How Common Is Shingles
Shingles affects 1 out of every 3 people in the United States. More than 1 million cases of shingles are diagnosed every year. The risk of shingles increases as you get older, with about half the cases occurring in people over the age of 50. Shingles develops in about 10% of people who have had chickenpox at an earlier time in their life.
What Are The Symptoms
The first sign of shingles is often burning, sharp pain, tingling, or numbness in your skin on one side of your body or face. The most common site is the back or upper abdomen. You may have severe itching or aching. You also may feel tired and ill with fever, chills, headache, and upset stomach or belly pain.
One to 14 days after you start feeling pain, you will notice a rash of small blisters on reddened skin. Within a few days after they appear, the blisters will turn yellow, then dry and crust over. Over the next 2 weeks the crusts drop off, and the skin continues to heal over the next several days to weeks.
Because shingles usually follows nerve paths, the blisters are usually found in a line, often extending from the back or side around to the belly. The blisters are almost always on just one side of the body. Shingles usually doesn’t cross the midline of the body. The rash also may appear on one side of your face or scalp. The painful rash may be in the area of your ear or eye. When shingles occurs on the head or scalp, symptoms can include headaches and weakness of one side of the face, which causes that side of the face to look droopy. The symptoms usually go away eventually, but it may take many months.
In some cases the pain can last for weeks, months, or years, long after the rash heals. This is called postherpetic neuralgia.
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What Are Symptoms Of Shingles
The first signs of shingles include:
- Unusual sensations such as tingling, itching, or burning in an area of skin on one side of the body
After one to two days, signs and symptoms of shingles include:
- A rash that looks like a band-like pattern of blisters on one side of the body
- Commonly appears on the trunk but can appear on almost any part of the body
- After three to four days, blisters become open sores
- After 7 to 10 days, sores crust over and are no longer contagious
- A rash near the eye that can permanently affect vision if not treated
Skin color changes and scarring may occur after shingles have gone away.
Shingles Chickenpox And Pregnancy
An attack of shingles during pregnancy will not harm the unborn baby. The mother is already carrying the varicella zoster virus before developing shingles and there is no increase in the risk of passing it on to the fetus if shingles develops. However, an attack of chickenpox during pregnancy can be serious and requires urgent medical attention.
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Shingles Rash In The Eyes
Ophthalmic shingles, or herpes zoster ophthalmicus , is when the shingles rash is in and/or around the eye. It is a severe variant that affects 20% of people with the infection.
If you develop a shingles rash near your eye, contact your healthcare provider right away.
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HZO usually appears within two to four weeks after a shingles rash starts. People who have a compromised immune system, such as those with HIV/AIDS, are at higher risk for developing this.
All parts of the eye can be affected. For example:
- You can develop blisters around the eye that may cause the eyelids and surrounding area to swell.
- The corneaâthe transparent part over the front of the eyeâcan be affected, causing calcification .
- Blood vessels in the eye could become more pronounced blood flow to the eye could be impacted.
To reduce your risk of long-term eye complications, contact your healthcare provider right away if you have a shingles rash on your face.
Active Phase Of Shingles
The active phase of shingles begins with the appearance of a rash. The shingles rash is red, inflamed, and turns into fluid-filled pustules. The rash usually appears on one side of the body in a band.
The torso is the most common area affected by the shingles rash. It can take 1421 days for the rash to crust over and no longer be contagious. Other symptoms that occur during the active phase include:
- Acute neuritis : Burning, throbbing, and stabbing pain at the infection site.
- Postherpetic neuralgia : When nerve pain persists for 90 days after the onset of the rash, it is called PHN. Other symptoms of PHN are numbness, itching, and sensitivity to touch. About 10%15% of people with shingles will develop PHN.
- Cellulitis : Immunosuppressed people and the elderly are at risk of developing skin infections from bacteria such as Staphylococcus aureus and Streptococcus pyogenes.
- Vision deficit or blindness: If the virus involves the ophthalmic division of the fifth cranial nerve or the cornea, it can cause blindness.
- Ramsay Hunt syndrome: Also known as herpes zoster oticus, can cause facial paralysis, ear pain, blisters in the ear, hearing abnormalities, altered taste, and tongue lesions.
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What Can Be Done For Recurrent Shingles
Though most people will experience only one episode of shingles during their lifetime, recurrence can occur in certain individuals. In order to help prevent recurrent episodes of shingles, individuals with no contraindications can receive the zoster vaccine , which can prevent recurrent episodes of shingles. Otherwise, people who do experience a recurrent case of shingles should see their doctor as soon as the rash appears to promptly receive antiviral medication.
