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Shingles: What you need to know | BY HEIDI

 






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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