First Signs: Burning Tingling Or Numbness Of The Skin
Usually, a small area of skin may burn, tingle, itch or simply feel very sensitive before any rash occurs, says Alina G. Bridges, D.O., an associate professor of dermatology at the Mayo Clinic in Rochester, MN. This sensation can last roughly one to three days prior to skin lesions appearingand the discomfort can be intense. Its often mistaken for appendicitis, a heart attack or severe headache, says Dr. Bridges.
What If I Have Shingles And A Poor Immune System
If you have a poor immune system and develop shingles then see your doctor straightaway. You will normally be given antiviral medication whatever your age and will be monitored for complications. People with a poor immune system include:
- People taking high-dose steroids. per day for more than one week in the previous three months. Or, children who have taken steroids within the previous three months, equivalent to prednisolone 2 mg/kg per day for at least one week, or 1 mg/kg per day for one month.)
- People on lower doses of steroids in combination with other immunosuppressant medicines.
- People taking anti-arthritis medications which can affect the bone marrow.
- People being treated with chemotherapy or generalised radiotherapy, or who have had these treatments within the previous six months.
- People who have had an organ transplant and are on immunosuppressive treatment.
- People who have had a bone marrow transplant and who are still immunosuppressed.
- People with an impaired immune system.
- People who are immunosuppressed with HIV infection.
How Contagious Is Disseminated Shingles
Zoster transmission A person is not infectious before the blisters appear or after the rash has crusted over. For disseminated zoster, transmission occurs through airborne and droplet transmission, in addition to contact with fluid in the blisters of the rash. Disseminated zoster is likely as infectious as varicella.
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Can Shingles Come Back
Given that shingles results from the varicella zoster virus reactivating some amount of time after having chickenpox, you may be wondering if the virus can…re-reactivate after having shingles.
“Once shingles clears up, the virus simply goes back into hiding and, unfortunately, it can reactivate again in the future,” says Dr. Brown. “As far as the likelihood of shingles reoccurring, that’s still largely up for debate. One study found that the chance of getting shingles a second time is about 5%, but other studies show this number to be lower.”
One way to reduce your risk of getting shingles twice is the same preventive measure that helps prevent you from ever getting it in the first place: the shingles vaccine.
Signs And Symptoms Of Shingles
Shingles may cause mild to severe pain, and the viral rash most commonly appears on the trunk, notes the CDC. Unlike chickenpox, the shingles rash usually occurs on one side of the body or face.
The first symptom of shingles is usually pain, itching, or tingling in the area where the shingles rash will later appear. This may happen several days before the rash erupts, leading to fluid-filled blisters like those of chicken pox. The blisters typically scab over in 7 to 10 days and clear up within two to four weeks, according to the CDC.
Other signs and symptoms of shingles may include:
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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.
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.
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Steroid Medication For Shingles
Steroids help to reduce swelling . A short course of steroid tablets may be considered in addition to antiviral medication. This may help to reduce pain and speed healing of the rash. However, the use of steroids in shingles is controversial. Your doctor will advise you. Steroids do not prevent PHN.
What The Research Says
What we do know is that when your immune system is compromised or distracted fighting off another virus, it tends to give the herpes zoster virus a chance to reactivate.
Past research has established that immune-suppressing medications like chemotherapy and corticosteroids as well as health conditions that attack your immune system like Crohns disease, HIV, and lupus increase your risk for a shingles outbreak.
Researchers are currently trying to understand whether COVID-19 may do the same thing.
Preliminary data suggests that this could be the case, but we do not know yet.
A small 2021 study involving 491 vaccinated people in Israel showed that six participants experienced shingles for the first time after getting their first dose of COVID-19 vaccine. All six individuals had pre-existing conditions that lowered their natural immune response, and all six fully recovered after developing shingles.
This study prompted researchers to advocate for more studies on COVID-19 vaccines as possible triggers for the shingles virus.
Data gathered in Brazil also showed an increase of 10.7 cases of shingles per million inhabitants during the time of the pandemic.
Its impossible to know exactly how and to what extent the effect of increased stress of the pandemic and other factors played into these numbers increasing during that span of time. Stress has long been suspected to be a possible factor in developing shingles.
