The Stages Of Shingles
Clinical manifestations divided into 3 phases.
Shingles, or herpes zoster , is an infection caused by the varicella zoster virus which remains in the body following an episode of chickenpox. After lying dormant and forgotten for decades in the neurons of a spinal nerve, it reactivates as shingles.
The primary symptom associated with shingles is a painful red rash that erupts along 1 side of the body. Most commonly presenting as a band around the patients waistline or trunk, the rash can also break out in other locations like the face, neck, eyes, and ears.
Shingles clinical manifestations are divided into 3 distinct phases: preeruptive, acute eruptive, and chronic.
The preeruptive phase usually lasts about 48 hours but can stretch to 10 days in some cases. It is characterized by sensory phenomena along 1 or more dermatomes, which correspond to an area of skin mainly supplied by a single spinal nerve. Symptoms common to this stage include headache, general fatigue, sensitivity to light, and fever.
The chronic phase, also known as postherpetic neuralgia occurs in up to 20% of all patients with shingles. It is defined as recurrent pain lasting more than 4 weeks after the vesicles have healed. Other symptoms include abnormal skin sensations like tingling, burning, and numbness caused by pressure on a nerve and nerve damage . The resulting pain, which can be excruciating and disabling, can last months and even years.
What Does It Mean To Let Shingles Run Its Course
This refers to the typical course a shingles rash takes, even with antiviral treatment:
Will Shingles Ever Be Obsolete
Unfortunately, shingles cases are on the rise worldwide. And more younger people are getting the virus. This is in spite of our efforts to vaccinate kids against chickenpox.
Remember, shingles happens because the varicella virus, which causes chickenpox, stays in the body and can come back years later. Vaccinating kids against varicella virus should mean no more chickenpox and no more shingles. But chickenpox vaccination is fairly new it began around 20 years ago. And not everyone is on board with vaccination.
The vaccine is not used everywhere in the world. And there are pockets of people who dont get the vaccine or dont respond to it here in the U.S., says Thomas. So I think it will be many decades before this virus disappears, if at all.
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My Shingles Never Go Away
I was looking at the stories that people have here about the never ending shingles. I have had them for the past 5+ years now and I have them in my mouth, and throat, sometimes they get around my ear canal, and even have got so back I cannot talk. Most of the time when they are acting up it is hard to eat anything mostly drink lots of ice cold water, or Milk, and eat anything that will slide down easy. I am glad to see that I am not alone in this struggle. I usually feel tired or flu like for a day or so then the sores come in and after a couple days of wanting to crawl in bed and stay there then I cannot eat or talk much because my mouth and throat are blistered so bad. I was beginning to think something was wrong with me until I read your posts. I did not understand why I had them all the time and some people get them once and not again. I guess I have a week imune system but otherwise I am healthy never have ate alot of junk, but stress is over the top and this came on when a family issue started. It is in the past but now I get the remnants from all of that for the rest of my life!! Gotta love family. I do by the way love my family, but it is hard sometimes to deal with the drama!! Anyhow Thank you for the posts and making me feel better about being crazy. God Bless all and calm and happy thoughts!!
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Best Treatments For Lasting Shingles Pain
Postherpetic Neuralgia Pain: What Works, What Doesn’t
Doctors call it postherpetic neuralgia or PHN. It’s caused by nerve damage left behind by a case of shingles. Shingles itself comes from reactivation of a chickenpox virus, varicella zoster. The virus travels down nerve fibers to cause a painful skin rash.
When the rash goes away, the pain usually goes with it. But for 12% to 15% of people the pain remains. If your shingles pain lasts eight to 12 weeks after the rash goes away, you’re part of an “unfortunate minority,” says pain researcher Andrew S.C. Rice, MD, of Imperial College, London.
“Among people with PHN, some have their pain resolve in the first year to 18 months after the shingles rash goes away,” Rice tells WebMD. “But if they have pain longer than that, it is not going to go away on its own. In either case, a person must deal with the pain.”
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Is The Zostavax Vaccine Still Being Used
Yes. The CDC, however, recommends Zostavax for adults age 60 and older, but not routinely for people aged 50 to 59. Zostavax is given as a single-dose shot versus the two-dose shot for Shingrix. Zostavax is less effective than Shingrix in preventing shingles and postherpetic neuralgia .
You can consider Zostavax if you are allergic to Shingrix or if Shingrix is unavailable because of supply shortage and you want some immediate protection from a possible case of shingles and/or postherpetic neuralgia. Because its a weakened live vaccine, it may be dangerous if you have cancer, HIV, or take steroids, chemotherapy or other medications that suppress your immune system. Ask your healthcare provider if the Zostavax vaccine is an option for you.
Nerve Pain: Most Common Complication Of Shingles
Nerve pain is the most common complication of shingles. The formal name for shingles nerve pain is postherpetic neuralgia . What causes PHN? Nerves damaged by the vaccine-preventable herpes zoster virus.
Pain occurs in the skin that was initially affected by the shingles rash, says Thomas. It can be a mild, lingering pain or an abnormal sensation when touching the skin. For other people, it can be persistent, burning, or shooting pain that can be really disruptive to daily life.
