Is it shingles? Pictures and symptoms
Shingles is an infection that causes a painful, burning rash on the body. It can occur as a complication after a person has had chicken pox, but it may not appear until years later.
In most cases, shingles is not a life-threatening condition. It can cause severe pain, however, which can sometimes last for months.
The most common symptom of shingles is a painful rash that usually appears on one side of the body.
A few days before the rash develops, other symptoms may be present, including weakness, chills, muscle aches, and nausea. Some people also develop pain, itching, tingling, and burning on the skin before the rash appears.
The rash from shingles tends to develop in a certain pattern, most commonly on the trunk. It is sometimes referred to as a “shingles band” due to the striped pattern. The rash may start as red patches but changes over time and develops into fluid-filled blisters. These blisters may ooze.
After about 7 to 10 days, the blisters may crust or scab. Although it can vary, the rash often clears up in 2 to 4 weeks.
Typically, shingles appears on the trunk. The rash also can develop on other areas of the body, including the face. When the rash appears on the face, it often develops around the eyes or over the nose.
One of the biggest misconceptions about shingles is that it only affects older adults. Although people over the age of 50 are more likely to develop shingles, the disease can also affect younger people. Even children can develop shingles.
Some people may also be under the impression that the condition is rare. That’s not the case. In fact, shingles is common. According to the National Foundation for Infectious Diseases, about 50 percent of people who live to age 85 will develop shingles at some point in their life.
One of the most common complications of shingles is postherpetic neuralgia. The condition involves continued pain long after the rash from shingles clears up.
According to the CDC, postherpetic neuralgia affects of people over the age of 60 who develop shingles.
If it appears near or over the eyes, shingles can also lead to a severe infection of the retina, which can lead to vision loss. Bacterial skin infections are another possible complication.
In rare cases, shingles can lead to encephalitis, which is an inflammation of the brain.
Shingles vs. other conditions
Shingles can sometimes be mistaken for another skin conditions, such as hives, psoriasis, or eczema.
The characteristics of a rash may help doctors identify the cause. For example, hives are often raised and look like welts. Psoriasis often involves red patches that have white scales throughout the rash.
At first, the shingles rash appears as small raised dots. One difference between shingles and other rashes is the pattern that develops. The shingles rash often develops in a pattern along the nerves of the chest and belly.
A rash due to allergies or eczema may develop anywhere, including the legs and the arms. The shingles rash also tends to clear up in a few weeks. Rashes due to eczema and psoriasis may last longer. A shingles rash is also usually a lot more painful than other rashes.
The best way to work out if a rash is shingles is to see a doctor. In most cases, a doctor can make a diagnosis based on medical history, a physical exam, and symptoms.
Anyone who suspects they have shingles should consider seeing their healthcare provider. In some cases, medication is prescribed to speed recovery. Medications are most effective when taken within 72 hours of the rash appearing.
A virus called varicella zoster causes shingles. Varicella zoster virus also causes chickenpox, which used to be a common childhood illness before a vaccine was developed.
Once a person is infected with chickenpox, the virus remains in their nervous system, even after they recover. Although the virus stays in the body, it’s considered latent, which means it’s inactive and does not cause any symptoms.
At some point, the virus can reactivate and cause shingles. The reason the virus reactivates is not entirely clear. According to the Mayo Clinic, it may become active again if a person’s immune system becomes weakened or stressed.
Anyone who has had chickenpox is at risk for developing shingles. Factors that increase a person’s chances of developing the condition include being over age 50 and having a disease that weakens the immune system.
People taking medications that decrease their immune system function, such as chemotherapy or steroids, are also at an increased risk for shingles.
According to the , shingles is not transmitted from person to person. The varicella zoster virus can be transmitted, but a person exposed to it develops chickenpox instead of shingles if they have not had chickenpox in the past.
Currently, there is no cure for shingles. Treatment is available to decrease the severity of the infection and reduce symptoms.
For example, antiviral medications may be recommended. Antiviral medication for shingles does not kill the virus. Instead, it stops it from multiplying, which may shorten the length of the illness.
Medications to treat pain may also be prescribed. Various medications are available, including creams, which are applied to the skin, and oral medications.
Home treatment may include applying cool compresses to the skin to ease the pain.