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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.
When Should I Get The Shingles Vaccine
The current shingles vaccine is a safe, easy, and more effective way to prevent shingles than the previous vaccine. In fact, it is over 90% effective at preventing shingles. Most adults age 50 and older should get vaccinated with the shingles vaccine, which is given in two doses. You can get the shingles vaccine at your doctors office and at some pharmacies.
You should get the shingles vaccine if you:
- Have already had chickenpox, the chickenpox vaccine, or shingles
- Received the prior shingles vaccine called Zostavax
- Dont remember having had chickenpox
Medicare Part D and private health insurance plans may cover some or all of the cost. Check with Medicare or your health plan to find out if it is covered.
You should not get vaccinated if you:
- Currently have shingles
- Are sick or have a fever
- Had an allergic reaction to a previous dose of the shingles vaccine
If you are unsure about the above criteria or have other health concerns, talk with your doctor before getting the vaccine.
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Week Two: Possible Infection
It is important to wash your hands, keep the shingles rash and blisters clean and try not to scratch. Scratching blisters can cause infection, says Dr. Bridges. Cellulitis and impetigo are two secondary skin infections associated with shingles. Folks with a compromised immune system are far more likely to also develop these types of infections. If your shingles rash swells, become pus-filled or weeps, these are signs that you have, in fact, gotten a bacterial infection. A topical antibiotic may be prescribed to apply to lesions to treat an infection, says Dr. Bridges, noting that a topical can also help prevent infection.
Questions To Ask Your Doctor
- Ive had chickenpox. Am I at risk of developing shingles?
- What is the best treatment for my shingles?
- The pain from shingles isnt going away. What can I do to make myself more comfortable?
- Im on treatment for shingles. When should I call my doctor if things dont get better?
- I have shingles and my children havent had the chickenpox vaccine. Should I get them vaccinated?
- Is the shingles vaccine right for me?
- Are there any risks associated with the shingles vaccine?
- Will my post-herpetic neuralgia ever go away?
- If Ive never had the chickenpox, should I still get the shingles vaccination?
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Could It Really Be Monkeypox
The first thing to ask yourself is â do you think you could have been exposed? It takes close, prolonged contact â often skin-to-skin â with an infected person. There are very few people in the world who currently have it, meaning there are not that many opportunities to catch it.
Even in remote parts of some African countries where it can sometimes circulate, children rarely contract it.
If you were to get sick with monkeypox, the first thing you would notice is flu-like symptoms â feeling tired, generally unwell and feverish. Itâs what doctors call the âinvasion periodâ of the disease, when the virus enters your cells.
Your glands would feel swollen because your immune system is ramping up to fight the infection.
Next comes the rash, which goes through different âskin eruptionâ phases. It starts off flat and red, but then gets bumpy and blistered, before forming scabs.
Dr Rosamund Lewis from the World Health Organizationâs Emergencies Programme explains: âIt starts with what we call macules. These are just red areas. Then it progresses to papules. This is something you can feel. Itâs raised.â
Those red lumps and bumps then start to blister, and fill with a whitish fluid that looks like pus.
These pustules then begin to dry out and scab over. Eventually, the scabs will heal and drop off.
âThis is why it can be confused with chickenpox,â says Dr Lewis.
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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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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.
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.
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Face And Head Involvement
When an outbreak of shingles occurs on the head or face, it also typically is found on one side of the scalp, face, mouth or neck or in one eye or ear. As with the rash on the body, the location corresponds to a reactivation of the virus within a nerve. The nerves that supply sensation and motor function to the head and face are called cranial nerves. In addition to causing a painful, blistering red skin rash on the face or head, shingles involving a cranial nerve may cause weakness of the corresponding face muscles. Shingles involving the inside of the mouth or ear may cause ulcers and problems with taste or hearing.
- When an outbreak of shingles occurs on the head or face, it also typically is found on one side of the scalp, face, mouth or neck or in one eye or ear.
- In addition to causing a painful, blistering red skin rash on the face or head, shingles involving a cranial nerve may cause weakness of the corresponding face muscles.
