Shingles Information
Erie Shingles is a painful rash that causes blisters. It can lead to serious complications, including long-term nerve pain called postherpetic neuralgia.
You can get shingles at any age, but it’s more common in people over 60. It’s also more likely if your immune system is weak due to medical conditions or medicines like steroids or chemotherapy.
Shingles (or herpes zoster) is a painful skin rash caused by the varicella-zoster virus, the same one that causes chickenpox. After you get chickenpox as a child, the virus stays in a part of your nervous system called the dorsal root ganglia for the rest of your life. But sometimes, the virus reactivates and travels along nerve pathways to your skin, causing shingles. It’s most common in people over 50, but anyone who’s had chickenpox can later develop shingles.
When it happens, a shingles rash is a stripe of fluid-filled blisters that wraps around one side of your body or face. The most serious type of shingles is ophthalmic shingles, which can cause permanent vision loss if it occurs near the eye. Shingles around the eye are a medical emergency, and you should seek care immediately.
Signs of shingles include pain or a tingling feeling in a limited area of your body, usually on one side. This is followed by a red rash with small, fluid-filled blisters. The rash is most noticeable on your trunk but can appear on the face or legs. The blisters can be itchy but aren’t contagious.
Typically, a physical exam and your medical history are enough for your doctor to make the diagnosis. But they may swab your rash to collect fluid for laboratory testing. In addition, a simple blood test can show if you have the herpes zoster virus in your body.
You can also receive the herpes zoster vaccine (Shingrix) to help protect against shingles. The vaccine is recommended for adults over 50 who have had chickenpox or who carry the herpes zoster virus. It’s not a cure for shingles, but it can lessen the severity and length of symptoms and reduce your risk of complications, such as postherpetic neuralgia.
Because of the increased risk of complications, especially in people over 60, doctors recommend you get a shingles vaccine if you have a weakened immune system due to cancer, chemotherapy, AIDS or another illness. It’s also recommended if you’re pregnant or breastfeeding. You can find out if you are eligible for the vaccine by speaking to your healthcare provider.
Symptoms
The first signs of shingles are pain, tingling, or itching in a certain area of the skin. Then red blotches and fluid-filled blisters appear. These usually scab over within 7 to 10 days. The rash usually happens around the chest and abdomen, but it can be on the face or genitals. Pain often gets worse after the blisters appear. But the pain usually goes away a few weeks after the rash fades. Sometimes people develop a fever, headache, chills, and stomach upset. In rare cases, a person can have the pain of shingles without the rash. This is called herpes zoster nerve pain syndrome (HSNP).
If the rash is near the eyes, you may have problems with vision and hearing. In rare cases, herpes zoster can cause a complication that looks like brain inflammation (called encephalitis). You may also have a bacterial infection of the rash and blisters (called impetigo or cellulitis).
Shingles is most common in adults over 50. It’s also more likely to happen if your immune system is weak, because of illness, a medical condition such as cancer, or certain medications including corticosteroids. It’s also more likely to happen in children if the mother had shingles or chickenpox during pregnancy.
It’s important to get treatment right away. Your doctor will give you medicine to stop the virus from spreading and reduce your pain. You may also need to take antiviral medicines and pain relievers for a while. If you’re pregnant and get shingles, your doctor will talk to you about whether it’s safe for both you and your baby.
A vaccine is available to help prevent shingles and the painful complications that can occur from it. The CDC recommends that healthy adults over 50 get the vaccine, Shingrix. Ask your doctor if you can get the vaccine. If you do, you’ll get two doses of the vaccine at different times. It isn’t effective for kids under 19 years old. But it’s possible that the vaccine might work for older kids and adults who have a weakened immune system. This includes people with HIV infection or AIDS, transplant recipients, and those who have had chemotherapy or radiation therapy.
Treatment
A vaccine against the varicella zoster virus can prevent or lessen shingles and related pain. Most people who get shingles have only one attack, but it can come back, especially in those with weakened immune systems. If you have a rash, cover it up to avoid spreading the virus to others. Home and over-the-counter treatments can help reduce the symptoms of shingles. These include cool compresses, calamine lotion and oatmeal baths. Pain relievers, including acetaminophen or ibuprofen, may also be helpful. Getting treatment early can decrease the severity of symptoms and speed healing.
Usually, symptoms start with itching or tingling sensations in an area of skin on one side of the body. This is followed by redness of the skin and fluid-filled blisters that later scab over. A fever, chills and a general feeling of unwellness may also occur. Some people also experience a headache or a stomach upset.
Pain medicine, such as acetaminophen or NSAIDs, can help with the pain of shingles. Your doctor can prescribe a stronger pain medication if necessary. Antiviral medications are important to take as soon as the rash appears. These include acyclovir (Zovirax), valacyclovir (Valtrex) and famciclovir (Famvir). These medications help to shorten the illness and decrease how painful it is.
Other medicines, such as corticosteroids or steroid creams, can help reduce swelling and inflammation of the skin, but aren’t very effective in treating the pain of shingles. Lidocaine patches, available over-the-counter or by prescription, can reduce nerve pain for up to 12 hours. Capsaicin cream, which is applied directly to the rash, can also be used for pain. However, do not apply this cream near your eyes.
Some people with shingles develop a burning pain in the area where the rash was, called postherpetic neuralgia (PHN). PHN is usually the worst in adults over 60 and can last for years after the rash has gone away. Medicine to treat PHN is very effective and can significantly reduce the intensity of the pain. Medications that work to block the pain signals in the brain, such as tricyclic antidepressants (TCAs), are the most common medications that are prescribed.
Prevention
Shingles is caused by the same virus that causes chickenpox. Once you’ve had chickenpox, the varicella zoster virus goes into your nerve tissues and stays there for the rest of your life — sometimes, years later, it “wakes up” and travels along the nerve fibers to your skin and causes shingles (also known as herpes zoster).
It’s most common in people over 50, but it can happen in any age group or any person who has a weakened immune system, such as from illness or chemotherapy.
The first symptoms of shingles are pain and burning, usually on one side of the body and along a particular area of skin called a dermatome. Then a rash appears, which can be red or dark pink depending on your skin tone. It’s more often seen on the back or chest, but you can get it anywhere else, even inside your mouth. The CDC says if you have shingles in your mouth, it can make eating painful or difficult and could affect your sense of taste.
Usually, the rash is small groups of fluid-filled blisters. The blisters will eventually dry up and form scabs, which clear within a few weeks. But the nerve pain that follows can last much longer, up to a year. This is known as postherpetic neuralgia and can be very severe.
You can’t avoid getting shingles, but you can protect yourself from complications by seeking treatment quickly. That’s especially important if you’re pregnant. There’s evidence that shingles can increase your risk of miscarriage, and the more painful and widespread your rash is, the more likely it is to cause serious complications, including permanent nerve damage.
There are antiviral drugs you can take to shorten the duration and severity of your shingles. And you can get a shingles vaccine. The CDC recommends all adults who’ve had chickenpox get two doses of the varicella vaccine, or a shingles vaccine approved by the FDA called Shingrix. You can also get the vaccine if you’re over the age of 50, and if you have a weakened immune system due to an illness or cancer treatment.