Seek Treatment Right Away
Many people have the mistaken impression that, like poison ivy, shingles is a nuisance rash that fades on its own. But in fact a shingles rash should alert people, especially in middle or old age, to seek immediate medical help, says Dr. Oaklander.
Rapid treatment with one of three antiviral drugs, acyclovir , valacyclovir , or famciclovir , can shorten a shingles attack and reduce the risk of serious damage, such as:
- Long-term pain. Pain that lingers in the area of a healed shingles rash is called postherpetic neuralgia. This often-disabling pain can last several months to a year.
- Prolonged itching. Many people are left with an itchy area from their shingles, which can be as disabling as chronic pain. It is most common on the head or neck.
- Damage to vision and hearing. Pain and rash near an eye can cause permanent eye damage and requires an urgent ophthalmological exam. When the nerve to the ear is affected, it can permanently damage hearing or balance.
- Strokes and heart attacks. A PLOS Medicinestudy that tracked about 67,000 people ages 65 and older who were newly diagnosed with shingles found that stroke risk more than doubled in the first week after the shingles diagnosis. The same study reported an increased risk for heart attacks in the three months after shingles, but the additional risk dissipated after six months.
S Of The Shingles Rash
If you have a rash of blisters on your skin or a rash that looks like any shown below, see your doctor immediately for a diagnosis. If you have shingles, its important to get treatment, preferably within 2 to 3 days.
If youve had the rash for longer than 2 to 3 days, its still important to see your doctor.
A typical shingles rash
Doctors often refer to this rash as the shingles band because it looks like a band that appears on one area of your body, as shown here.
A rash on one side of the body
A key that you have shingles is that the rash only develops on one side of your body.
Close-up of a shingles rash
The shingles rash often causes a cluster of tiny blisters. You may notice that the skin beneath the blisters is red and inflamed, as shown here.
The rash will also feel painful.
Blistering shingles rash on a man’s chest
Although the rash can begin in one area, you may notice that a few scattered blisters develop in other areas, as shown here.
Shingles rash on the palm of a man’s hand
While shingles tends to develop on your body or face, it can appear anywhere on your skin.
Is The Shingles Rash Dangerous
The shingles rash doesnt usually cause any long-term damage to your body. However, if your rash develops on your face or ears, it can cause long-term issues Ill explain the full risks in the section below.
No matter how minor your case of shingles you should still go see your doctor to get treatment for your shingles. Theyâll likely provide you with medication to ease your pain and help fight the virus.
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How Is Internal Shingles Treated
Even though shingles is a virus, this is a case where there are antiviral medications available by prescription. Thats why its important to see your doctor right away if you suspect you have shingles. Early treatment may reduce the risk of complications, like PHN. Serious complications require hospitalization.
Common antiviral medications for shingles include:
Depending on the location and severity of the shingles infection, steroids may also help. Anti-inflammatory medications like ibuprofen and pain-relieving medication such as acetaminophen or other prescription pain medication can help in easing pain experienced from shingles.
Tips For Coping With Shingles
If you have shingles, here are some tips that might help you feel better:
- Wear loose-fitting, natural-fiber clothing.
- Take an oatmeal bath or use calamine lotion to soothe your skin.
- Apply a cool washcloth to your blisters to ease the pain and help dry the blisters.
- Keep the area clean and try not to scratch the blisters so they dont become infected or leave a scar.
- Do things that take your mind off your pain. For example, watch TV, read, talk with friends, listen to relaxing music, or work on a hobby such as crafts or gardening.
- Get plenty of rest and eat well-balanced meals.
- Try simple exercises like stretching or walking. Check with your doctor before starting a new exercise routine.
- Avoid stress. It can make the pain worse.
Also, you can limit spreading the virus to other people by:
- Staying away from anyone who has not had chickenpox or the chickenpox vaccine, or who might have a weakened immune system
- Keeping the rash covered
- Not touching or scratching the rash
- Washing your hands often
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Zoster Sine Herpete : Shingles Without The Rash
It is possible for a person to develop shingles without being affected by the rash, although this is rare. When shingles occurs without the rash being present, this is called zoster sine herpete .