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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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What Shingles Symptoms Come Next
After about 1 to 5 days, a shingles rash will appear on one side of the body, often in a single characteristic band around one side of the torso or face.
The painful rash will then form itchy or burning blister-like sores filled with a clear fluid. The blisters will scab over in 7 to 10 days. Theyll gradually grow smaller before disappearing.
Shingles rash symptoms commonly last between 2 to 4 weeks.
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Tingling Pain Or Numbness
During the first stage of shingles, before anything appears on your skin, a particular area of your body may begin to feel different. âWhen a shingles outbreak is starting, you may feel itching, burning, or pain,â Kim says. Often you will feel this on only one side of your body.
The initial signs of shingles may feel different for each person. In some cases, shingles can cause intense sensitivity, making it painful to even wear clothes over your skin, while in other cases, your skin may feel numb.
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Timeline Of Shingles Symptoms
Shingles actually doesn’t occur without a prior chickenpox infection. VZV lies dormant in nerve roots after you recover where it can reactivate years later, returning as shingles. But though they share the same viral cause, the two conditions are distinct.
The first sign of shingles is usually a burning or stinging sensation in a band-like formation around the waist, chest, stomach, or back.
You may experience itching or become incredibly sensitive to even the softest touch. The weight of bed sheets on your skin may be uncomfortable. You may also experience fatigue, fever, and headache.
After a few days or even up to a couple of weeks, the telltale shingles rash will appear. This rash consists of fluid-filled blisters that worsen quickly. The blisters may look like chickenpox, but they are clustered together.
The shingles rash can vary in color, depending on your skin tone. On darker skin, the rash may be pink, grayish, dark brown, or even purple. On lighter skin, it will be red.
This is the stage at which VZV can be passed on to someone who has never had or been vaccinated against chickenpox.
Blisters typically scab over within a week to 10 days. Shingles typically takes three to five weeks to progress through all of its stages.
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.
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How To Diagnose Shingles Without Rash
Shingles is viral infections that may be occurring after being dominant at central nervous system and it is difficult to diagnose it without rash but still, some symptoms can represent its occurrence. When a person is suffering from shingles, he or she may experience symptoms to one side of the body like face, neck, and eyes as well as in the internal organs.
These symptoms can be a feeling of tingling or numbness, itchiness, sensitivity to touch, headache, burning sensations, pain that comes from the spine like dermatomal pain and often laboratory investigations. The laboratory investigation may include immune-fluorescent microscopy of vesicle cells, serological testing, and real-time polymerase chain reaction.
Things that increase risk for shingles include:
- Having had chickenpox. You must have had chickenpox to get shingles.
- Being older than 50.
- Having a weakened immune system due to another disease, such as diabetes or HIV infection.
- Experiencing stress or trauma.
- Having cancer or receiving treatment for cancer.
- Taking medicines that affect your immune system, such as steroids or medicines that are taken after having an organ transplant.
If a pregnant woman gets chickenpox, her baby has a high risk for shingles during his or her first 2 years of life. And if a baby gets chickenpox in the first year of life, he or she has a higher risk for shingles during childhood.footnote 1
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
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What Are The Symptoms Of Shingles
Usually, shingles develops on just one side of the body or face, and in a small area. The most common place for shingles to occur is in a band around one side of the waistline.
Most people with shingles have one or more of the following symptoms:
- Fluid-filled blisters
- Tingling, itching, or numbness of the skin
- Chills, fever, headache, or upset stomach
For some people, the symptoms of shingles are mild. They might just have some itching. For others, shingles can cause intense pain that can be felt from the gentlest touch or breeze. Its important to talk with your doctor if you notice any shingles symptoms.
If you notice blisters on your face, see your doctor right away because this is an urgent problem. Blisters near or in the eye can cause lasting eye damage and blindness. Hearing loss, a brief paralysis of the face, or, very rarely, inflammation of the brain can also occur.
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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How Is Postherpetic Neuralgia Treated
Treatments include lotions or creams and/or other medications not specifically used for pain, such as antidepressants or drugs for epilepsy. Regular pain relievers are not usually effective for this type of pain.
If your pain doesnt lessen, you might try therapies like nerve blocks or steroid injections near the area where the nerves exit the spine. Your provider might suggest an implantable nerve stimulator device for severe, ongoing pain that hasnt responded to other treatments.
Who Should Not Be Vaccinated With Shingrix
You shouldnt receive the Shingrix vaccine if you:
- Have ever had a severe allergy to this vaccine or any ingredient in this vaccine.
- Are breastfeeding or pregnant.
- Currently have shingles.
- Are ill and have a high fever.
- Have tested negative for immunity to varicella-zoster virus .
Ask your healthcare provider if the benefits of getting the vaccine outweigh any potential risks.
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