What Can I Do For Shingles

Can You Get Chickenpox If Youve Been Vaccinated

Yes. About 15% 20% of people who have received one dose of varicella vaccine do still get chickenpox if they are exposed, but their disease is usually mild. Vaccinated persons who get chickenpox generally have fewer than 50 spots or bumps, which may resemble bug bites more than typical, fluid-filled chickenpox blisters. In 2006, the Advisory Committee on Immunization Practices voted to recommend routine two-dose varicella vaccination for children. In one study, children who received two doses of varicella vaccine were three times less likely to get chickenpox than individuals who have had only one dose.

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Help Is Available For Phn

Fortunately,early treatment for shingles can lower your chances of getting PHN.

For some people, the pain becomes refractory, or resistant to treatment, explains Dr. Rosenquist. So we want to treat shingles as fast as we can ideally as soon as somebody feels a tingling or burning sensation, even before a rash develops.

Sheadds that whenever nerve pain is involved, some people respond to treatment andsome dont.

However,medications taken orally or injected that can target the affected nerves may beable to stun the nervous system into behaving properly. That meanstransmitting the appropriate signal to the brain.

Home Care For Shingles

Colloidal oatmeal baths are an old standby for relieving the itch of chickenpox and can help with shingles, as well. To speed up the drying out of the blisters, try placing a cool, damp washcloth on the rash If your doctor gives you the green light, stay active while recovering from shingles. Gentle exercise or a favorite activity may help keep your mind off the discomfort.

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What Does Early Stages Of Shingles Look Like

Shingles progress through several stages as the virus replicates in your body. Shingles start as a rash with red bumps, known as papules, distributed most frequently over your back and torso.

Within several days, grouped blisters are present. Within seven to ten days, the vesicles dry up and crust.

The early stage of shingles looks like small, red, raised, solid pimples or an inflamed rash. These are tiny, raised bumps on the skin. Eventually, these bumps blister and later crust. The beginning stages of shingles create tingling and localized pain.

The early stages of shingles are also described as itching, burning, or deep pain. People who have had shingles also described the early stages as similar to the beginning of the flu.

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.

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What Can I Do For The Pain

To help with the pain of shingles, your doctor might have you take an over-the-counter pain medicine. This could include acetaminophen or ibuprofen .

Applying a medicated anti-itch lotion to the blisters might reduce the pain and itching. Placing cool compresses soaked in water mixed with white vinegar on the blisters and sores might also help.

If shingles causes severe pain, your doctor might prescribe a stronger pain medicine.

Preventing Nerve Pain After Shingles

But if you’re worried about PHN, don’t despair. There are medications that can cut your risks of getting the condition. There are three antiviral drugs used: famciclovir , valacyclovir , and acyclovir . These medications need to be started within two to three days of the onset of shingles.

“If you look at the clinical trials with any of these drugs in people over 50,” says Dworkin, “they cut the rate of pain at six months in half. That’s a very significant improvement.” They are also very safe and have few side effects, he says.

But who needs the drugs? Dworkin says there’s not a clear consensus yet.

There are some obvious cases. “I think everyone would agree that someone who is over 50 and has severe symptoms should get preventative treatment,” he tells WebMD.

But for younger people or those with fewer risk factors, the course is less clear.

“Some people think that everyone who gets shingles should get preventative treatment with antiviral medicines, because the medicines are so safe and have such few side effects,” he says.

Others argue that preventative treatment should only be given to those at greater risk. The main reason for this, Dworkin says, is cost.

“A full course of treatment could cost anywhere between $100 and $160,” he says. “That can add up, and insurance companies might not want to pay if the risks are very, very low.”

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Have Shingles Get Treatment Take Action

If you have shingles, it’s important to talk to your doctor about your risk for developing PHN. Ask whether preventative treatment with antiviral drugs makes sense. If your doctor says it’s not necessary, ask why.

The full implications of the psychological risk factors for PHN aren’t clear yet, says Dworkin. But he suggests that people with shingles should try to stay active and connected.

“If psychological distress is a risk factor for PHN,” he says, “then we think that people who have shingles might benefit from getting out and not being isolated and homebound.”

You might make an effort to stay connected to family and friends and not to dwell on your symptoms. Also, keep in mind that even if you do develop PHN, there are treatments that can help.

“We have about a half dozen types of drugs that are used as first-line treatments for PHN,” says Dworkin. They include lidocaine patch , pregabalin , gabapentin , capsaicin , carbamazepine , tricyclic antidepressants, and painkillers.

