What Causes Shingles To Break Out

Prevent Shingles With Vaccination

Shingles: What you need to know about causes, symptoms, and prevention.

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 Are The Complications Of Shingles

Symptoms of shingles usually dont last longer than 3 to 5 weeks. However, complications can happen. The main complications that can result from shingles include:

Postherpetic neuralgia . The most common complication of shingles is called postherpetic neuralgia . This continuous, chronic pain lasts even after the skin lesions have healed. The pain may be severe in the area where the blisters were present. The affected skin may be very sensitive to heat and cold. If you had severe pain during the active rash or have impaired senses, you are at increased risk for PHN. The elderly are also at greater risk. Early treatment of shingles may prevent PHN. Pain relievers and steroid treatment may be used to treat the pain and inflammation. Other treatments include antiviral drugs, antidepressants, anticonvulsants, and topical agents.
Bacterial infection. A bacterial infection of the skin where the rash happens is another complication. Rarely, infections can lead to more problems, such as tissue death and scarring. When an infection happens near or on the eyes, a corneal infection can happen. This can lead to temporary or permanent blindness.

What To Think About

For some people, nonprescription pain relievers are enough to help control pain caused by shingles or postherpetic neuralgia. But for others, stronger medicines may be needed. And if prescription medicines dont help control your pain, you may need to see a pain specialist about other ways to treat PHN.

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Can You Get Shingles If You Havent Had Chickenpox

No. You cant get shingles if youve never had chickenpox, but you can get chickenpox from someone who has shingles. If youve never had chickenpox and you come into direct contact with the oozing, blister-like rash of someone with shingles, the varicella-zoster virus can infect you and you would develop chickenpox.

Once youve had chickenpox, you could develop shingles at some point in your life. This is because the varicella-zoster virus never fully goes away after youve had chickenpox. It lies quietly inactive in your nerve tissue. Later in life, the virus may become active again and appears as shingles.

Can you get chickenpox more than once?

Its rare to get chickenpox twice in your life. Once youve had chickenpox, youre usually immune to it for the rest of your life. However, its not totally impossible. If you have a severely weakened immune system , you can get chickenpox a second time. If youve had chickenpox, you are more likely to get shingles at some point in your life than a repeat bout of chickenpox.

Things To Know About The Shingles Virus

What Is Herpes Zoster Shingles Herpes Free Me

Intense pain, burning, tingling and a blistering rash these are some of the common symptoms of shingles.

If youve ever had chicken pox, the varicella-zoster virus that causes shingles is dormant in your nerve tissue.

So what causes shingles to spring to life wreaking havoc on your body and what can you do about it? Here are seven things you should know about the shingles virus.

1. Shingles is chicken pox coming back to get you

2. A common cold could trigger shingles

3. You can get shingles more than once

4. You cant give someone shingles

5. Vaccination can prevent shingles

6. Treatment options vary

7. Its rare but shingles can cause blindness

Randell Wexler is an associate professor of family medicine at The Ohio State University Wexner Medical Center.

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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.

Early Symptoms Of Shingles

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What is shingles?

The same virus that causes chickenpox causes shingles. Its called the varicella zoster virus .

VZV stays dormant in your body even after you recover from chickenpox. The chickenpox virus can reactivate years or even decades later, but its not understood why.

When this happens, a person will develop shingles. Recognizing the early symptoms is important because it can be a painful condition with severe complications.

state that almost 1 in 3 people in the US will develop shingles in their lifetime. But some people are more likely to develop shingles than others.

It is that half of all cases of shingles occur in people aged 60 years and older.

Other groups prone to developing shingles include:

people who have had organ transplants
people experiencing a lot of stress

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How Is Shingles Diagnosed And Treated

If you think you might have shingles, talk to your doctor as soon as possible. Its important to see your doctor no later than three days after the rash starts. The doctor will confirm whether you have shingles and can make a treatment plan. Most cases can be diagnosed from a visual examination. If you have a condition that weakens the immune system, your doctor may order a shingles test. Although there is no cure for shingles, early treatment with antiviral medications can help the blisters clear up faster and limit severe pain. Shingles can often be treated at home.

