Early Signs And Symptoms Of Shingles
Quick intervention can reduce duration and severity of shingles.
Shingles is a viral infection most often associated with and diagnosed by the appearance of a red, blistering rash that typically appears as a band along 1 side of the torso. Like many illnesses, however, there are precursor signs and symptoms that if recognized and treated early can lead to a shorter course of infection, less discomfort, and fewer complications.
The varicella zoster virus that causes shingles is the same virus that causes chickenpox and then lays inactive in the body for years or decades before reactivating. When it does, the first pre-rash sign of shingles is typically pain that may be stabbing and intense. It can manifest as steadily worsening burning, numbness, or tingling sensations in a limited area on the skin.
Other early symptoms include hypersensitivity to touch and itching. Additionally, patients may complain of fatigue, muscle ache, nausea, chills, headaches, fever, and a general overall feeling of unwellness.
It is important to note that in some rare cases people with shingles do not experience a visible rash. This is known as zoster sine herpete, and 1 example is enteric zoster. The shingles rash can also emerge on parts of the body other than the torso, including the eyes and ears.
When it comes to shingles, prevention by vaccination is always better than treatment after the fact. Currently there are 2 vaccination options available.
Can Shingles Be Prevented
There are 2 vaccines available to reduce the likelihood of developing shingles, Zostavax and Shingrix. If you are over 50, you can talk to your doctor about whether you need it. It is recommended for everyone over 60 and is given free of charge in Australia to people aged 70 to 79.
Vaccination will not guarantee that you will not get shingles, but it will reduce your chance of developing the condition. The vaccine used to protect against shingles is not the same as the vaccine used to protect against chickenpox. Read more about the chickenpox vaccine here.
Should I Get The Shingles Vaccine
“Because the vaccine has been shown to reduce the risk of developing herpes zoster and shingles complications, getting the vaccine is highly recommended,” says Dr. Mohring. “I strongly recommend it for all patients 50 years or older and those who are immunocompromised. It’s safe and effective and reduces severity if you have a breakthrough episode.”
The Shingrix vaccine is a two-dose series given two to six months apart. It’s been shown to be over 90% effective in preventing shingles and postherpetic neuralgia and remains over 85% effective for at least four years afterward. You will not get shingles from this vaccine, and it is generally safe for those with weakened immune systems.
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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.
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.
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Ringworm Causes An Itchy Red Circular Rash
Ringworm is a skin infection that, despite its name, is caused by a fungus, whereas the shingles rash is caused by a virus, according to the CDC. Ringworm can cause a red, itchy, circular rash on your skin. It may also cause scaly, cracked skin and hair loss. The rash can appear on any part of your body, and it spreads easily through skin-to-skin contact or contact with an item contaminated with the fungus, like dirty clothes or a shower floor. Some forms of ringworm can be treated with over-the-counter medication, while others must be treated with prescription antifungal medication.
How Is Shingles Diagnosed
Your healthcare provider will do a complete physical exam and ask about your medical history, specifically about whether you have ever had chickenpox.
Your healthcare provider will likely know right away that it is shingles based on the unique rash. The rash usually appears one area on one side of the body or face. It appears as red spots, small fluid- or pus-filled vesicles, or scabs.
The healthcare provider may also take skin scrapings for testing.
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Eczema Can Cause Red Itchy Skin With Bumps
Like shingles, a skin allergy can also cause red, bumpy, itchy skin, according to the American College of Allergy, Asthma & Immunology . These reactions include eczema, hives, and contact dermatitis. Eczema can cause dry, red, itchy, irritated skin, per the ACAAI. Small, oozing, fluid-filled bumps may also appear, especially when the skin is infected. Eczema is most common on the face, inside the elbows and behind the knees, and on the hands and feet, per MedlinePlus. There is no cure for eczema, but treatments can help manage the condition.
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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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
How Is Shingles Spread
A person must have already had chickenpox in the past to develop shingles. A person cannot get shingles from a person that has shingles. However, the virus that causes chickenpox and shingles can be spread from a person with active shingles to a person who has never had chickenpox or had the chickenpox vaccine. The person exposed to the virus would develop chickenpox, not shingles. A person with shingles can spread the virus when the rash is in the blister-phase. The blister fluid is filled with virus particles. The virus is spread through direct contact with the rash or through breathing in virus particles that get mixed in the air. Once the rash has developed crusts, the person is no longer contagious. A person is not infectious before blisters appear or if pain persists after the rash is gone .
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Do You Need To Stay Away From Children People Who Are Pregnant Have Cancer Or Anyone With A Weak Immune System After You Get The Zostavax Vaccine
According to the CDC, its safe to be around babies and young children, pregnant women or anyone with a weakened immune system after you get the Zostavax vaccine. Even though the Zostavax vaccine contains a weakened live varicella-zoster virus, the CDC says theres no documented case of a person getting chickenpox from someone who has received the Zostavax vaccine. And remember: You cant get shingles unless youve already had chickenpox.
What Are The Symptoms Of Shingles Without A Rash
The symptoms of ZSH are similar to the symptoms of shingles, but without a rash. The symptoms are usually isolated to one side of the body and commonly occur on the face and neck, and in the eyes. Symptoms can also occur in the internal organs. Typical symptoms include:
Shingles isnt contagious. You cant give someone else shingles. If you have shingles and are in contact with someone who hasnt had chickenpox or wasnt vaccinated for chickenpox, you can give that person chickenpox. That person would have to come in direct contact with your shingles rash.
If you have shingles without a rash, you shouldnt be able to pass it to others. Still, its a good idea to avoid contact with people who havent had chickenpox as well as pregnant women until your other symptoms have cleared up.