The most important thing is to get prompt medical attention if you think you might have shingles.

“If you have a one-sided rash — especially if you’re over 50 — see your doctor right away,” says Dworkin. “It could be shingles. And we know that prompt treatment can dramatically reduce the likelihood of developing long-term pain.”

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Coping With Shingles Pain

If you have shingles, you may be wondering how to cope with the pain:

• Be sure to get plenty of sleep and eat a healthy diet to help boost your immune system.
• Wear comfortable, loose clothing with natural fiber .
• Establish or maintain a regular exercise routine.
• Utilize home remedies to help soothe pain from blisters.
• Engage in activities that help take your mind off of the pain.
• Establish a routine to help manage stress.
• Seek out support when needed from family and friends as well as professional supportive services.

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Can I Go To Work With Shingles

You can go to work if you have shingles and are no longer contagious. However, you may need to wait until youre feeling better. Shingles can be excruciating and debilitating.

Youre no longer contagious when the rash and blisters begin to scab over. This is typically 10 days after the rash first crops up.

What Are The Health Complications

The most common complication of shingles is postherpetic neuralgia . PHN causes severe pain even after the shingles rash clears.

People aged 60 years and older who dont seek treatment for shingles are more likely to develop PHN.

Shingles can also cause serious sight problems if it infects the structures of the eye.

Other rare complications include:

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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.

Who Should Be Vaccinated With Shingrix

The Shingrix vaccine is recommended for those 50 years of age and older who are in good health.

You should get the Shingrix vaccine even if:

• Youve had shingles already.
• Youve been previously vaccinated with Zostavax . If youve been vaccinated with Zostavax, wait at least eight weeks before getting vaccinated with Shingrix.
• You dont know for sure if youve ever had chickenpox.

Ask your healthcare provider, who knows your entire health history if getting this vaccine is right for you.

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What Everyone Should Know About The Shingles Vaccine

Shingles vaccination is the only way to protect against shingles and postherpetic neuralgia , the most common complication from shingles.

CDC recommends that adults 50 years and older get two doses of the shingles vaccine called Shingrix to prevent shingles and the complications from the disease. Adults 19 years and older who have weakened immune systems because of disease or therapy should also get two doses of Shingrix, as they have a higher risk of getting shingles and related complications.

Your doctor or pharmacist can give you Shingrix as a shot in your upper arm.

Shingrix provides strong protection against shingles and PHN. In adults 50 years and older who have healthy immune systems, Shingrix is more than 90% effective at preventing shingles and PHN. Immunity stays strong for at least the first 7 years after vaccination. In adults with weakened immune systems, studies show that Shingrix is 68%-91% effective in preventing shingles, depending on the condition that affects the immune system.

How Can You Prevent Spreading The Virus

You cant give shingles to someone else, but the varicella-zoster virus is very contagious. If you have shingles and you expose someone else who has not had chickenpox or the chickenpox vaccine, you can give them the virus. Theyll get chickenpox, not shingles, but this puts them at risk for shingles later on.

Youre contagious when your blisters are oozing, or after they break and before they crust over. Do the following to avoid spreading the virus to others:

• Keep your rash covered, especially when the blisters are active.
• Try not to touch, rub, or scratch your rash.
• Wash your hands thoroughly and often.

Avoid contact with people whove never had chickenpox or the chickenpox vaccine, especially:

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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.

Should I See A Doctor For Shingles

It is usually worth seeing a doctor to be certain about the diagnosis and to see if you need treatment or not. Ideally you should see a doctor as soon as possible after the rash appears.

The rash of shingles can be very painful. So even if the doctor doesn’t think you need an anti-shingles medicine, they may be able to give you stronger painkillers than those you can buy over the counter from the chemist.

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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.

When Should You Call For Help

or seek immediate medical care if:

• You have a new or higher fever.
• You have a severe headache and a stiff neck.
• You lose the ability to think clearly.
• The rash spreads to your forehead, nose, eyes, or eyelids.
• You have eye pain, or your vision gets worse.
• You have new pain in your face, or you can’t move the muscles in your face.
• Blisters spread to new parts of your body.
• You have symptoms of infection, such as increased pain, swelling, warmth, or redness.

Watch closely for changes in your health, and be sure to contact your doctor if:

• The rash has not healed after 2 to 4 weeks.
• You still have pain after the rash has healed.

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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.

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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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.