Is There A Treatment For Shingles
Several antiviral medicines, acyclovir , valacyclovir , and famciclovir , are available to treat shingles. These medications should be started as soon as possible after the rash appears and will help shorten the illness and decrease how severe the illness is. Pain medicine may also help with pain caused by shingles. Call your provider as soon as possible to discuss treatment options.
How Is Shingles Treated
Specific treatment for shingles will be determined by your healthcare provider based on:
- Your age, overall health, and medical history
- How long the shingles have been present
- Extent of the condition
- Your tolerance for specific medicines, procedures, or therapies
- Expectations for the course of the condition
- Your opinion or preference
There is no cure for shingles. It simply has to run its course. Treatment focuses on pain relief. Painkillers may help relieve some of the pain. Antiviral drugs may help lessen some of the symptoms and reduce nerve damage. Other treatments may include:
- Creams or lotions to help relieve itching
- Cool compresses applied to affected skin areas
- Antiviral medicines
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.
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What Is The Contagious Period For Shingles
The virus that causes shingles, the varicella-zoster virus, can be transmitted from person to person by direct contact with the fluid from the active blistering rash. Therefore, susceptible individuals should avoid contact with people who have active shingles, especially pregnant women who have never had chickenpox and immunocompromised individuals. It cannot be transmitted by coughing or sneezing, and it is not contagious before the blisters appear. Once the shingles rash has dried and developed crusting, it generally is not considered to be contagious.
There are a few important points to consider when discussing the varicella-zoster virus and transmissibility.
- If an individual who has never had chickenpox or the chickenpox vaccine comes in direct contact with the fluid from the shingles rash, they may go on to develop chickenpox, but they will not immediately develop shingles.
- It is possible, however, for them to develop shingles later in life, just as it is with others who have previously been exposed to the virus and developed chickenpox.
- Also, if you have previously been exposed to the varicella-zoster virus and you have had chickenpox, you will not contract the virus from others with shingles.
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.
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Hows Shingles Without A Rash Diagnosed
Shingles without a rash isnt common, but it may be more common than previously thought because it often goes undiagnosed. Shingles without a rash is difficult to diagnose based on your symptoms alone.
Your doctor may test your blood, cerebrospinal fluid, or saliva to identify the presence of VZV antibodies. This will allow them to confirm a diagnosis of shingles without a rash. However, these tests are often inconclusive.
Your medical history may provide clues that suggest you have shingles without a rash. Your doctor may ask if youve had a recent operation or if youre under increased stress.
Once your doctor suspects you have VZV, theyll use antiviral medicines such as acyclovir to treat the shingles. They may also prescribe drugs for the pain.
Other treatment will vary based on the location and severity of symptoms.
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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Who’s At Risk For Shingles
Anyone who has ever had chickenpox can get shingles, but the risk increases with age. People older than age 60 are up to 10 times more likely to get shingles than younger people. Other factors that increase your risk include:
- Some cancer medicines
- A weak immune system from illnesses such as cancer or HIV
A quarter of adults will develop shingles at some point, and most are otherwise healthy.
What Should I Do About An Exposure To Varicella
If you have been in contact with someone with chickenpox or shingles, or if you have a rash-associated illness that might be chickenpox or shingles, discuss your situation with your healthcare provider. Blood tests may be done to see if you have become infected with the virus or have had the disease in the past. If you are pregnant and not immune and have been exposed to chickenpox or shingles, call your healthcare provider immediately. Your provider may choose to treat you with a medication called varicella-zoster immune globulin , but in order for this medication to be most helpful, it needs to be given as soon as possible after your exposure to varicella.
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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.
How To Prevent Shingles: Get Vaccinated
Two vaccines may help prevent the shingles virus: the chickenpox vaccine and the shingles vaccine. The shingles vaccine is approved for adults ages 50 and older and for those 18 and older with weakened immune systems or at increased risk of herpes zoster because of a disease or treatment, according to the CDC.
Per the CDC, talk to your doctor about getting a shingles vaccination if you are 50 or older or if you have the following risk factors:
- You have cancer, especially leukemia or lymphoma.
- You are a bone marrow or solid organ transplant recipient.
- You take immunosuppressive medications, including steroids, chemotherapy, or transplant-related medications.
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Other Complications Some Severe Include:
- Bacterial infection of the rash
- Herpes zoster ophthalmicus causes eye problems when shingles is severe on the face, near the eyes, impacting sight. When very severe, blindness can occur
- Ramsay Hunt syndrome causes problems within the ear’s auditory canal or external parts. It is accompanied by ear pain, internal or external blisters, and one-sided facial paralysis
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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Im Pregnant And Have Recently Been Exposed To Someone With Chickenpox How Will This Exposure Affect Me Or My Pregnancy
- Susceptible pregnant women are at risk for associated complications when they contract varicella. Varicella infection causes severe illness in pregnant women, and 10%-20% of those infected develop varicella pneumonia, with mortality reported as high as 40%.
- Because of these risks, pregnant women without evidence of immunity to varicella who have been exposed to the virus may be given varicella-zoster immune globulin to reduce their risk of disease complications.
