People can develop shingles if they had chickenpox in the past. This virus can lie dormant for years, and then reactivate as shingles. A person who has not had chickenpox before can get chickenpox through exposure to someone with shingles.
Symptoms
Shingles usually affects one side of the body. This is most often the waist, chest, abdomen, or back. Symptoms can also appear on the face and in the eyes, mouth, ears. The virus can also affect some internal organs.
Shingles typically affects a single sensory nerve ganglion near the spinal cord, called a dorsal root ganglion. This is why the symptoms occur in specific areas of the body, rather than all over it. The pain results from nerve involvement, rather than the rash itself.
Symptoms can vary in nature, depending on where on the body they appear.
Some people have pain but no rash. Others may have a rash with pain that is accompanied by other symptoms, such as fever, chills, or headache.
Most common symptoms
a constant dull, burning, or gnawing pain, or a sharp, stabbing pain that comes and goes
a skin rash that resembles a chickenpox rash but only affects certain areas
fluid-filled blisters that develop as part of the rash
Symptoms on the body
Common locations for this include:
the chest
the abdomen
the back
around the waist
It usually occurs only on one side of the body.
The location of the symptoms will depend on which dermatome distribution the virus affects.
Facial symptoms
They can include:
pain over the affected dermatome
a rash
muscle weakness
headache
Eye symptoms
This can cause pain, redness, and swelling in and around the eye, as well as temporary or permanent loss of vision.
Ear symptoms
Shingles can also occur in or around the ear, leading to problems with balance and hearing, as well as muscle weakness on the affected side of the face.
These changes can be long-term or even permanent.
A person who develops symptoms in or around the ears and eyes should seek immediate medical attention to reduce the risk of complications.
Mouth symptoms
If shingles affects the mouth, a person may experience:
facial tenderness
pain in the mouth
toothache
lesions in hard and soft palate tissues
The pain and discomfort of these symptoms can make it difficult to eat or drink.
Internal shingles
Shingles can also affect the internal organs. There will not be a rash, but other problems can arise.
For example, researchers have found evidence of shingles in the digestive system, which can leadTrusted Source to gastrointestinal dysfunction, and in the arteries in the brain, which may increase the risk of stroke and dementia.
Other symptoms
fever
fatigue
chills
headache
upset stomach
Symptom progression
Symptoms typically progress as follows:
Pain, tingling, numbness, and itching start to affect a specific part of the skin.
Red blotches and itchy, fluid-filled blisters develop and continue to do so for 3–5 daysTrusted Source.
The blisters may merge, forming a solid red band that looks similar to a severe burn. The gentlest touch may be painful.
Inflammation may affect the soft tissue under and around the rash.
After 7–10 days, the blisters gradually dry up and form scabs or crusts. As the blisters disappear, they may leave minor scarring.
Shingles usually lasts around 2–4 weeks. It is contagious until the blisters dry up and crust over.
Most people will only have an episode of shingles once, but it can recur in some people.
When to see a doctor
Getting treatment shortly after the onset of symptoms can help decrease the duration and severity of infection.
This is especially important for people over 60Trusted Source and those who have a weakened immune system, as this could increase the risk of developing serious complications.
If the rash continues spreading to other parts of the body or other symptoms occur, such as high fever, it is best to consult with a doctor.
Additionally, those who develop a rash near the eye should seek immediate medical attention, as this can be a sign of HZO. The condition can cause scarring, vision loss, and permanent eye damage if left untreated.
Treatment
Antiviral treatment can help with:
reducing the severity and duration of symptoms
preventing complications from developing
lowering the risk of the rash coming back
In addition to antiviral drugs, there are several other ways to help manage symptoms, including:
using pain relief medication
reducing stress as much as possible
eating regular, nutritious meals
getting some gentle exercise
wearing loose fitting clothes for comfort
applying calamine lotion
taking a lukewarm, oatmeal bath
placing a cool, damp washcloth on the blisters
Calamine lotion is available for purchase online.
Learn more home remedies for itching here.
Most people will recover with home treatment, but a person should seek medical help if other symptoms appear, such as a fever. Around 1–4%Trusted Source of people will need to spend time in the hospital due to complications.
Pictures: What does shingles look like?
Chickenpox is caused by the varicella-zoster virus. It leads to an itchy rash.
The rash can spread across the body and leave scars.
