Shingles

Shingles

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:

  • fever
  • chills
  • nausea
  • diarrhea
  • headache.

Shingles occurs most often on the trunk 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 60 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 treatment

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 (Tylenol) or ibuprofen (Motrin, Advil).

Applying a medicated anti-itch lotion (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?

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