or other medications that suppress your immune system. Ask your healthcare provider if the Zostavax vaccine is an option for you.
How Can I Take Care Of Myself
- Take a pain-relief medicine such as acetaminophen. Take other medicine as prescribed by your healthcare provider.
- Put cool, moist washcloths on the rash.
- Rest in bed during the early stages if you have fever and other symptoms.
- Try not to let clothing or bed linens rub against the rash and irritate it.
- You develop worsening pain or fever.
- You develop a severe headache, stiff neck, hearing loss, or changes in your ability to think.
- The blisters show signs of bacterial infection, such as increasing pain or redness, or milky yellow drainage from the blister sites.
- The blisters are close to the eyes or you have pain in your eyes or trouble seeing.
- You have trouble walking.
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What Are Complications Of Shingles
Though shingles often resolve without any major problems, several potential complications can arise from shingles.
- Postherpetic neuralgia : This is the most common complication of shingles. PHN is characterized by persistent pain and discomfort in the area affected by shingles. The pain can last for months to several years after the rash has cleared up. This complication is thought to occur because of damage to the affected nerves. The pain can sometimes be severe and difficult to control, and the likelihood of developing postherpetic neuralgia increases with age.
- This chronic post-herpetic pain can sometimes lead to depression and disability.
- In people 60 years of age and older with shingles, postherpetic neuralgia will develop in approximately 15%-25% of cases. It rarely occurs in people under 40 years of age.
- Timely treatment with antiviral medication during a shingles outbreak may help reduce the incidence of developing postherpetic neuralgia.
- If postherpetic neuralgia develops, there are various treatment options available including topical creams such as capsaicin , topical anesthetic lidocaine patches , and antiseizure medications such as gabapentin , pregabalin , tricyclic antidepressant medications, and opioid pain medications.
- Intrathecal glucocorticoid injections may be useful for select patients with postherpetic neuralgia who do not respond to conventional medications and treatment measures.
Where Does Shingles Come From
When you have chickenpox as a child, your body fights off the varicella-zoster virus and the physical signs of chickenpox fade away, but the virus always remains in your body. In adulthood, sometimes the virus becomes active again. This time, the varicella-zoster virus makes its second appearance in the form of shingles.
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Is Stress A Risk Factor For Shingles
You may have heard that someone got shingles because they were stressed, perhaps after the death of a relative, soon after a divorce, or at the end of a difficult semester at school.
Clinical Infectious Diseases
Theres some controversy about the matter, says Safdieh. We know for a fact that stress can have an impact on the function of the immune system. If theres stress, immunity is depressed, and I certainly see patients who tell me they were having a lot of stress when they got shingles. But, he adds, there are many people who are stressed and dont get shingles, and many people who get them while theyre on vacation.
If there is a link between stress and shingles, its probably not that the stress itself is putting a strain on the immune system it may be that stress creates conditions that lower immunity. Keep in mind, says Safdieh, that when youre stressed, you dont sleep and you dont eat, and all these factors can play a role.
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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.
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How Are Shingles Treated
Treatment for shingles depends on whether the condition is mild or severe. Mild cases of shingles often go away on their own within a few weeks.
But if you have a more severe case, your doctor may recommend prescription antiviral medications to help bring you relief and speed up healing.
Theres no cure for shingles, but treatment can help relieve symptoms and shorten the duration of an outbreak. The most common treatments are antiviral drugs and pain relievers such as ibuprofen or acetaminophen .
Most cases of shingles resolve within two to four weeks without treatment. But you might need medications to relieve your symptoms. If you have shingles on your face or genitals, its important to get medical attention right away because complications can occur if left untreated.
Treatment options include:
Over-the-counter pain relievers such as acetaminophen and nonsteroidal anti-inflammatory drugs such as ibuprofen or naproxen sodium . These medications might cause stomach irritation and other side effects if taken long-term.
Prescription antiviral medications: oral acyclovir, valacyclovir or famciclovir, to reduce symptoms and shorten the length of time it takes for lesions to heal.
These medications arent 100% effective against shingles and wont prevent recurrences once youve had one attack of shingles.
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Antiviral Medicines For Shingles
Antiviral medicines used to treat shingles include aciclovir, famciclovir and valaciclovir. An antiviral medicine is not a cure for shingles, it 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.
If prescribed, a course of an antiviral medicine normally lasts seven days.
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