It’s also important to prevent the virus from spreading. Although shingles itself cannot be transmitted, the virus can be passed on, possibly causing chickenpox.
Someone with shingles is not contagious once the blisters have scabbed over and are no longer weeping. Before they have scabbed over, it is important to keep them covered around other people.
One way to prevent shingles is to get vaccinated. The chickenpox vaccine is often given as a routine childhood vaccine. Adults who have not had chickenpox can also get the vaccine.
For those who have already had chickenpox, there is also a shingles vaccine. The Food and Drug Administration approved the shingles vaccine for adults over the age of 50. The CDC recommend adults who have a history of chickenpox get the vaccine. There is no maximum age for getting the vaccine.
It’s important to understand that both vaccines do not guarantee an individual will not be infected with the virus. They do substantially decrease a person’s chances of developing the diseases, however.
According to the U.S. Department of Health and Human Services, the shingles vaccine provides protection from the virus for about 5 years. After that, the effectiveness of the vaccine decreases. Currently, the vaccine is only given once.
Shingles can affect someone more than once. People who have already had shingles can also get vaccinated to prevent getting the infection again.
The shingles vaccine is safe for most people. As always, someone considering the vaccine should discuss it with their doctor. Side effects from the vaccine are usually mild and include pain, redness, and swelling at the injection site.
How to treat shingles on the face
Shingles causes a painful rash that can bleed, burn, or itch. It typically affects just one side of the body. Shingles can appear on the face, though most people develop symptoms on their torso.
According to the Centers for Disease Control and Prevention (CDC), will develop shingles at some point during their lives. Shingles, or herpes zoster, is caused by the varicella-zoster virus, which is the same virus that causes chickenpox — so anyone who has previously had chickenpox can develop shingles.
Once someone has had chicken pox, the virus stays in their body, hidden in the nerve cells but does not usually cause further symptoms. Sometimes, however, the virus becomes re-activated, and the infection returns as shingles, not chickenpox.
What causes shingles on the face and eyes?
The location of the shingles rash depends on which nerves the virus has infected.
Shingles symptoms appear on the face when the chickenpox virus infects the facial nerves.
When shingles affects the eyes, the condition is medically referred to as herpes zoster ophthalmicus.
Doctors do not know why some people who have had chickenpox get shingles and others do not.
People with weak immune systems — including older people, people with HIV, people with AIDS, and people taking drugs that weaken the immune system — are more vulnerable to shingles.
Anyone of any age can, however, develop shingles on the face.
Shingles vs. other skin conditions
Shingles is different from other conditions in several ways:
- People may experience pain, including burning, tingling, or electrical sensations on their skin for 1 to 2 days before the rash develops.
- The shingles rash looks like a group of small blisters or lesions.
- The rash usually develops in one area, not as patches of blisters in different areas on the face.
- Shingles usually affects just one side of the face.
- Makeup, sun exposure, or an allergy do not trigger shingles.
- Shingles will not spread from one area of the body through contact, unlike some other rashes.
- Some people develop more lesions after the initial outbreak. These blisters might be near the location of the first rash, or somewhere else.
- The rash begins as sore blisters that may then crack, bleed, and scab over.
- Shingles lasts 1 to 2 weeks.
- Shingles sometimes causes other symptoms, such as a fever, headache, muscle aches, and stomach pain or vomiting.
- Only people who have previously had chickenpox can get shingles.
Are there any complications?
The most common complication of shingles is called postherpetic neuralgia (PHN).
PHN is damage to the nerves that can cause tingling, burning, pain, and other symptoms for months or years after the infection. Some people experience constant pain, while the pain comes and goes for others.
Complications from shingles are more common in people who have a weak immune system or a chronic medical condition, such as diabetes, HIV, and AIDS.
Shingles can, rarely, including:
Untreated or poorly managed shingles complications can be fatal. However, the death rate for shingles is low. A estimates that shingles is an underlying cause of 78 deaths each year in the United States.
A doctor can usually diagnose shingles with a clinical exam. A doctor may take a sample of the skin for testing if it is unclear what is causing the rash. The test that assesses skin for shingles will, however, also give a positive result if a person has another herpes virus.