When shingles occurs without a rash, the first symptoms of the condition may involve:
- A feeling of numbness in a certain area
- An itchy, burning sensation
- Generalized aches
- Hypersensitivity to touch
When shingles is present, even without the rash, sensations will be concentrated in a specific area of the body â commonly the face, neck, one side of the torso or the eyes. However, in the absence of the shingles rash, zoster sine herpete may still rarely lead toneurological and visceral diseases, such as inflammation of the brain , Varizella pneumonia, paralysis of the facial nerves and problems related to keeping oneâs balance or problems with hearing.
Because shingles shares characteristics with many other conditions, including herpes simplex, impetigo, dermatitis herpetiformis and contact dermatitis, it can easily be confused with these conditions. In cases where a rash is not present, a laboratory test will usually be necessary to establish the presence of the varicella zoster virus in the body.
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What Does Shingles Look Like
My shingles rash looked like someone had put a cigarette out on my eyelid. Frankly, I bet that would be less painful.
You would have thought by now I wouldve caught on but I never really realized that young people can get shingles. It just never crossed my mind. If I had simply done an internet search of my symptoms, it wouldve been obvious what I had.
According to Healthline:
You may begin to notice pink or red blotchy patches on one side of your body. These patches cluster along nerve pathways The rash quickly develops fluid-filled blisters similar to chickenpox. They may be accompanied by itching. New blisters continue to develop for several days. Blisters appear over a localized area and do not spread over your whole body.
Shingles also commonly has a rash that wraps around half of your waist, which people sometimes call the shingles belt or shingles girdle. Lovely. Id never heard of that, but I am also not over 70, and I assume these terms are more popular in that age bracket.
Developing shingles on your face, like I did, is common. Its also common to get them on your neck and torso though there are lots of other possibilities. And no matter where they look truly ugly and disgusting. More importantly, those blisters hurt. Its deep down nerve pain.
Heres what my shingles looked like around my eye :
So I didnt catch all those initial symptoms of shingles, but my doctor did.
Yeah, youve got shingles, my doctor told me.
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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:
- You have had shingles already.
- You have been previously vaccinated with Zostavax .
- You do not 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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Am I Contagious If I Have Shingles
Shingles cannot be passed from one person to another. But someone who has never had chickenpox can contract VZV from a person with active shingles. They would then develop chickenpox, not shingles.
Only direct contact with fluid from shingles blisters can transmit the virus. Keep shingles blisters covered with a fluid absorbent dressing to prevent others from contracting the virus.
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Appearance Of The Shingles Rash
The eruptive stage of shingles begins a few days later. This is when a rash appears.
The skin in the area of the prodromal pain caused by shingles will often be sensitive to the touch and reddish in appearance. As these symptoms get worse, it may begin to feel like a sunburn.
Within three to five days of the initial pain, a few tiny pimple-like spots appear and quickly multiply into clusters, forming a rash that feels prickly to the touch.
From there, sometimes within hours, the pimples develop into water-filled blisters, or vesicles, that then consolidate into larger blisters. Often, redness and swelling accompany the rash.
The shingles rash looks very much like the chickenpox rash, with a key difference: Chickenpox blisters are widely scattered over the entire body. With shingles, the rash almost always occupies a finite strip of skin.
Ultimately, the pain of shingles may get so excruciating that simply grazing the skin with clothing can set off what feels like an electric shock.
Psoriasis Forms Red Patches On The Skin
Psoriasis is an autoimmune disease that is easy to confuse with the shingles rash. As with the shingles virus, psoriasis forms red patches on the skin, according to Johns Hopkins Medicine. One type of psoriasis pustular can lead to the development of blisters. Areas of skin affected by psoriasis often develop into silvery scales on the scalp, elbows, knees, and lower back. Treatment can help control the condition.
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What Can You Do To Prevent Shingles
While you may not be able to control certain factors that might trigger shingles, there are strategies you can use to prevent shingles. The most important is vaccination. Research shows that the shingles vaccine Shingrix is 90% effective in preventing an outbreak of shingles. Even if you do get shingles after being vaccinated, Shingrix greatly reduces your risk of developing persistent pain in the affected area, known as post-herpetic neuralgia.
In addition to getting vaccinated, its always a good idea to take steps to keep your body healthy, such as choosing healthy foods, staying active, and getting sufficient sleep. Its not clear if healthy lifestyle habits like these can prevent shingles, but even if they dont, theyre worthwhile because they will benefit your body in many other ways.