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What Causes Shingles To Activate
Shingles, also known as herpes zoster, is a painful band-like rash caused by reactivation of varicella zoster virus , the same virus that causes chickenpox. Shingles affects the nerves and skin, causing an itchy, scaly rash that is flat in appearance. Itching these rashes can lead to scarring and scabs on the infected area.
Shingles are quite commonit is estimated that up to 1 in 3 people will have at least one episode of shingles during their life. VZV usually hangs around harmlessly in the body, but reactivation is more common in those more than 50 years old, with a weakened immune system, or those who are experiencing physical or emotional stress.
This article addresses what causes shingles to activate.
Halfpoint Images / Getty Images
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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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.
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 Can Be Mistaken For Shingles
Shingles can sometimes be mistaken for another skin conditions, such as hives, psoriasis, or eczema. Share on Pinterest A doctor should always be consulted if shingles is suspected. The characteristics of a rash may help doctors identify the cause. For example, hives are often raised and look like welts.
Can I Prevent Shingles
- are over the age of 50 years
- have previously had chickenpox
- do not remember whether or not you have had chickenpox
Contact your doctor to discuss getting the shingles vaccine.
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How Is Shingles Diagnosed
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.
Treating The Pain Of Phn
Exactly how best to deal with the pain is a difficult question. Rice led a research team that looked at 35 clinical trials of various treatments. The findings appear in the July issue of the free-access online journal PloS Medicine.
“The most important thing to realize is these are painkillers,” Rice says. “You are treating the pain, not the disease itself. And this is due to permanent nerve damage. It is like a stroke. We can’t make the nerve damage better, but we can treat the disability. And for PHN, pain is one of those disabilities.”
What helps? Rice’s team found good evidence supporting:
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When Should You Call For Help
or seek immediate medical care if:
- You have a new or higher fever.
- You have a severe headache and a stiff neck.
- You lose the ability to think clearly.
- The rash spreads to your forehead, nose, eyes, or eyelids.
- You have eye pain, or your vision gets worse.
- You have new pain in your face, or you can’t move the muscles in your face.
- Blisters spread to new parts of your body.
- You have symptoms of infection, such as increased pain, swelling, warmth, or redness.
Watch closely for changes in your health, and be sure to contact your doctor if:
- The rash has not healed after 2 to 4 weeks.
- You still have pain after the rash has healed.
Where Does Shingles Come From
When you have chickenpox as a child, your body fights off the varicella-zoster virus and the physical signs of chickenpox fade away, but the virus always remains in your body. In adulthood, sometimes the virus becomes active again. This time, the varicella-zoster virus makes its second appearance in the form of shingles.
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S Of The Shingles Rash
If you have a rash of blisters on your skin or a rash that looks like any shown below, see your doctor immediately for a diagnosis. If you have shingles, its important to get treatment, preferably within 2 to 3 days.
If youve had the rash for longer than 2 to 3 days, its still important to see your doctor.
A typical shingles rash
Doctors often refer to this rash as the shingles band because it looks like a band that appears on one area of your body, as shown here.
A rash on one side of the body
A key that you have shingles is that the rash only develops on one side of your body.
Close-up of a shingles rash
The shingles rash often causes a cluster of tiny blisters. You may notice that the skin beneath the blisters is red and inflamed, as shown here.
The rash will also feel painful.
Blistering shingles rash on a man’s chest
Although the rash can begin in one area, you may notice that a few scattered blisters develop in other areas, as shown here.
Shingles rash on the palm of a man’s hand
While shingles tends to develop on your body or face, it can appear anywhere on your skin.
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
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Can You Get Shingles From The Covid
There have been a few reports of shingles happening in people who were vaccinated against COVID-19. The varicella-zoster virus was reactivated in these people.
A note from Cleveland Clinic
If youve had chickenpox, youre at risk of developing shingles later in life. Shingles causes a rash that is contagious and painful. The disease can have serious complications. The best thing you can do to reduce your risk is to get the shingles vaccine. The vaccines are safe and effective.
When To Seek Medical Advice
Shingles is not usually serious, but you should see your GP as soon as possible if you recognise the symptoms. Early treatment may help reduce the severity of your symptoms and the risk of developing complications.
You should also see your GP if you are pregnant or have a weakened immune system and you think you have been exposed to someone with chickenpox or shingles and haven’t had chickenpox before.
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How Does Shingles Rash Appear
The typical red shingles rash and blisters follow pain, itching and tingling. The rash is usually limited to one side of the face and body.
Shingles on the face, scalp, mouth and ear
- Rash and shingles blisters appear on one side of the face, extending to the scalp and ear.
- If the rash involves the ear, it can lead to hearing loss, imbalance and weakness of the facial muscles.
- Shingles rash on the scalp causes pain while combing and bald patches.
- Shingles can occur in the mouth, which is usually very painful, causing pain while eating and change in taste.
Shingles of the eye and forehead
- Rash and blisters appear around the eye, over the eyelids, once side of the forehead, extending to the tip of the nose.
- Patients complain of burning or throbbing in the eye, with watering of eyes, swelling and blurred vision.
- The pain may be present after the rash disappears due to nerve damage, but improves eventually. Without treatment, shingles of the eye and forehead can lead to corneal damage and vision loss.
Shingles on the waist and back
- Rashes and blistering appear over one side of the waist and the back in a stripe pattern, extending up to the lower back.
Shingles on the buttocks
- Shingles rash and blisters over the buttocks, usually on one side.