What To Do If You Have Shingles

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:

What Triggers Shingles Flare

Most people who get shingles will have a one and done type of experience. In other words, theyll get it and likely never have it again. That said, there are some people who get shingles more than once.

Heres how it happens: the varicella-zoster virus, the same virus that causes chickenpox, lies dormant in nerve cells after you recover from chickenpox or shingles.

For the most part, the virus stays inactive after your shingles symptoms subside and youve healed. But certain risk factors can trigger flare-ups and cause the virus to reactivate. Experts call this recurrent shingles.

A 2021 review looked at the incidences of first and recurrent shingles episodes and found that the average time between infections was 2 years for people ages 45 to 54 and 3 years for those ages 55 and older.

In addition, of the participants who experienced a flare-up, the incidence was higher in those who were immunosuppressed compared with people with healthy immune systems.

In other words, if you have a compromised or weakened immune system, you have a greater chance of getting shingles again. This can happen if you:

• are undergoing chemotherapy

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 .

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Can I Prevent Shingles

There are two shingles vaccines. Shingrix is recommended over the older vaccine, Zostavax, because it is more than 90% effective in preventing a shingles outbreak

Who should get it: The CDC recommends that you get this vaccine if youâre a healthy adult age 50 or older, whether or not you remember having had chickenpox, because most people have been exposed to the virus. If you have had the Zostavax vaccine, you can also have Shingrix.

How many shots do you need? You would need two shots for Shingrix: One at first, with a follow-up in 2 to 6 months.

What it does:Shingrix reduces your chance of getting shingles by more than 90%. Even if you still get shingles, the vaccine may help it be less painful.

I never had chickenpox. Do I still need the shingles vaccine? Yes, you do. Shingrix is recommended for everyone age 50 or older, whether or not you remember having had chickenpox.

If Iâve had shingles, can I still get the vaccine? Yes. It may help prevent you having another bout of shingles later on. If you have shingles right now, you should wait until the rash is gone before you get vaccinated.

Donât get the Shingrix vaccine if you:

• Are allergic to any of the ingredients
• Are pregnant or nursing
• Have tested negative for immunity to the chickenpox virus. Ask your doctor about the chickenpox vaccine instead.
• Have shingles now

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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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:

Shingles And Chickenpox Vaccination

The National Immunisation Program provides a free shingles vaccine, Zostavax® at 70 years of age . There is also a free catch-up program for 71 to 79 year olds until the end of 2021. The Zostavax® vaccine is available on prescription for people aged 50 to 69 years and from 80 years but it must be paid for by the patient.

Zostavax® vaccine contains live attenuated varicella-zoster virus, containing 14 times more virus than childhood varicella vaccines and is contraindicated in immunocompromised people. Zostavax® vaccine should not to be used in people with compromised immune function due to the risk of disseminated disease from the vaccine virus.

• Safety advisory – Zostavax® vaccine for health professionals and consumers

Vaccination is still recommended for people who have had shingles infection in the past. It is recommended to wait at least a year after recovery.

The NIP provides a free chickenpox vaccine to children aged 18 months of age and as catch-up for children up to 20 years of age as part of the No Jab No Pay legislation. People aged 14 years and older require two doses of the chickenpox vaccine, one to two months apart. People from 20 years of age must purchase the vaccine privately.

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Shingles On Your Face

Shingles usually occurs on one side of your back or chest, but you can also get a rash on one side of your face.

If the rash is close to or in your ear, it can cause an infection that could lead to:

• loss of hearing
• issues with your balance
• weakness in your facial muscles

Shingles inside your mouth can be very painful. It may be difficult to eat and may affect your sense of taste.

A shingles rash on your scalp can cause sensitivity when you comb or brush your hair. Without treatment, shingles on the scalp can lead to permanent bald patches.

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.

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Do You Always Get The Typical Rash If You Have Shingles

Occasionally, some people dont get a rash. If you have any of the other symptoms of shingles , see your healthcare provider sooner rather than later. There are effective treatments you can take early for shingles. Even if you dont have shingles, seeing your healthcare provider will help you get your condition diagnosed and treated.