What Are The Symptoms Of Postherpetic Neuralgia
Common postherpetic neuralgia symptoms include:
- Burning, sharp, jagging or aching pain in the area where the shingles rash appeared.
- Itchiness or numbness at or near the area of the former rash.
- Pain that is constant or comes and goes. Pain typically lasts, on average, for three months after the rash has healed, but can last for more than a year or longer.
- Pain at affected skin area can be brought on even with a light touch .
- Pain gets worse at night or in heat or cold temperatures.
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Can Shingles Cause Chronic Pain
In some people, the pain of shingles may linger for months or even years after the rash has healed. This pain, due to damaged nerves in and beneath the skin, is known as postherpetic neuralgia. Others feel a chronic itch in the area where the rash once was. In severe cases, the pain or itching may be bad enough to cause insomnia, weight loss, or depression.
What Are The Signs And Symptoms Of Shingles
Shingles causes a painful, blistering rash on your skin. If you get shingles, you may notice the following:
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Before the rash appears: For 1 to 2 days before the rash appears, you may have pain, burning, or tingling on an area of skin where the rash will develop. Some people say they felt an electrical sensation on their skin before getting the rash.
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Rash appears: A painful, blistering rash appears. It usually appears on one side of your body, often on the torso however, it can appear anywhere on your skin. Some people get more blisters after the rash appears, so it can seem that the rash is spreading.
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Rash starts to clear: As the rash clears, the blisters may crack open, bleed, and scab over. For most people, the rash will clear within 2 to 4 weeks.
Although the rash will clear on its own, treatment is important. Taking medication within 3 days of getting the shingles rash can:
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Reduce your risk of developing other health problems, such as long-lasting nerve pain, pneumonia, or hearing loss
Shingles rash on the face
If you have a shingles rash on your face, immediately seeing a doctor for treatment could save your eyesight.
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The Shingles Rash Usually Occurs On One Side Of The Body Or Face Most Commonly On The Trunk
Its easy to mistake a shingles rash for another health condition that affects the skin. The shingles virus typically causes a painful rash and blisters, which can resemble many other skin conditions psoriasis, eczema, and hives among them. However, there are a few signs that your rash is more likely to be shingles than something else.
To get shingles, you must have had chickenpox. Shingles, or herpes zoster, occurs when the chickenpox virus reactivates after lying dormant in the body. The Centers for Disease Control and Prevention estimates that 1 out of 3 people in the United States will get shingles in their lifetime. While your risk of getting shingles increases as you age, anyone can get it if they had chickenpox, notes the CDC.
About half of all shingles cases occur in adults age 60 or older, and the risk of getting shingles becomes much greater by age 70, according to the National Institute on Aging.
Can Shingles Be Prevented
Shingles can be prevented. Vaccine is available against varicella zoster virus to prevent chickenpox and shingles. According to the CDC , children are routinely recommended to take two doses of the vaccine, the first dose at the age of 12 to 15 months and the second between four and six years. Two doses of the vaccine are recommended in children and adults who have never had chickenpox. One dose of the vaccine prevents 95% of moderate disease and 100% of severe disease. Two doses of the vaccine are more effective. It is not known how long the vaccine is effective, but studies have shown that the vaccine provides protection against the varicella zoster virus for 10 to 20 years following vaccination.
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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 Causes Shingles
Shingles is a painful skin rash thats caused by the varicella-zoster virus. When you recover from chickenpox, the virus doesnt go away. Instead, it sleeps in your nerve roots. In some people, the virus stays dormant forever. But in others, the virus wakes up when disease, stress or aging weaken your immune system. The virus travels up your nerve roots, which supply feeling to your skin along a pathway on each side of your body. Once the virus is active again, it can only cause shingles, not chickenpox.
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How Is It Treated
It is best to start treatment as soon as possible after you notice the rash. See your healthcare provider to discuss treatment with antiviral medicine, such as acyclovir. This medicine is most effective if you start taking it within the first 3 days of the rash. Antiviral medicine may speed your recovery and lessen the chance that the pain will last for a long time.
Your provider may also recommend or prescribe:
- medicine for pain
- antibacterial salves or lotions to help prevent bacterial infection of the blisters
- corticosteroids
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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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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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