People who have shingles in or around the eyes should see an ophthalmologist because shingles around the eyes can cause eye problems, including glaucoma.
Treating shingles on the face
Treatment is the same no matter where shingles develop. Treatment will involve taking an antiviral drug to reduce the severity of the outbreak and help it disappear more quickly.
People will see the best results if they take antiviral medication within 72 hours of the rash appearing.
In most cases, a doctor will prescribe the drugs famciclovir and valacyclovir. People with weak immune systems may need to take a different drug, such as acyclovir, instead.
Most research suggests anti-shingles drugs are safe for people who are breast-feeding, but those who are pregnant or breast-feeding should discuss medications with their doctors.
People who develop PHN may also require pain medication. PHN medication may include oral drugs, such as opioids or creams that people can apply directly to the skin.
Concealing the rash
People who have shingles on the face may want to conceal the rash.
However, makeup and lotions may irritate the blisters. This is most likely if the blisters are open or oozing. Putting anything on the blisters can make the rash last longer. It can, in rare cases, also cause an infection.
People should keep the rash clean and avoid using makeup, lotion, and anything else that could irritate the skin.
Shingles is not contagious. However, people who have never had chickenpox or are unvaccinated can contract the virus and develop chickenpox if exposed to an open sore.
Some ways to prevent developing shingles :
- Getting vaccinated for chickenpox.
- Having the shingles vaccine after a shingles outbreak, or if a doctor suggests doing so. Older adults and people with weak immune systems may need the shingles vaccine.
- Managing and treating any existing conditions can prevent serious complications associated with shingles, and also reduce the risk of developing shingles.
Shingles can be intensely painful and may cause embarrassment when the rash is visible on someone’s face.
For most people, however, shingles is temporary and goes away on its own. People who think they might have shingles should see a doctor immediately.
Proper treatment can prevent the symptoms from getting worse and prevent against scarring and damage to the face.
What is herpes zoster?
Herpes zoster is a localised, blistering and painful rash caused by reactivation of varicella-zoster virus (VZV). Herpes zoster is also called shingles.
VZV is also called herpesvirus 3 and is a member of the Herpesvirales order of double-stranded DNA viruses.
Who gets herpes zoster?
Anyone who has had varicella (chickenpox) may subsequently develop herpes zoster. Zoster can occur in childhood but is much more common in adults, especially older people. People with various kinds of cancer have a 40% increased risk of developing zoster. People who have had zoster rarely get it again; the chance of getting a second episode is about 1%.
Herpes zoster often affects people with weak immunity.
What causes herpes zoster?
After primaryinfection—varicella—VZV remains dormant in dorsal root ganglianerve cells in the spine for years before it is reactivated and migrates down sensory nerves to the skin to cause herpes zoster.
It is not clear why herpes zoster affects a particular nerve fibre. Triggering factors are sometimes recognised, such as:
- Pressure on the nerve roots
- Radiotherapy at the level of the affected nerve root
- Spinal surgery
- An infection
- An injury (not necessarily to the spine)
- Contact with someone with varicella or herpes zoster
What are the clinical features of herpes zoster?
Herpes zoster is characterised by dermatomaldistribution, that is the blisters are confined to the cutaneous distribution of one or two adjacent sensory nerves. This is usually unilateral, with a sharp cut-off at the anterior and posterior midlines.
The clinical presentation of herpes zoster depends on the age and health of the patient and which dermatome is affected.
The first sign of herpes zoster is usually localised pain without tenderness or any visible skin change. It may be severe, relating to one or more sensory nerves. The pain may be just in one spot, or it may spread out. The patient may feel quite unwell with fever and headache. The lymph nodes draining the affected area are often enlarged and tender.
Within one to three days of the onset of pain, a blistering rash appears in the painful area of skin. It starts as a crop of red papules. New lesions continue to erupt for several days within the distribution of the affected nerve, each blistering or becoming pustular then crusting over.
The chest (thoracic), neck (cervical), forehead (ophthalmic) and lumbar/sacral sensory nerve supply regions are most commonly affected at all ages. The frequency of ophthalmic herpes zoster increases with age. Herpes zoster occasionally causes blisters inside the mouth or ears, and can also affect the genital area. Sometimes there is pain without rash—herpes zoster "sine eruptione"—or rash without pain, most often in children.
