What to expect when you have shingles

  1. Timeline of symptoms
  2. Potential complications
  3. Post-herpetic neuropathy (PHN)
  4. Other complications
  5. Treatment
  6. Antiviral drugs
  7. Painkillers and antihistamines
  8. Antidepressants
  9. Anticonvulsant medications
  10. Managing shingles symptoms
  11. Is shingles contagious?
  12. Vaccinating against shingles
  13. Takeaway

Shingles causes a painful rash, itching, and burning skin, and lasts for 3 to 5 weeks in most cases. People usually only experience shingles once, but the infection can recur.

Shingles is a viral infection that affects approximately 1 in 3 adults in the United States. Around half of all shingles cases occur in adults over 60 years old.

It can occur in anyone who has had chickenpox, as both shingles and chickenpox are caused by the varicella-zoster virus (VZV). This virus remains in the body after chickenpox has cleared and can reactivate at any time, leading to shingles.

Shingles symptoms tend to develop on one side of the face or body. They often affect just a small area. The most common location is on the side of the waist, although they can occur anywhere.

Timeline of symptoms

A red rash usually forms after several days of early symptoms.

Several days before a rash appears, shingles may cause skin sensitivity or pain. Further early symptoms include:

general discomfort

hot skin

irritation

itching

numbness

tingling

Within the next 1 to 5 days, a red rash will normally form around the sensitive area. A few days later, fluid-filled blisters will develop at the site of the rash.

The blisters will ooze before drying up, typically within 10 days of appearing. At this point, scabs will form on the skin, tending to heal within 2 weeks.

There may be other symptoms accompanying the skin sensitivity and rash, including:

chills

fatigue

fever

headache

malaise or feeling of being unwell

nausea

sensitivity to light

A person’s vision may be affected if the shingles occurs near the eyes.

It should be noted that shingles symptoms range from mild to severe, with some people experiencing itching and mild discomfort and others having intense pain.

Potential complications

Most cases of shingles resolve without causing long-term effects. However, potential complications include:

Post-herpetic neuropathy (PHN)

Post-herpetic neuropathy (PHN) is a common complication of shingles. It refers to nerve damage that causes pain and burning that persists after the shingles infection is gone.

Some sources suggest that up to 20 percent of people who get shingles develop PHN with older adults thought to be especially at risk.

Treating PHN is difficult, and the symptoms can last for years. However, most people fully recover within 12 months.

It is not known why some people who have shingles go on to develop PHN. The risk factors for PHN include:

a weakened immune system

having pain during the early stages of a shingles infection

advanced age

having severe shingles that covers a large portion of the skin

According to some research, older women who get severe pain and rash symptoms may have a 50 percent chance of developing PHN.

Other complications

Other potential complications of shingles include:

bacterial infections of the skin

facial paralysis

hearing loss

hepatitis

loss of taste

pneumonia

ringing in the ears

vertigo, a type of dizziness

vision problems

Treatment

Over-the-counter or prescription medication may be recommended to treat shingles.

It is important to see a doctor as soon as a person notices the symptoms of shingles.

The National Institute on Aging recommend that people seek medical treatment no later than 3 days after the rash appears. Early treatment can limit pain, help the rash heal quicker, and may reduce scarring.

Once a doctor confirms shingles, they may suggest the following treatments:

Antiviral drugs

These ease symptoms, speed up recovery, and may prevent complications. A course of antiviral medications is usually prescribed for 7 to 10 days. Options include:

acyclovir (Zovirax)

famciclovir (Famvir)

valacyclovir (Valtrex)

Antiviral drugs are most effective when taken within 3 days of the rash onset, although they may still be prescribed within the first 7 days of the rash appearing.

Painkillers and antihistamines

Over-the-counter (OTC) or prescription medications may reduce pain and skin irritation. Options include:

anti-inflammatory drugs, such as ibuprofen (Advil)

antihistamines for itching, including diphenhydramine (Benadryl)

corticosteroids or local anesthetics for severe pain

numbing products, including lidocaine (Lidoderm)

Antidepressants

Certain antidepressant drugs have been proven effective in reducing shingles pain, as well as symptoms of PHN.

Tricyclic antidepressants (TCAs) are most commonly prescribed for shingles pain, including:

amitriptyline (Elavil)

imipramine (Tofranil)

nortriptyline (Aventyl, Pamelor)

It can take several weeks or months before antidepressants work for nerve pain.

Anticonvulsant medications

Although typically used to treat epilepsy, some anticonvulsant drugs may reduce nerve pain. Again, these can take several weeks to take effect. Commonly prescribed anticonvulsants for shingles include:

gabapentin (Neurontin)

pregabalin (Lyrica)

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Managing shingles symptoms

In addition to seeking medical treatment, people can take other steps to alleviate their symptoms and reduce discomfort. These include:

getting enough sleep and rest

using a wet compress on the itchy and inflamed skin and blisters

reducing stress through a healthy lifestyle, meditation, and deep breathing exercises

wearing loose-fitting clothing made of natural fibers, such as cotton.

taking an oatmeal bath

applying calamine lotion to the skin

People should avoid scratching the rash and blisters as much as they can. Breaking the skin or bursting the blisters can cause infection and further complications.

Is shingles contagious?

Shingles is not contagious but is the reactivation of a virus already present in the body.

However, a person with shingles can give chickenpox to someone who has never had the VZV infection before.

Therefore, people with shingles should avoid contact with those who have never had chickenpox until their rash has completely healed. To catch the virus, someone must have direct contact with the rash.

To avoid spreading VZV, people with shingles should:

Avoid close contact with people who have never had chickenpox or been vaccinated for chickenpox.

Avoid close contact with low birth-weight infants and people with a compromised immune system, such as those on HIV medication or who have had an organ transplant.

Keep the rash covered with loose, natural clothing to avoid others coming into contact with it.

Wash their hands frequently, especially after touching the rash or applying lotions to the skin.

Vaccinating against shingles

People over 60 should get a vaccination against shingles.

There is a vaccination available to reduce the risk of developing shingles and experiencing long-term complications, such as PHN.

The Centers for Disease Control and Prevention (CDC) recommends that adults aged 60 years and older have this vaccination, as it is believed to reduce the risk of shingles by 50 percent and PHN by 67 percent.

People who have already had shingles can have the vaccine to prevent future occurrences. Each vaccination protects for approximately 5 years.

Takeaway

Up to a third of the population in the U.S. is affected by shingles. Symptoms vary in their severity and duration. Early intervention is key in reducing symptom severity and avoiding complications, such as PHN.

Therefore, people should see their doctor, as soon as possible, if they have heightened skin sensitivity or develop a rash or blisters. Several home remedies can alleviate shingle symptoms when used in conjunction with medical treatments.

People should consider having the shingles vaccination to reduce their risk of getting shingles and long-term nerve pain.

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