Renelle Woodall, 1969/CDC
Chickenpox is highly contagious.
F malan, CC BY-SA 3.0, via Wikimedia Commons
Shingles comes from a reactivation of the virus that causes chickenpox.
VideoBCN/Shutterstock
Shingles causes a painful rash.
TisforThan/Shutterstock
Causes
VZV belongs to a group of viruses called herpes viruses. This is why shingles also has the name “herpes zoster.”
All herpes viruses can hide in the nervous system, where they can remain indefinitely in a latent state.
Under the right conditions, the herpes zoster virus can reactivate, similarly to waking up from hibernation, and travel down nerve fibers to cause a new active infection.
What triggers this is not usually clear, but it may happen when something weakens the immune system, prompting the virus to reactivate.
Is shingles contagious?
It is not possibleTrusted Source to directly transmit shingles to another person. However, a person who has never had chickenpox can contract the virus by coming into direct contact with the fluid in the blisters of a person who currently has shingles.
If this happens, and the person has not received a vaccination against chickenpox, they would develop chickenpox first, not shingles.
Shingles does not spread through coughing or sneezing. Only direct contact with fluid from the blisters can spread the virus. Therefore, covering the blisters reduces the risk of contagion.
It is important to note that the virus is only active from when the blisters first appear to when they dry up and crust over. Transmission is not possible before the blisters develop or after the crusts form. If a person does not develop blisters, the virus cannot spread in the traditional sense.
Taking the following precautions can help prevent the transmission of the virus:
covering the rash
washing the hands often
avoiding touching or scratching the rash
It is also important for someone with shingles to avoid contact with:
infants who are preterm or have a low birth weight
pregnant people who have never had chickenpox or the vaccine for it
those with a weakened immune system
Diagnosis
Doctors usually diagnose shingles through a physical exam by evaluating the appearance of the rash and blisters on the body.
In some cases, they may collect a tissue sample from the fluid of the blisters and send it to a lab to check if the virus is present.
They may also conduct a blood test to look for antibodies, which can determine whether a person has ever been exposed to the virus.
Vaccine
Vaccination can offer protection from both chickenpox and shingles.
For children: Chickenpox vaccine
With two doses of the vaccine, there is at least a 90% chance of preventing chickenpox. Preventing chickenpox will also prevent shingles.
Tests have shown the vaccine to be safe, though some children may experience:
pain at the injection site
a fever and a mild rash
temporary joint pain and stiffness
Also, click here to learn more about the brands of childhood chickenpox vaccines.
For older adults: Shingles vaccine
A different vaccine, the herpes zoster vaccine, is available for people aged 50 and older who have had chickenpox and therefore carry VZV. Experts also recommend this vaccine for those who have not had chickenpox or shingles.
In the U.S., 99.5%Trusted Source of people born before 1980 already have this virus in their system. The herpes zoster vaccine can help prevent shingles in people who already have the virus.
After two doses of Shingrix, a person will have more than 90% protection against shingles, falling to just above 85% after 4 years, according to the CDC.
Who should not have the vaccine?
People who should not have the shingles vaccine without first discussing it with their doctor include those who:
have an allergy to any component of the shingles vaccine
have a weakened immune system
are or might be pregnant
Risk factors
Although anyone who has had chickenpox can develop shingles, some people may be at a higher risk.
Possible risk factors and triggers include:
older age
certain cancers or cancer treatment options
HIV
treatments that suppress the immune system
stress or trauma
Complications
Rarely, complications can arise — especially in people with an impaired immune system.
postherpetic neuralgia (PHN)
inflammation of the brain or spinal cord, increasing the risk of stroke, encephalitis, and meningitis
eye and vision problems
weakness
problems with balance and hearing
damage to blood vessels, which could lead to stroke
pneumonia
According to the CDC, around 10–18%Trusted Source of people who have shingles will develop PHN, a long-term complication in which the pain of a shingles rash lasts long beyond the rash itself.
It is more likely to occur if a person develops shingles after the age of 40, and the risk continues to increase with age.
In people with weak immune systems
This includes people who:
have cancer, especially leukemia or lymphoma
have HIV
have undergone an organ transplant
are taking medications to suppress the immune system, including chemotherapy drugs
These people should seek medical attention as soon as possible if they have concerns about shingles-related symptoms.
What other precautions should a person take if they have a weak immune system? Find out here.
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