Pain and general symptoms subside gradually as the eruption disappears. In uncomplicated cases, recovery is complete within 2–3 weeks in children and young adults, and within 3–4 weeks in older patients.
See more images of herpes zoster.
What are the complications of herpes zoster?
- Involvement of several dermatomes, or sometimes, bilateraleruptions in unique dermatomes
- Eye complications when the ophthalmic division of the fifth cranial nerve is involved
- Deep blisters that take weeks to heal followed by scarring
- Muscle weakness in about one in 20 patients. Facial nerve palsy is the most common result (see Ramsay Hunt syndrome). There is a 50% chance of complete recovery, but some improvement can be expected in nearly all cases
- Infection of internal organs, including the gastrointestinal tract, lungs, and brain (encephalitis)
Herpes zoster is infectious to people who have not previously had chickenpox.
Herpes zoster in the early months of pregnancy can harm the fetus, but luckily this is rare. Shingles in late pregnancy can cause chickenpox in the fetus or newborn. Herpes zoster may then develop as an infant.
Post-herpetic neuralgia is defined as persistence or recurrence of pain in the same area, more than a month after the onset of herpes zoster. It becomes increasingly common with age, affecting about a third of patients over 40. It is particularly likely if there is facial infection. Post-herpetic neuralgia may be a continuous burning sensation with increased sensitivity in the affected areas or spasmodic shooting pain. The overlying skin is often numb or exquisitely sensitive to touch. Sometimes, instead of pain, the neuralgia results in a persistent itch (neuropathicpruritus).
What is the treatment of herpes zoster?
Prevention of herpes zoster
Because the risk of serious complications from herpes zoster is more likely in older people, those aged over 60 years might consider the zoster vaccine, which can reduce the incidence of herpes zoster by half. In people who do get herpes zoster despite being vaccinated, the symptoms are usually less severe, and post-herpetic neuralgia is less likely to develop. In New Zealand, the zoster vaccine will be funded from 1 April 2018 for people aged between 66 and 80 years old.
Herpes zoster vaccination is contraindicated in immunosuppressed patients due to the risk of it causing disseminated herpes zoster infection.
- Rest and pain relief
- Protective ointment applied to the rash, such as petroleum jelly.
- Oral antibiotics for secondary infection
Antiviral treatment can reduce pain and the duration of symptoms if started within one to three days after the onset of herpes zoster. Aciclovir 800 mg 5 times daily for seven days is most often prescribed. Valaciclovir and famciclovir are also useful. The efficacy of prescribing systemic steroids is unproven.
Nonsteroidal anti-inflammatories and opioids are generally unhelpful.
Herpes Zoster (Shingles)
What is herpes zoster (shingles)?
Herpes zoster, or shingles, is a common viral infection of the nerves, which results in a painful rash of small blisters on a strip of skin anywhere on the body. Even after the rash is gone, the pain may continue for months.
- Shingles is relatively rare in children.
- Your child is most at risk if he had chickenpox during the first year of life or if you had chickenpox very late during pregnancy.
- A rash most often occurs on the trunk and buttocks, and usually goes away in one to two weeks.
- Medication may help alleviate some of the pain, but the disease has to run its course.
What causes herpes zoster?
Herpes zoster is caused by the reactivation of the chickenpox virus. After a person has had chickenpox, the virus lies dormant in certain nerves for many years.
Is herpes zoster common?
Shingles is more common in people with a depressed immune system and those over the age of 50. It's quite rare in children, and the symptoms are mild compared to what an adult may experience.
What are the symptoms of herpes zoster?
The rash associated with herpes zoster most often occurs on the trunk and buttocks. It may also appear on the arms, legs, or face. While symptoms may vary child to child, the most common include:
- skin hypersensitivity in the area where the herpes zoster (shingles) is to appear
- mild rash, which appears after five days and first looks like small, red spots that turn into blisters
- blisters, which turn yellow and dry, often leaving small, pitted scars
- rash goes away in one to two weeks
- rash is usually localized to one side of the body
How do we diagnose herpes zoster?