The First Symptoms Of Shingles

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Early symptoms of shingles can appear several days before the more obvious symptoms. However, some people will not have early symptoms before a rash appears.

The most common early symptoms occur on one part of the body or face. This often happens in the abdominal area.

These symptoms many include:

The pain can worsen as shingles develops. The pain can be sharp, stabbing, and intense.

It may also cause hypersensitivity, or an excessive reaction to touch.

There are also other early symptoms of shingles.

Although not every person with shingles will experience them, early symptoms include:

general feeling of being unwell

Your doctor can often diagnose shingles based on these symptoms. Your doctor may prescribe medication to speed up recovery.

Medication also reduces the chance of complications, so seeking early intervention is important.

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Shingles Risks And Pregnancy

Pregnant women are susceptible to shingles. Fortunately, shingles in pregnancy is very rare. The antiviral medications described previously are considered safe to use in pregnant women, as are most pain-relieving drugs. Women should not take nonsteroidal anti-inflammatory medications such as ibuprofen or naproxen in the later stages of pregnancy, but acetaminophen is considered safe. Having chickenpox during pregnancy has the potential to cause birth defects, depending upon when in the pregnancy the infection occurs. The risk of birth defects is believed to be lower with shingles than with primary chickenpox infection.

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Image reprinted with permission from Medscape.com, 2012. Dr. Dancewiez/CDC

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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What Triggers Shingles In Some People And Not Others

Experts dont fully understand this. One theory is that shingles occurs when your immune system loses its ability to keep the virus in check.

After you get chickenpox, your immune system is able to recognize the varicella-zoster virus thanks to specialized immune system cells, called B and T cells, that are able to remember the virus and quickly marshal an attack on it. Factors that weaken the immune system increase your risk of developing shingles. These include

certain illnesses, such as HIV , cancer, or autoimmune conditions.
medicines that suppress your immune system, such as cancer drugs, steroids, medications to treat autoimmune conditions, and drugs given to patients who undergo an organ transplant to keep their bodies from rejecting it.
age-related changes: shingles can occur in people of any age, including children, but is most common in people over age 60. Your immune system may become weaker as you get older. While its not totally clear why this happens, it may be due to a decline in T cells. Some experts also think that as you age, the bone marrow produces fewer stem cells, the progenitors of T cells and B cells. With fewer of these white cell soldiers in the army, the immune system might not be able to mount as powerful a response to invaders as it once did.
certain genetic factors: past studies have indicated that an increased susceptibility to shingles can run in families, according to the National Institutes of Health.

What Are The Signs & Symptoms Of Shingles

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Often the first shingles symptoms happen in the area where the rash will appear. A person may have tingling, itching, or pain in this area. When the rash shows up, the pain may be mild or severe.

The rash starts as groups of tiny pimples on one side of the body or the face. It’s often in the shape of a band or belt. The pimples change to pus-filled blisters that break open and scab over in about 710 days. The scabs usually heal and fall off about 24 weeks after the rash starts.

Some kids with shingles also may have a fever and a headache, and might feel tired and achy. Rarely, a child has the pain of shingles without the rash. More severe symptoms can happen, but usually in people over age 50.

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What Can You Do To Avoid Stress

Reducing or eliminating stress from your life may not guarantee that you wont get shingles, but it will make you healthier. Experimenting with different techniques for stress can help you find what works for you. Try these techniques to reduce stress:

Identify and avoid the things that trigger your stress. Consider keeping a journal of your moods and possible triggers.
Wind down before sleep. Reading a book, turning off the computer, and creating a bedtime routine may help.
Turn mealtimes into social rituals with people you like, complete with conversation, soft music, and healthy, well-prepared food.
Spend time with your pet or someone elses pet if you like animals.
Turn off your phone.
Spend time in nature or taking quiet walks in peaceful surroundings.
Practice meditation.

What Is The Treatment For Shingles And Recurring Shingles

The treatment for recurring shingles is the same as for shingles.