You can only get shingles if youve had chickenpox in the past. Youre at an increased risk for shingles if you:
- are over age 50
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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.
Who Should Not Get The Vaccine
Do not get the shingles vaccine if:
- You have a severe allergic reaction, such as anaphylaxis, to any ingredient of a vaccine or to a previous dose of Shingrix
- You have shingles now.
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You are sick with an illness and a fever of 101°F or higher.
- You should also consider delaying the vaccine if you are pregnant or breastfeeding. Not enough is known about its safety for expectant and lactating women.
- You have had a negative test for varicella this would be uncommon for adults eligible for the vaccine, as most adults worldwide ages 50 and older have been exposed to the virus. You do not have to be tested before getting the vaccine.
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What Is Shingles And What Causes It
The varicella-zoster virus that causes chickenpox is the same virus that causes shingles. When you’ve had chickenpox as a child or teenager, the physical signs disappear as your body fights off the virus. However, the virus always remains in your body and can reactivate as you age.
For some, the virus stays in the body quietly in a portion of your spinal nerve root called the dorsal root ganglion. For others, the virus can become reactivated and develop into shingles.
Treatments For Other Problems Caused By Shingles
In some cases, shingles causes long-term problems. Treatment depends on what the problem is.
- Disseminated zoster. This is a blistery rash over a large portion of the body. It may affect the heart, lungs, liver, pancreas, joints, and intestinal tract. Treatment is done in the hospital. It may include antiviral medicines to prevent the virus from multiplying and antibiotics to stop infection.
- Herpes zoster ophthalmicus. This is a rash on the forehead, cheek, nose, and around one eye. It could threaten your sight. Get treatment from an ophthalmologist right away. Treatment may include antiviral medicines and steroid eye drops.
- If the shingles virus affects the nerves that begin in the brain , serious problems involving the face, eyes, nose, and brain can occur. Treatment depends on what the problem is and where it is.
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Can Shingles Be Prevented Or Avoided
The best way to prevent shingles is through vaccination. Vaccinate your children for chickenpox. This vaccine reduces their risk for getting chickenpox. You cant get shingles unless youve had chickenpox first.
When you are older, get the shingles vaccine. It is recommended for adults 50 years of age and older. It can prevent shingles. People who have had shingles should get the vaccine to help stop the disease from reoccurring. Common side effects of the vaccine are headache, plus redness, swelling, itching, and soreness at the injection site.
The shingles vaccine is not recommended for anyone who:
- Has had an allergic reaction to gelatin or the antibiotic neomycin
- Has an allergy to any component of the shingles vaccine
- Has a weakened immune system due to conditions such as leukemia, HIV, or AIDS
- Is receiving treatment for cancer
- Is being treated with drugs that suppress their immune system, including high-dose steroids
- Is pregnant or might become pregnant within 4 weeks of getting the vaccine
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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Once You’ve Had Shingles Can It Come Back
Reoccurrence is relatively uncommon. Only a small percentage of patients may have a second episode, more commonly in women. “Three or more shingles episodes in the same person is considered extremely rare,” says Dr. Mohring. “In this case, it would prompt us to investigate other potential diseases that may be going on. Those with higher risk factors, especially weakened immune systems or autoimmune disease, are the most at risk for reoccurrence.”
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.
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Hives Can Cause Itchy Red Bumps
Hives are red or skin-colored bumps that can cause mild to severe itching, according to the ACAAI. They typically appear suddenly and disappear quickly. Pressing the middle of a red bump will make it turn white, which is known as blanching. Hives can be caused by a number of triggers, including allergies, cold or hot weather, and infections.
Shingles: What Triggers This Painful Burning Rash
- By Kelly Bilodeau, Former Executive Editor, Harvard Women’s Health Watch
If youre like 95% of American adults, you had chickenpox as a kid. Before the United States started its widespread vaccination program in 1995, there were roughly four million cases of chickenpox every year. So, most people suffered through an infection with this highly contagious virus and its itchy, whole-body rash.
But unlike many childhood viruses, the varicella-zoster virus that causes chickenpox doesnt clear from the body when the illness ends. Instead it hangs around, taking up residence and lying dormant in the nerves, sometimes for decades, with the immune system holding it in check. In some people, it lives there harmlessly for the rest of their life. But in others, the virus can suddenly emerge and strike again, this time appearing as a different condition known as shingles.
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Ringworm Or Shingles Virus: A Case Of Mistaken Identity
Ringworm is an infectious skin disease that, despite its name, is caused by a fungus, whereas the shingles rash is caused by a virus. Ringworm infection causes red, itchy, scaly patches on your skin, often in several places at once. Sometimes the patches blister and ooze, much like the shingles rash. Ringworm is most common in children, and it spreads easily through skin-to-skin contact or contact with an item contaminated with the fungus, like dirty clothes or a shower floor.
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Am I At Risk For Shingles
Everyone who has had chickenpox is at risk for developing shingles. Researchers do not fully understand what makes the virus become active and cause shingles. But some things make it more likely:
- Older age. The risk of developing shingles increases as you age. About half of all shingles cases are in adults age 60 or older. The chance of getting shingles becomes much greater by age 70.
- Trouble fighting infections. Your immune system is the part of your body that responds to infections. Age can affect your immune system. So can HIV, cancer, cancer treatments, too much sun, and organ transplant drugs. Even stress or a cold can weaken your immune system for a short time. These all can put you at risk for shingles.
Most people only have shingles one time. However, it is possible to have it more than once.
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