Diagnosis usually involves obtaining a medical history of your child and performing a physical exam. Your doctor also may want to:
- take skin scrapings (gently scraping the blisters to determine if the virus is shingles or another virus)
- run blood tests
How do we treat herpes zoster?
Medication may help alleviate some of the pain, but the disease has to run its course. Your doctor will prescribe medication based on your child's age and the severity of the symptoms. Immediate treatment with antiviral drugs may help lessen some of the symptoms and minimize nerve damage.
Pictures zoster rash
Some kids with shingles also may have a fever and a headache, and might feel tired and achy. Rarely, a child has the pain of shingles without the rash. More severe symptoms can happen, but usually in people over age 50.
What Problems Can Happen?
Most cases of shingles heal on their own, with or without treatment, and won't lead to any other problems. In rare cases, shingles can lead to complications, including:
- Ongoing pain (post-herpetic neuralgia): Damaged nerve fibers in the skin send confused messages to the brain, leading to pain. Pain can go on for a long time after the shingles rash is gone. This is the most common shingles complication.
- Vision problems: Shingles near or in an eye can lead to vision loss.
- Skin infections: A shingles rash can become infected with bacteria, leading to impetigo or cellulitis.
- Nervous system problems: Shingles on the face can involve different nerves that connect to the brain. This can lead to nerve-related problems such as facial paralysis, hearing problems, and problems with balance. In very rare cases, shingles can lead to encephalitis (inflammation of the brain).
How Is Shingles Diagnosed?
Doctor usually can diagnose shingles by looking at the rash. Rarely, a doctor may send a small sample of infected skin to be checked in a laboratory.
If you think your child might have shingles, call your doctor. If your child might have shingles on the face, it's important to get a doctor's help right away to keep the infection from spreading to the eyes.
How Is Shingles Treated?
Not all kids who get shingles need treatment. If a doctor decides a treatment may help, it should start right away. Treatment usually includes an antiviral medicine and pain-control medicines.
Antiviral medicines like acyclovir (Zovirax) or valcylovir (Valtrex):
- help heal the skin rash
- stop the virus from multiplying
- help control pain
Pain medicines (over-the-counter or prescription creams, sprays, or skin patches):
- help control pain
- ease inflammation (swelling and redness)
Medicines can't rid the body of the virus, but they can lower the chances of complications and help speed healing. Ask your doctor if treatment might help your child.
As the rash heals, keep the area clean. Wash it with water and a mild soap, and apply cool, wet compresses to the blisters several times a day to ease pain and itching. Oatmeal baths also can bring relief.
To prevent the virus from spreading to other people, keep the rash covered at all times.
Can Shingles Be Prevented?
It's not always possible to prevent shingles. But the chickenpox vaccine can make a case of shingles less serious. If your child hasn't had chickenpox, ask your doctor about getting the chickenpox vaccine.
There is a shingles vaccine, but it's mostly given to older adults. The older someone is, the more severe shingles can be. Kids are unlikely to be seriously affected by shingles.
What Else Should I Know?
Children whose shingles rash that can't be completely covered should not go to school or childcare until the blisters scab over and are dry.
Newborn babies, pregnant women, people with weakened immune systems, and anyone who is not immune to chickenpox should avoid close contact with anyone who has shingles until the rash is gone.
What Does Shingles Look Like?
What is shingles?
Shingles, or herpes zoster, occurs when the dormant chickenpox virus, varicella zoster, is reactivated in your nerve tissues. Early signs of shingles include tingling and localized pain.
Most, but not all, people with shingles develop a blistering rash. You may also experience itching, burning, or deep pain.
Typically, the shingles rash lasts two to four weeks, and most people make a complete recovery.
Doctors are often able to quickly diagnose shingles from the appearance of the rash.
Early symptoms of shingles may include fever and general weakness. You may also feel areas of pain, burning, or a tingling sensation. A few days later, the first signs of a rash appear.
You may begin to notice pink or red blotchy patches on one side of your body. These patches cluster along nerve pathways. Some people report feeling shooting pains in the area of the rash.
During this initial stage, shingles is not contagious.
The rash quickly develops fluid-filled blisters similar to chickenpox. They may be accompanied by itching. New blisters continue to develop for several days. Blisters appear over a localized area and do not spread over your whole body.