Other Complications Of Shingles
If the shingles rash appears around the eye or forehead, it can cause eye infections and temporary or permanent loss of vision. If the shingles virus attacks the ear, people may develop hearing or balance problems. In rare cases, the shingles virus may attack the brain or spinal cord. These complications can often be prevented by beginning treatment for shingles as soon as possible.
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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.
You are sick with an illness and a fever of 101Â°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.
Month Three To Multiple Years: Long
Most peoples pain decreases within two to three months, but for some the pain lingers longer. That persistent pain, called postherpetic neuralgia, is the most common complication of shingles, impacting up to 18% of folks with the infection. PHN develops when nerve fibers are damaged at the site of the shingles rash. The pain may be constant or intermittent, moderate, severe or even incapacitatingand it may last for months or even years. Its experienced as burning, itching, a stabbing pain or an altered sensation, says Dr. Rosen. While anyone can suffer with post herpetic neuralgia, your risk increases with age and with a history of chronic illness, such as asthma or diabetes.
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Check If You Have Shingles
The first signs of shingles can be:
- a tingling or painful feeling in an area of skin
- a headache or feeling generally unwell
A rash will appear a few days later.
Usually you get the shingles rash on your chest and tummy, but it can appear anywhere on your body including on your face, eyes and genitals.
The rash appears as blotches on your skin, on 1 side of your body only. A rash on both the left and right of your body is unlikely to be shingles.
Scott Camazine / Alamy Stock Photo https://www.alamy.com/herpes-zoster-shingles-rash-image3217474.html?pv=1& stamp=2& imageid=04C48F81-4F80-4503-BEE8-E369C12FA659& p=9949& n=0& orientation=0& pn=1& searchtype=0& IsFromSearch=1& srch=foo%3dbar%26st%3d0%26pn%3d1%26ps%3d100%26sortby%3d2%26resultview%3dsortbyPopular%26npgs%3d0%26qt%3dA02G43%26qt_raw%3dA02G43%26lic%3d3%26mr%3d0%26pr%3d0%26ot%3d0%26creative%3d%26ag%3d0%26hc%3d0%26pc%3d%26blackwhite%3d%26cutout%3d%26tbar%3d1%26et%3d0x000000000000000000000%26vp%3d0%26loc%3d0%26imgt%3d0%26dtfr%3d%26dtto%3d%26size%3d0xFF%26archive%3d1%26groupid%3d%26pseudoid%3d%26a%3d%26cdid%3d%26cdsrt%3d%26name%3d%26qn%3d%26apalib%3d%26apalic%3d%26lightbox%3d%26gname%3d%26gtype%3d%26xstx%3d0%26simid%3d%26saveQry%3d%26editorial%3d1%26nu%3d%26t%3d%26edoptin%3d%26customgeoip%3d%26cap%3d1%26cbstore%3d1%26vd%3d0%26lb%3d%26fi%3d2%26edrf%3d0%26ispremium%3d1%26flip%3d0%26pl%3d
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Shingles: Not Just A Band Of Blisters
Shingles is a common condition in which the virus that causes chickenpox reactivates after years of lying dormant in your body. As the virus reactivates, it causes pain and tingling and eventually a rash of short-lived blisters.
“Shingles normally isn’t a serious condition, but in some people the rash can cause an eye infection,” explains Jeffery Wheeler, M.D., Mayo Clinic Health System family physician. “Vaccines can help reduce the risk of shingles, while early treatment can help shorten a shingles infection and lessen the chance of complications.”
One complication is called postherpetic neuralgia, which can cause the skin to remain painful and sensitive to touch for months or years. When identified early, shingles can be treated with prescription medications that help shorten the infection and reduce the risk of complications.
Dr. Wheeler says signs and symptoms of shingles may include:
- A feeling of pain, burning, tingling, itching, numbness or extreme sensitivity in a limited area of your body
- A red rash with fluid-filled blisters that begins a few days after the pain and lasts two to three weeks before scabbing over and healing
- General feeling of unease and discomfort
A person with shingles can pass the varicella-zoster virus to anyone who isn’t immune to chickenpox. This usually occurs through direct contact with the open sores of the shingles rash. Once infected, the person will develop chickenpox, however, not shingles.
- Anyone who has a weak immune system
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