If you suspect that you have recurring shingles, see your doctor as soon as possible. Taking an antiviral drug like acyclovir , valacyclovir , or famciclovir can reduce the severity of shingles and reduce how long it lasts.

Your doctor may also prescribe medications to lessen your pain and help you sleep. These include the following:

Skin patches with the painkiller lidocaine are available. You can wear them on the affected area for a specific length of time.
Skin patches that have 8 percent capsaicin, an extract of chili peppers, are available. Some people cannot tolerate the burning sensation, even though the skin is numb before the patch is put on.
Antiseizure drugs, such as gabapentin and pregabalin , reduce pain by reducing the nerve activity. They have side effects that may limit the amount of the drug that you can tolerate.
Antidepressants such as duloxetine and nortriptyline can be useful, especially to relieve pain and allow you to sleep.
Opioid painkillers can relieve pain, but they have side effects, such as dizziness and confusion, and they can become addictive.

You can also take cool baths with colloidal oatmeal to ease the itching, or apply cold compresses to the affected area. Rest and stress reduction are also important.

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Stages Of Chickenpox And Shingles

The progress of each disease can be marked through stages. Some stages will last longer for some, depending on your age, immune system, and other factors.

Stages of chickenpox

The main stages in chickenpox are:

Exposure to the virus: It takes 10 to 21 days after exposure for symptoms to start.

Initial symptoms: Feeling unwell, body aches, fever, and headache are usually the first symptoms to set in.

Small red bumps on the body: These usually develop on the torso or face first, eventually covering the body.

Bumps develop into blisters: The itchy lesions will fill with fluid and become blisters.

Blisters scab over and heal: After all your blisters scab over, youre no longer contagious.

Stages of shingles

Feeling unwell: You might develop fever, headaches, or body aches before developing the rash.

Tingling pain: Its common to feel tingles, pain, or itchiness in the area the rash will develop.

Burning rash: Anywhere from 1 to 5 days after the tingling started, the rash will start to develop.

Blisters: The rash will start to blister and then crust over.

You may still feel mild or extreme pain after the rash is gone, due to a condition called post-herpetic neuralgia . You can develop shingles more than once, but it is rare.

Is There A Vaccine Against Shingles

Shingles: What Are the Causes and Best Treatments?

Shingix is currently the only shingles vaccine available in the United States. Its given to people over age 50.

Previously, an additional vaccine, Zostavax, was used, but it was phased out in the United States as of November 2020.

According to the CDC, two doses of Shingrix are over 90 percent effective at preventing shingles. Youll retain at least 85 percent protection for 4 years after being vaccinated.

If you get shingles after being vaccinated, your symptoms will likely be less severe. Youll also have a lower chance of developing postherpetic neuralgia a complication where pain remains even after a shingles rash goes away.

Shingles usually follows a pattern of development. It typically progresses with the following symptoms:

First, you may notice a tingling or burning sensation in your skin.
One to 5 days later a rash appears as small red spots.
Fluid-filled blisters develop a few days later.
After 7 to 10 days, the lesions crust over.
The rash disappears over the next 2 to 4 weeks.

In some cases, pain may persist for several months or even years after the rash has disappeared. This complication, known as postherpetic neuralgia , can be severe enough to affect your quality of life.

Certain antiseizure medications can help manage the pain. Gabapentin and pregabalin are two that are commonly used.

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Causes And Risk Factors Of Shingles

The varicella-zoster virus the virus that causes chicken pox and shingles is part of a group of viruses called herpes viruses. This group also includes the viruses that cause cold sores and genital herpes.

But the varicella-zoster virus is not the same virus that causes cold sores and genital herpes. The viruses that cause oral and genital herpes are herpes simplex 1 and herpes simplex 2.

If youve had chicken pox, you can get shingles. After the chicken pox is over, varicella-zoster lies inactive, mainly in spinal or cranial nerves. Sometimes the virus reactivates, and thats when it travels along the nerves to erupt as a rash on your skin, causing shingles.