Blisters are most common on the torso and face, but they can occur elsewhere. In rare cases, the rash appears on the lower body.
It’s not possible to transmit shingles to someone. However, if you’ve never had chickenpox or the chickenpox vaccine, it’s possible to get chickenpox from someone with shingles through direct contact with active blisters. The same virus causes both shingles and chickenpox.
Scabbing and crusting
Blisters sometimes erupt and ooze. They may then turn slightly yellow and begin to flatten. As they dry out, scabs begin to form. Each blister can take one to two weeks to completely crust over.
During this stage, your pain may ease a little, but it can continue for months, or in some cases, years.
Once all blisters have completely crusted over, there is low risk of spreading the virus.
The shingles “belt”
Shingles often appears around the rib cage or waist, and may look like a “belt” or half belt. You might also hear this formation referred to as a “shingles band” or a “shingles girdle.”
This classic presentation is easily recognizable as shingles. The belt can cover a wide area on one side of your midsection. Its location can make tight clothing particularly uncomfortable.
Ophthalmic shingles affects the nerve that controls facial sensation and movement in your face. In this type, the shingles rash appears around your eye and over your forehead and nose. Ophthalmic shingles may be accompanied by headache.
Other symptoms include redness and swelling of the eye, inflammation of your cornea or iris, and drooping eyelid. Ophthalmic shingles can also cause blurred or double vision.
According to the U.S. (CDC), about 20 percent of people with shingles develop a rash that crosses multiple dermatomes. Dermatomes are separate skin areas that are supplied by separate spinal nerves.
When the rash affects three or more dermatomes, it is called disseminated, or widespread zoster. In these cases, the rash may look more like chickenpox than shingles. This is more likely to happen if you have a weakened immune system.
Open sores of any kind are always susceptible to bacterial infection. To lower the possibility of a secondary infection, keep the area clean and avoid scratching. Secondary infection is also more likely if you have a weakened immune system.
Severe infection can lead to permanent scarring of the skin. Report any sign of infection to your doctor immediately. Early treatment can help prevent it from spreading.
Most people can expect the rash to heal within two to four weeks. Although some people may be left with minor scars, most will make a complete recovery with no visible scarring.
In some cases, pain along the site of the rash can continue for several months or longer. This is known as postherpetic neuralgia.
You may have heard that once you get shingles, you can’t get it again. However, the cautions that shingles can return multiple times in some people.
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What is shingles?
Shingles is a painful skin rash. It is also called zoster or herpes zoster. It is caused by the varicella zoster virus. This is the same virus that causes chickenpox. Nearly one-third of people in the United States will get shingles in their lifetime. Most people will only get it once. But some people can have more than one episode.
The virus that causes shingles is not the same virus that causes oral or genital herpes. That virus is called the herpes simplex virus. The two are in the same family of viruses.
Symptoms of shingles
Shingles usually causes a painful, blistering rash. Sometimes pain, itching, or tingling start a few days before the rash appears. The rash begins with reddish bumps. In a few days, these bumps turn into fluid-filled blisters. You might feel a stinging or burning pain. The rash might also itch. Other symptoms include:
Shingles occurs most often on the trunk of the body. It also occurs on only one side of the body. This could be a band of blisters around your back or chest. The blisters usually scab over in about a week. The rash usually clears up in 2 to 4 weeks. You may see changes in the color of your skin when the scabs fall off. In more severe cases of shingles, these color changes could be permanent.
Even though the rash from shingles gets better or goes away in a few weeks, the pain may last longer. This condition is known as post-herpetic neuralgia (PHN). In most people, however, the pain of shingles goes away in 1 to 2 months.
What causes shingles?
Shingles is caused by the varicella zoster virus, the same virus that causes chickenpox. After you’ve had chickenpox, the virus goes dormant (inactive) in your body. It stays inside certain nerve cells. Your immune system keeps the virus in these cells. As you get older, your immune system may get weaker. If this happens, the virus may reactivate, causing shingles. Many times this happens years after you’ve had chickenpox. If you have had the chickenpox vaccine, you are less likely to get chickenpox. Therefore, you’re less likely to later develop shingles.
