Tuesday, June 25, 2024

Why Does One Get Shingles

Who Shouldn’t Get It

Shingles: Signs, Symptoms and Treatment with Dr. Mark Shalauta | San Diego Health

A person should not get Shingrix if:

  • They have ever had a severe allergic reaction to any component of the vaccine or the first dose of the vaccine.
  • They test negative for immunity to varicella-zoster virus.
  • They currently have shingles.
  • They are pregnant.

If you are experiencing a moderate to severe illness, with a fever or not, you should consider waiting until you are better before getting the vaccine.

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.

Is There A Vaccine For Shingles

There are two shingles vaccines currently available, Shingrix and Zostavax. Shingrix vaccine, a newer vaccine, is preferred over Zostavax for the prevention of shingles and its complications. Two doses of Shingrix given 2 to 6 months apart are recommended for healthy adults 50 years of age and older. Shingrix is also recommended for adults who have previously received Zostavax. A single dose of Zostavax may still be used to prevent shingles in certain cases for healthy adults 60 years and older.

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When To See A Healthcare Provider

For most people, the effects of Shingrix are mild and short-term. In very rare cases, Shingrix can cause more serious side effects.

Seek urgent medical care if you experience signs of a severe allergic reaction a few minutes or hours after your second dose of Shingrix, such as:

  • Rapid heartbeat
  • Facial swelling
  • Swelling in the throat or mouth

You should also let your healthcare provider know if your Shingrix side effects are severe or arent going away on their own.

What Is The Best Way To Prevent Shingles

Check if you have shingles

Your best chance at preventing shingles is to get vaccinated. There is one vaccine, Shingrix, which is very effective in preventing shingles and complications, including postherpetic neuralgia.

  • Shingrix is a recommended vaccine for all adults age 50 years and older whether or not they have had shingles or previously received varicella vaccine. The vaccine is a series of two doses. The administration of the second dose is given 2 to 6 months after the first dose.

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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.

Shingles Vaccine Reduces Your Risk Of Getting Shingles

While there is no cure for shingles, getting the shingles vaccine can greatly reduce your risk of getting this disease.

Shingles vaccine reduces risk

The CDC recommends the shingles vaccine for healthy adults who are 50 years of age or older.

If you think you may already have shingles, treatment is important. It can reduce your pain and how long the rash lasts.

Find out how dermatologists diagnose and treat this condition at, Shingles: Diagnosis and treatment.

3 Centers for Disease Control and Prevention . Prevent Shingles: Get vaccinated. Page last reviewed July 23, 2018. Last accessed March 28, 2019.

ImageGetty Images

ReferencesCenters for Disease Control and Prevention . Prevent Shingles: Get vaccinated. Page last reviewed July 23, 2018. Last accessed March 28, 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.

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Will Shingles Go Away On Its Own

Shingles isn’t life-threatening, but it can be incredibly painful and, in some cases, complications can arise. While this rash typically goes away its own, prompt treatment can reduce your pain and help shingles go away faster.

“Several antivirals can be used to treat shingles. These drugs can help you heal more quickly and reduce your pain, but they are most effective when started within 72 hours of your rash appearing. This means it’s important to see your doctor as soon as you suspect shingles,” says Dr. Brown. “When it comes to the pain associated with shingles, most people are able to manage it using over-the-counter pain relievers. But, pain can be severe for some people. In these cases, your doctor can prescribe stronger pain medications.”

Beyond treating your immediate pain and rash, seeing your doctor is also important since serious complications can occur as a result of shingles, such as:

  • Postherpetic neuralgia pain that lasts for months to years after the rash clears, with this pain being debilitating in some cases
  • Skin infection occurs if the open sores of your rash become infected with bacteria, which can require antibiotics and delay healing
  • Vision problems while rare, if your rash develops near your eye, the associated inflammation can damage your retina and, in some cases, result in vision loss

How Is Shingles Diagnosed

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Your healthcare provider will do a complete physical exam and ask about your medical history, specifically about whether you have ever had chickenpox.