- If you are pregnant and have never had chickenpox, and you get chickenpox during the:
- First half of your pregnancy, there is a very slight risk for birth defects or miscarriage.
- Second half of your pregnancy, the baby may have infection without having any symptoms and then get shingles later in life.
- Newborns whose mothers develop varicella rash from 5 days before to 2 days after delivery are at risk for neonatal varicella, associated with mortality as high as 30%. These infants should receive preventive treatment with varicella-zoster immune globulin .
Is A Vaccine Available To Prevent Shingles
Two vaccines are available in the United States to reduce your chance of developing shingles and postherpetic neuralgia. One vaccine, Zostavax®, has been available since 2006. The second vaccine, Shingrix®, has been available since 2017. Shingrix is recommended as the preferred vaccine by the Advisory Committee on Immunization Practices, a group of medical and public health experts.
Shingrix is given as a two-dose shot in your upper arm. You should receive the second dose two to six months after receiving the first. Shingrix has been shown to be more than 90% effective in preventing shingles and postherpetic neuralgia. Its effectiveness remains above 85% for at least four years after receiving the vaccine.
What Are The Complications Associated With Shingles
Shingles is not usually dangerous to healthy individuals although it can cause great misery during an attack. Anyone with shingles on the upper half of their face, no matter how mild, should seek medical care at once because of the risk of damage to the eye. Very rarely, shingles can lead to pneumonia, hearing problems, blindness, brain inflammation or death. For about one person in five, severe pain can continue even after the rash clears up. This pain is called post-herpetic neuralgia. As people get older, they are more likely to develop post-herpetic neuralgia, and it is more likely to be severe.
Is Shingles Contagious
People cannot catch shingles from another person but it is possible for someone to catch chickenpox from a person with shingles. This can only happen if someone has not had chickenpox or received the chickenpox vaccine.
The varicella-zoster virus present in shingles blisters can be spread if someone comes into direct contact with the fluid. It remains contagious until the last blister has dried up and scabbed over.
The risk of spreading the virus is low if the rash is kept covered. Individuals with shingles should avoid contact with anyone who has not already had chickenpox. This is particularly important in the following cases:
- Gilden, D., Cohrs, R. J., Mahalingam, R., & Nagel, M. A. . Neurological disease produced by varicella zoster virus reactivation without rash. Current Topics in Microbiology and Immunology, 342,, 243253
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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.
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.
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When To See A Doctor
A person should see a doctor if they are experiencing any early symptoms of shingles, especially if they have a history of shingles or are at a higher risk of developing an acute outbreak of the virus due to any of the risk factors above.
A person undergoing treatment for shingles should follow up with a doctor if:
- the symptoms get significantly worse after treatment
- the symptoms do not go away within a few weeks
- new or different symptoms appear in addition to the rash
- there are signs of secondary infection, such as high fever, an open wound, or red streaks coming out of a shingles lesion
People should also speak to a doctor if they have lasting nerve pain in the affected region after the rash of shingles disappears. This complication, called postherpetic neuralgia, affects
In many cases , a doctor will prescribe an antiviral medication, such as famciclovir, valacyclovir, or acyclovir. Pain-relieving medicine can also help ease symptoms. Calamine lotion, colloidal oatmeal compresses and baths, and cold compresses may ease the itching of shingles.
It is important to refrain from scratching the affected area as this can irritate the blisters and increase the risk of infection.
Some people develop a superimposed bacterial skin infection over their shingles lesions. This infection can be very painful, and it may spread if a person does not receive treatment. Individuals who develop this infection in addition to shingles may require antibiotic treatment or even hospitalization.
Once You’ve Had Shingles Can It Come Back
Reoccurrence is relatively uncommon. Only a small percentage of patients may have a second episode, more commonly in women. “Three or more shingles episodes in the same person is considered extremely rare,” says Dr. Mohring. “In this case, it would prompt us to investigate other potential diseases that may be going on. Those with higher risk factors, especially weakened immune systems or autoimmune disease, are the most at risk for reoccurrence.”
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What To Think About
For some people, nonprescription pain relievers are enough to help control pain caused by shingles or postherpetic neuralgia. But for others, stronger medicines may be needed. And if prescription medicines don’t help control your pain, you may need to see a pain specialist about other ways to treat PHN.
Treatment If The Condition Gets Worse
In some cases, shingles causes long-term complications. Treatment depends on the specific complication.
- Postherpetic neuralgia is persistent pain that lasts months or even years after the shingles rash heals. Certain medicines, such as anticonvulsants, antidepressants, and opioids, can relieve pain. Most cases of PHN resolve within a year.
- Disseminated zoster is a blistery rash over a large portion of the body. It may affect the heart, lungs, liver, pancreas, joints, and intestinal tract. Treatment may include both antiviral medicines to prevent the virus from multiplying and antibiotics to stop infection.
- Herpes zoster ophthalmicus is a rash on the forehead, cheek, nose, and around one eye, which could threaten your sight. You should seek prompt treatment from an ophthalmologist for this condition. Treatment may include rest, cool compresses, and antiviral medicines.
- If the shingles virus affects the nerves originating in the brain , serious complications involving the face, eyes, nose, and brain can occur. Treatment depends on the nature and location of the complication.
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