Most people who get shingles are over 50 years of age or have a weak immune system. For example, you might get shingles if you:
- Have cancer
- Take medicines that weaken your immune system
- Have HIV or AIDS
Can I give shingles to others?
No one can catch shingles from you. But the virus can be spread to a person who has never had chickenpox. The virus lives in the blisters that shingles causes. It can be spread until the blisters are completely healed. If you have blisters that have not crusted over yet, you should stay away from:
- Anyone who has never had chickenpox
- Babies under 12 months old
- Pregnant women
- Very sick people (such as those with cancer or AIDS)
Tell your doctor if you live with children who have not had chickenpox. They may need to be vaccinated.
How is shingles diagnosed?
Your doctor will ask you about your medical history, including if you’ve ever had chickenpox. He or she will also ask about your symptoms. They will do a physical exam and inspect your rash. There is a test that can confirm shingles, but it is not normally needed.
Can shingles be prevented or avoided?
The best way to prevent shingles is through vaccination. Vaccinate your children for chickenpox. This vaccine reduces their risk for getting chickenpox. You can’t get shingles unless you’ve had chickenpox first.
When you are older, get the shingles vaccine. It is recommended for adults 50 years of age and older. It can prevent shingles. People who have had shingles should get the vaccine to help stop the disease from reoccurring. Common side effects of the vaccine are headache, plus redness, swelling, itching, and soreness at the injection site.
The shingles vaccine is not recommended for anyone who:
- Has had an allergic reaction to gelatin or the antibiotic neomycin
- Has an allergy to any component of the shingles vaccine
- Has a weakened immune system due to conditions such as leukemia, HIV, or AIDS
- Is receiving treatment for cancer
- Is being treated with drugs that suppress their immune system, including high-dose steroids
- Is pregnant or might become pregnant within 4 weeks of getting the vaccine
Shingles is often treated with an antiviral medicine. These medicines can reduce the severity and duration of your symptoms. Acyclovir, famciclovir, or valacyclovir are commonly prescribed. Your doctor will decide whether one of these medicines is right for you. These medicines work better if you start taking them in the first 3 days after you get the rash.
Your doctor might also have you take a steroid medicine to reduce your pain and swelling. This medicine along with the antiviral medicines may reduce your risk of developing postherpetic neuralgia.
What can I do for the pain?
To help with the pain of shingles, your doctor might have you take an over-the-counter pain medicine. This could include acetaminophen (one brand: Tylenol) or ibuprofen (two brands: Motrin, Advil).
Applying a medicated anti-itch lotion (two brands: Benadryl, Caladryl) to the blisters might reduce the pain and itching. Placing cool compresses soaked in water mixed with white vinegar on the blisters and sores might also help.
If shingles causes severe pain, your doctor might prescribe a stronger pain medicine.
Living with shingles
Most people will only get shingles once in their life. The pain and the rash resolve in 3 to 5 weeks, and the blisters don’t leave scars. There are a few complications that can occur.
The most common complication of shingles is post-herpetic neuralgia (PHN). This is when the pain of shingles lasts for a long time after the rash is gone. About 10% of people who have shingles will develop PHN. It is caused by damaged nerve fibers that send exaggerated pain messages from your skin to your brain. The older you are, the more likely you are to develop PHN. It is also likely to be more severe when you are older.
Shingles can also lead to an eye condition called herpes zoster ophthalmicus (HZO). HZO can cause a rash with small blisters to break out on the forehead and around the eye. Usually this happens only on one side of your face. Sometimes you will have pain in the same area of your face a few days before the outbreak. Infection of the eye causes extreme pain, swelling of the eyelid, light sensitivity and redness. In severe cases, the cornea can be damaged. This can affect your vision.
People who have HZO should see an eye doctor right away.
Questions to ask your doctor
- I’ve had chickenpox. Am I at risk of developing shingles?
- What is the best treatment for my shingles?
- The pain from shingles isn’t going away. What can I do to make myself more comfortable?
- I’m on treatment for shingles. When should I call my doctor if things don’t get better?
- I have shingles and my children haven’t 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 I’ve never had the chickenpox, should I still get the shingles vaccination?
Copyright © American Academy of Family Physicians
This information provides a general overview and may not apply to everyone. Talk to your family doctor to find out if this information applies to you and to get more information on this subject.