Your healthcare provider will likely know right away that it is shingles based on the unique rash. The rash usually appears one area on one side of the body or face. It appears as red spots, small fluid- or pus-filled vesicles, or scabs.

The healthcare provider may also take skin scrapings for testing.

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What Are The Complications Of Shingles

After the shingles rash has disappeared, you might continue to have nerve pain in that same area. Postherpetic neuralgia can last for months or years and become quite severe.

More than 10% of people who get shingles develop postherpetic neuralgia. Researchers dont know why some people get postherpetic neuralgia and others dont. It may be that nerves become more sensitive or that the virus may be invading and damaging the central nervous system.

Other complications include:

  • Other types of nerve issues like numbness or itching.
  • A bacterial infection of the shingles rash.
  • Eye and ear inflammation if the rash is near these organs.

The Biology Behind That Blistering Rash

During the initial exposure to chickenpox, some of the virus particles settle into the nerve cells around the spinal cord and brain. When the virus reactivates sometimes decades later, as a result of things like stress it travels down those nerve fibers to the skin. As the virus multiplies, the telltale rash erupts.

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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.

Can Shingles Come Back

Shingles: Signs, Symptoms, and Complications

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.

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Can Shingles Be Prevented

There are vaccines to prevent shingles or lessen its effects. The Centers for Disease Control and Prevention recommends that healthy adults 50 years and older get the Shingrix vaccine. You need two doses of the vaccine, given 2 to 6 months apart. Another vaccine, Zostavax, may be used in certain cases.

Why More Adults Arent Getting The Super

Despite such impressive results, only about 35 percent of adults 60 and older reported receiving the shingles vaccine in 2018. Whats behind the hesitation? A couple of things. First, says Kristin Christensen, M.D., an internal medicine specialist affiliated with Penn Medicine, in Radnor, Pennsylvania, some of us dont take shingles as seriously as we should: People think, If its not going to kill me I dont need it, without realizing that singles can be incapacitating, causing severe pain that can really limit peoples functioning.

Whats more, difficulty in getting the vaccine may have discouraged those who sought out the vaccine earlier on. The company that makes the vaccine couldnt keep up with the initial demand, resulting in long waiting lists at pharmacies that dispensed the vaccines.

Then theres the hit to your wallet. Shingrix costs on average about $195 per injection, and two injections are required. But unlike the flu and pneumonia vaccines, which are fully covered as preventive services under Medicare Part B, the shingles shot falls under the prescription drug plan under Medicare Part D. Depending on your plan, even after youve met your annual deductible youll likely end up shelling out money for it. If youre between the ages of 50 and 65, and covered by a private health insurance, ask your doctor about getting your vaccine now, while youve got good coverage, Schaffner suggests.

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What Is The Treatment For Shingles And Recurring Shingles

The treatment for recurring shingles is the same as for shingles.

If you suspect that you have recurring shingles, see your doctor as soon as possible. Taking an antiviral drug like acyclovir , valacyclovir , or famciclovir can reduce the severity of shingles and reduce how long it lasts.

Your doctor may also prescribe medications to lessen your pain and help you sleep. These include the following:

  • Skin patches with the painkiller lidocaine are available. You can wear them on the affected area for a specific length of time.
  • Skin patches that have 8 percent capsaicin, an extract of chili peppers, are available. Some people cannot tolerate the burning sensation, even though the skin is numb before the patch is put on.
  • Antiseizure drugs, such as gabapentin and pregabalin , reduce pain by reducing the nerve activity. They have side effects that may limit the amount of the drug that you can tolerate.
  • Antidepressants such as duloxetine and nortriptyline can be useful, especially to relieve pain and allow you to sleep.
  • Opioid painkillers can relieve pain, but they have side effects, such as dizziness and confusion, and they can become addictive.

You can also take cool baths with colloidal oatmeal to ease the itching, or apply cold compresses to the affected area. Rest and stress reduction are also important.

What Are The Risk Factors For Recurring Shingles

Pain relief from shingles

People dont know what causes recurring shingles, but certain factors increase your chances of getting shingles again.