What Are The Symptoms Of Shingles

The initial symptoms of shingles include:

• a burning, tingling or itching sensation
• a stabbing sensation
• numbness in the affected area of the body
• sensitivity to light
• fever and/or headache

Two to 3 days after these symptoms appear, a painful rash will appear on the sensitive area of skin, usually on one side of the body in the area of one skin nerve .

At first this rash consists of painful red bumps that quickly develop into fluid-filled blisters, which will eventually have a crusty surface. The rash can last for 10 to 15 days.

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Can You Still Develop Shingles If Youve Been Vaccinated For Chickenpox

Yes. Despite being vaccinated for chickenpox, you can still get shingles. No vaccine is 100% protective, and the effectiveness of vaccines lessens with time. However, people who get the chickenpox vaccine are significantly less likely to develop shingles later in life compared with people who never received the chickenpox vaccine. One recent 12-year study found that the number of shingles cases was 72% lower in children who had received the chickenpox vaccine compared with those who didnt.

Should Someone With Shingles Stay Home From Work Or School

In general, as long as the lesion can be covered, a person with shingles does not need to stay home from work or school.

Health care workers and others working with high-risk individuals should remain home from work until the blisters have scabbed over.

Anyone who cannot keep their blisters covered should stay home from work or school until all blisters have scabbed over.

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How Can I Take Care Of Myself

• Take a pain-relief medicine such as acetaminophen. Take other medicine as prescribed by your healthcare provider.
• Put cool, moist washcloths on the rash.
• Rest in bed during the early stages if you have fever and other symptoms.
• Try not to let clothing or bed linens rub against the rash and irritate it.
• You develop worsening pain or fever.
• You develop a severe headache, stiff neck, hearing loss, or changes in your ability to think.
• The blisters show signs of bacterial infection, such as increasing pain or redness, or milky yellow drainage from the blister sites.
• The blisters are close to the eyes or you have pain in your eyes or trouble seeing.
• You have trouble walking.

Can You Get Shingles More Than Once

Although possible, its rare to experience shingles more than once. In a 2019 study , researchers found the reoccurrence rate of shingles was 5.3 percent over an average of a 4.4-year follow-up period.

The researchers found that experiencing shingles that lasted more than 30 days significantly increased the risk of reoccurrence. Other risk factors were:

• being 51 to 70 years old
• having shingles lasting longer than 90 days
• having a blood cancer, an autoimmune disease, high blood pressure, or dyslipidemia

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Are There Natural Ways To Boost Your Immune System To Help Lessen The Chances Of Developing Shingles

Stress is a risk factor for developing shingles, so limiting your stress can be helpful. Try meditation, yoga or other relaxation methods.

Other things you can do include:

• Eat a healthy diet.
• Aim for seven to nine hours of sleep each night.
• Dont smoke or use tobacco products.

These are all tips for an overall healthy lifestyle, not just for reducing your chance of getting shingles.

What Is The Outlook

If you have a particularly severe case of shingles, it could take months to go away. It can also become a long-term problem for some people. If you have postherpetic neuralgia, you may need to see your doctor more often.

Complications that involve the eye or ear may require ongoing care, especially if you have lingering vision or hearing problems.

Most people have shingles only once, but it can recur. This is more likely to happen if you have a weakened immune system.

If you havent had any major complications, your symptoms should clear up within a matter of weeks with few, if any, lasting effects.

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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.

Can I Give Shingles To Others

No one can catch shingles from you. But the virus can be spread to a person who has never had chickenpox. The virus lives in the blisters that shingles causes. It can be spread until the blisters are completely healed. If you have blisters that have not crusted over yet, you should stay away from:

• Anyone who has never had chickenpox
• Babies under 12 months old
• Very sick people

Tell your doctor if you live with children who have not had chickenpox. They may need to be vaccinated.

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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

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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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.

Who Should Not Get Shingrix

You should not get Shingrix if you:

• Have ever had a severe allergic reaction to any component of the vaccine or after a dose of Shingrix.
• Currently have shingles.
• Currently are pregnant. Women who are pregnant should wait to get Shingrix.

If you have a minor illness, such as a cold, you may get Shingrix. But if you have a moderate or severe illness, with or without fever, you should usually wait until you recover before getting the vaccine.

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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

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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