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.
How Long Does A Shingles Outbreak Last
It can take three to five weeks from the time you begin to feel symptoms until the rash totally disappears.
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
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.
What Happens If Shingles Are Not Treated With Medicine
Physicians diagnose about 500,000 new cases of shingles in the United States each year. There is no treatment for shingles, which is a reactivation of the varicella-zoster virus that causes chickenpox however, antiviral medications can reduce the length and severity of symptoms. In approximately 33 percent of the cases, the patient will develop severe complications, according to the Centers for Disease Control and Prevention. Without antiviral medication, problems are most likely to develop among high risk groups, such as the elderly or those with compromised immune systems. But treatment within the first two days of symptoms may reduce the likelihood of complications, such as postherpetic neuralgia, according to the Mayo Clinic 3.
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What Problems Can Happen
Most cases of shingles heal on their own, with or without treatment, and won’t lead to any other problems. In rare cases, shingles can lead to complications, including:
- Ongoing pain : Damaged nerve fibers in the skin send confused messages to the brain, leading to pain. Pain can go on for a long time after the shingles rash is gone. This is the most common shingles complication.
- Vision problems: Shingles near or in an eye can lead to vision loss.
- Skin infections: A shingles rash can become infected with bacteria, leading to impetigo or cellulitis.
- Nervous system problems: Shingles on the face can involve different nerves that connect to the brain. This can lead to nerve-related problems such as facial paralysis, hearing problems, and problems with balance. In very rare cases, shingles can lead to encephalitis .
When You Should See Your Doctor
Go to your doctor as soon as you see the rash, as treatment is most effective if its started early.
Your doctor may prescribe antiviral medicine, which may help you recover faster and will reduce the chance that the pain will last for a long time.
Your doctor may also give you medicine for pain relief.
See your doctor again if:
- you get any blisters on your face
- your fever or pain gets worse
- your neck gets stiff, you cant hear properly or you feel less able to think clearly
- you develop new symptoms such as drooping or weakness to one side of your face
- the blisters show signs of infection or if you see milky yellow drainage from the blister sites.
Call Healthline if you are unsure what you should do.
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The Stages Of Shingles Recovery
After the rash develops, which usually appears on only one side of the body, it forms blisters. You may feel like you have the flu or a mild fever. As you recover, you will typically go through these stages:
- Blisters begin to burst or weep about 5 days after they develop, and lasts from 7 to 10 days. You should take time off from work and other activities during this period, because you can spread the virus to others through the fluid in the blisters. Otherwise, you can return to work when you feel comfortable doing so.
- The blisters will scab over and begin to heal, which takes from 1 to 3 weeks, unless the rash is on your scalp in which case it can take several months.
- As they heal, the blisters become smaller and less painful, generally over a period of 3 to 5 weeks.
- About 10 to 15% of people with shingles will develop chronic nerve pain, which can be severe. Sensitivity to touch at the site of the rash is possible. The older you are, the more likely it is you will develop this disorder, called post-herpetic neuralgia, or PHN. The pain often lessens over time. Available treatments include anti-inflammatory injections, nerve blocks, certain tricyclic antidepressants, or capsaicin cream, which is made from chili peppers and can help ease nerve pain.
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.
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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 .
Shingles Prevention: Reduce Your Risk
The varicella-zoster virus is highly contagious. If you have not had chickenpox, its important that you avoid exposure to anyone known to have the infection or even crowds where you may come in contact with the infection, particularly if you are pregnant. If you already had chickenpox, you cannot catch shingles from someone with chickenpox or shingles.
Having chickenpox during pregnancy could potentially lead to chickenpox infection or birth defects in your unborn child, depending on when you are infected. Shingles, too, could potentially cause problems for your baby, but most experts agree the risk is less than with chickenpox. In one large study, there was no evidence of fetal harm in pregnant women who developed shingles.
If youre not sure if you have had chickenpox, your doctor can perform a blood test to check for antibodies to VZV. If you have the antibodies , you run the risk of shingles in the future, but you cannot catch shingles from someone else.
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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.
Prevent Shingles With Vaccination
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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Can Eye Shingles Cause Blindness
Even with proper treatment, some eye shingles patients still develop eye disorders such as corneal scarring, glaucoma or retinal disease.
For example, eye shingles can cause:
A corneal dendrite which may lead to a scar
In the most severe cases of eye shingles, a patient may need a corneal transplant.
Eye shingles is not contagious. It cannot be spread to another person.
However, a person who has shingles-related rash anywhere on their body can transmit chickenpox virus to someone who hasnt already had chickenpox or been vaccinated for the condition.
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How Well Does Shingrix Work
Two doses of Shingrix provide strong protection against shingles and postherpetic neuralgia , the most common complication of shingles.
- In adults 50 to 69 years old with healthy immune systems, Shingrix was 97% effective in preventing shingles in adults 70 years and older, Shingrix was 91% effective.
- In adults 50 years and older, Shingrix was 91% effective in preventing PHN in adults 70 years and older, Shingrix was 89% effective.
- In adults with weakened immune systems, Shingrix was between 68% and 91% effective in preventing shingles, depending on their underlying immunocompromising condition.
In people 70 years and older who had healthy immune systems, Shingrix immunity remained high throughout 7 years following vaccination.
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If My Shingles Rash Is Mild Or Has Mostly Healed Do I Need To See A Doctor
Its a good idea to see a doctor whenever you have a case of shingles, no matter how mild.
Prompt antiviral treatment not only decreases the duration and severity of the rash but can also decrease the chance of developing post-herpetic neuralgia. Post-herpetic neuralgia is a complication of shingles characterized by long-term, debilitating pain.
If your rash has mostly healed, its still a good idea to see a doctor so they can monitor the rash for changes or complications, such as a bacterial skin infection that forms on top of your existing rash. This is known as a superimposed infection.
Who Is Susceptible To Developing Shingles
According to the CDC, more than 99 percent of Americans 40 years and older have had chickenpox.
Its important to note that even if you dont remember having the disease, it may be lying dormant in your body. Therefore, much of Americas population of people 40 and older are susceptible to developing shingles.
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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.
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.
What Are Risk Factors For Shingles
A weakened immune system might wake up the virus. After youâve had chickenpox, youâre more likely to get shingles if you:
- Are 50 or older
- Are under a lot of stress
- Have cancer, HIV, or another disease that lowers your bodyâs defenses
- Have had a serious physical injury
- Take long-term steroids or other medicines that can weaken your immune system
But many people who get shingles donât fit into any of these categories.
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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.