People with weakened immune systems are more likely to get shingles again. One study determined that the rate of shingles recurrence was among people with compromised immune systems. This is about 2.4 times higher than for those who didnt have compromised immune systems.

You may have a compromised immune system if you:

  • are getting chemotherapy or radiation therapy
  • have organ transplants
  • are taking high doses of corticosteroids like prednisone

Additional risk factors include:

  • longer-lasting and more severe pain with the first case of shingles
  • pain for 30 days or more with the first case of shingles
  • being over the age of 50

Having one or more blood relatives with shingles may also increase your risk of getting shingles.

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Is There A Vaccine Against Shingles

Shingix is currently the only shingles vaccine available in the United States. Its given to people over age 50.

Previously, an additional vaccine, Zostavax, was used, but it was phased out in the United States as of November 2020.

According to the CDC, two doses of Shingrix are over 90 percent effective at preventing shingles. Youll retain at least 85 percent protection for 4 years after being vaccinated.

If you get shingles after being vaccinated, your symptoms will likely be less severe. Youll also have a lower chance of developing postherpetic neuralgia a complication where pain remains even after a shingles rash goes away.

Shingles usually follows a pattern of development. It typically progresses with the following symptoms:

  • First, you may notice a tingling or burning sensation in your skin.
  • One to 5 days later a rash appears as small red spots.
  • Fluid-filled blisters develop a few days later.
  • After 7 to 10 days, the lesions crust over.
  • The rash disappears over the next 2 to 4 weeks.

In some cases, pain may persist for several months or even years after the rash has disappeared. This complication, known as postherpetic neuralgia , can be severe enough to affect your quality of life.

Certain antiseizure medications can help manage the pain. Gabapentin and pregabalin are two that are commonly used.

Key Points About Shingles

  • Shingles is a common viral infection of the nerves. It causes a painful rash or small blisters on an area of skin.
  • Shingles is caused when the chickenpox virus is reactivated.
  • It is more common in people with weakened immune systems, and in people over the age of 50.
  • Shingles starts with skin sensitivity, tingling, itching, and/or pain followed by rash that looks like small, red spots that turn into blisters.
  • The rash is typically affects just one area on one side of the body or face.
  • Treatment that is started as soon as possible helps reduce the severity of the disease.

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When Should I See A Doctor Because Of The Side Effects I Experience From Shingrix

Shingrix causes a strong response in your immune system, so it may produce short-term side effects. These side effects can be uncomfortable, but they are expected and usually go away on their own in 2 or 3 days. You may choose to take over-the-counter pain medicine such as ibuprofen or acetaminophen. Contact your healthcare provider if the symptoms are not improving or if they are getting worse.

In clinical trials, Shingrix was not associated with serious adverse events. In fact, serious side effects from vaccines are extremely rare. For example, for every 1 million doses of a vaccine given, only one or two people might have a severe allergic reaction. Signs of an allergic reaction happen within minutes or hours after vaccination and include hives, swelling of the face and throat, difficulty breathing, a fast heartbeat, dizziness, or weakness. If you experience these or any other life-threatening symptoms, see a doctor right away.

Are Chickenpox And Shingles Serious Illnesses

Shingles Rash Pictures, Symptoms, Vaccine Facts

The symptoms may be more severe in newborns, persons with weakened immune systems, and adults. Serious problems can occur and may include pneumonia , brain infection , and kidney problems. Many people are not aware that before a vaccine was available, approximately 10,600 persons were hospitalized, and 100 to 150 died, as a result of chickenpox in the U.S. every year.

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How Long Does Shingles Last

Most cases of shingles last three to five weeks.

  • The first sign is often burning or tingling pain sometimes it includes numbness or itching on one side of the body.
  • Somewhere between one and five days after the tingling or burning feeling on the skin, a red rash will appear.
  • A few days later, the rash will turn into fluid-filled blisters.
  • About one week to 10 days after that, the blisters dry up and crust over.
  • A couple of weeks later, the scabs clear up.

I’m 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 .

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