Shingles

What is shingles?

Most people who get this disease develop a painful, blistering rash.

Is it contagious?

Yes, but you cannot give anyone shingles. While you have blisters, you can spread a virus. If that virus infects someone who hasn't had chickenpox (or the chickenpox vaccine), the person can get chickenpox.  If you had chickenpox, the virus that caused it is still inside your body. When the chickenpox cleared, the virus moved from your skin to your nerves.  Should this virus travel back to your skin, you will get shingles instead of chickenpox.

Because you are contagious while you have shingles blisters, it’s extremely important to keep the rash covered and stay away from:

  • Pregnant women
  • Babies younger than 12 months
  • Anyone who is sick, especially with cancer or AIDS
  • Everyone who has not had chickenpox

Get medical care for shingles immediately

If you have a blistering rash, you want to see a doctor as soon as possible. Should you have shingles, starting prescription medication within 2 to 3 days of developing the rash can dramatically:

  • Reduce your symptoms, such as pain
  • Lessen the amount of time you have shingles
  • Lower your risk of developing other health problems, such as a condition called postherpetic neuralgia, which is pain that can linger for months or years after the rash clears

If you’ve had the rash for longer than 2 or 3 days, it’s still important to see a doctor. Shingles can lead to other health problems aside from long-lasting pain. For example, when the shingles rash develops on your face, it can affect your eyesight. Treatment can save your eyesight.

A few people who get shingles develop pneumonia, hearing loss, or a disease that causes the brain to swell (encephalitis). It’s important to find signs of these early, so that you can receive treatment.

When you see your doctor, you may hear the medical term “herpes zoster.” This is the medical name for shingles.

Herpes zoster differs from other types of herpes

Hearing the word “herpes” can be confusing. Herpes zoster (also called zoster) is not a sexually transmitted infection (STI). It cannot cause genital herpes. Herpes zoster also doesn’t cause cold sores. Both genital herpes and cold sores are caused by the herpes simplex virus.  The virus that causes shingles and chickenpox is called the varicella-zoster virus. It’s common.

Causes

A virus causes shingles. It’s the same virus that causes chickenpox.  Doctors diagnose more than 1 million cases of shingles in the United States every year.  In fact, to get shingles, you must have the chickenpox virus inside your body. Anyone who has had chickenpox has this virus. After you recover from chickenpox, the virus moves to nerves inside your body, where it goes to sleep. You will always have the virus inside your body. If the virus wakes up, you get shingles.

Many people mistakenly believe that they cannot get shingles because they don’t remember having chickenpox. If you were born in the United States before 1980, you likely had chickenpox.  More than 99% of people born in the United States before 1980 have had it, according to Centers for Disease Control and Prevention (CDC).3 Many people simply don’t remember having chickenpox. They may have been too young to remember or had a very mild case.

Symptoms

Shingles causes a painful, blistering rash on your skin. If you get shingles, you may notice the following:

  • Before the rash appears: For 1 to 2 days before the rash appears, you may have pain, burning, or tingling on an area of skin where the rash will develop. Some people say they felt an “electrical sensation” on their skin before getting the rash.
  • Rash appears: A painful, blistering rash appears. It usually appears on one side of your body, often on the torso; however, it can appear anywhere on your skin. Some people get more blisters after the rash appears, so it can seem that the rash is spreading.
  • Rash starts to clear: As the rash clears, the blisters may crack open, bleed, and scab over. For most people, the rash will clear within 2 to 4 weeks.

Shingles rash on the face

If you have a shingles rash on your face, immediately seeing a doctor for treatment could save your eyesight.

Pictures 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, it’s important to get treatment, preferably within 2 to 3 days.

 

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.

Other signs and symptoms of shingles

Along with a painful, blistering rash, some people can also have one or more of the following:

  • Fever
  • Headache
  • Muscle aches
  • Stomach pain
  • Vomiting

These tend to go away as the rash clears.

Other health problems due to shingles

Some people develop other health problems after the shingles rash clears, which include:

Postherpetic neuralgia (PHN): This is the most common. Occurring where you had the rash, PHN can cause constant tingling, burning, and pain. For others, the pain comes and goes.

Whether the pain is constant or intermittent, it can go on for a long time. You can have PHN for months, years, or the rest of your life. There is no way to know how long it will last.

The pain caused by PHN can become so severe that it interferes with your life, making everyday activities painful. A musician may no longer be able to play an instrument. Some people cannot walk comfortably. It may be difficult to bathe or get dressed. You may have trouble sleeping.

How to prevent PHN: If you have shingles, you can greatly reduce your risk of PHN by getting treated for shingles within 3 days of developing the rash.

Source: American Academy of Dermatology

How do dermatologists treat shingles?

An antiviral medication can:

  • Reduce the amount of time that you have a shingles rash
  • Decrease how severe the rash becomes
  • Lower your risk of developing long-lasting nerve pain and other health problems
  • One of three antiviral medications is usually prescribed—acyclovir, famciclovir, or valacyclovir.

To treat your symptoms, dermatologists typically recommend the following:

Pain: Medication that you can buy without a prescription can help, such as Acetaminophen or Ibuprofen.

If you have severe pain, your dermatologist may prescribe a medication that reduces inflammation, such as a corticosteroid.

What is the outcome for someone who has shingles?

Most people get shingles once, but it’s possible to get it again.  If you have a healthy immune system, the blisters tend to clear in 7 to 10 days. The rash tends to go away completely within 2 to 4 weeks. The pain may last longer, but usually stops in 1 or 2 months.

For some people, the pain will last longer than the rash. When it does, it’s called postherpetic neuralgia (PHN), which can come and go or be constant. PHN can last for months, years, or the rest of your life. Treatment can help reduce the amount of pain you feel.

Be sure to tell your doctor if you continue to have pain. Treatment can help you feel more comfortable.

Source: American Academy of Dermatology

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