What to expect
Shingles is an itchy, burning and typically painful rash caused by the varicella-zoster virus. This is the same virus that causes chickenpox. If you’ve ever had chickenpox, the virus can reactivate as shingles. It’s not known why the virus reactivates.
Keep reading to learn more.
What happens at each stage
When the virus first reactivates, you may feel a discomfort, tingling, or just a twinge under your skin, as if something were irritating a particular spot on one side of your body.
This can be anywhere on your body, including your:
- eye area
This location may be sensitive to the touch. It may also feel:
- hot, as if it’s burning
Usually within five days, a red rash will appear in that area. As the rash develops, small groups of liquid-filled blisters will also form. They may ooze.
Over the next week or two, these blisters will begin to dry up and crust over to form scabs.
For some people, these symptoms are accompanied by flu-like symptoms. This includes:
- light sensitivity
- general feeling of being unwell (malaise)
What treatment options are available
See your doctor as soon as you notice the rash forming. They can prescribe an antiviral drug to help ease your symptoms and clear the virus.
Some antiviral options include:
Your doctor may also recommend over-the-counter or prescription options to help relieve any pain and irritation you’re experiencing.
For moderate pain and irritation, you can use:
- anti-inflammatory drugs, such as ibuprofen (Advil), to reduce pain and swelling
- antihistamines, such as diphenhydramine (Benadryl), to reduce itching
- numbing creams or patches, such as lidocaine (Lidoderm) or capsaicin (Capzasin) to reduce pain
If your pain is more severe, your doctor may recommend prescription pain medication. Your doctor may also recommend treatment with corticosteroids or local anesthetics.
In some cases, your doctor may prescribe a low-dose antidepressant to help with pain. Certain antidepressant medications have been shown to reduce the pain of shingles over time.
Options often include:
Anticonvulsant medications may be another option. They have proved useful in reducing shingles nerve pain, although their main use is in epilepsy. The most commonly prescribed anticonvulsants are gabapentin (Neurontin) and pregabalin (Lyrica).
Although it may be tempting, you shouldn’t scratch. This can lead to infection, which can worsen your overall condition and lead to new symptoms.
The most common complication of shingles is postherpetic neuropathy (PHN). When this happens, feelings of pain remain long after the blisters have cleared up. It’s caused by nerve injury at the rash site.
You risk for PHN increases if you:
- are over age 50
- have a weakened immune system
- have a severe case of shingles that covers a large area
Having more than one of these factors increases your risk. For example, if you’re an older woman with a severe and painful shingles rash, you can have up to a 50 percent chance of developing PHN.
In addition to pain, PHN can make your body sensitive to touch and to changes in temperature and wind. It’s also associated with depression, anxiety, and sleeplessness.
Other complications include:
- bacterial infections on the skin at the rash site, usually from Staphylococcus aureus
- vision problems, if shingles is near or around your eye
- hearing loss, facial paralysis, loss of taste, ringing in your ears, and vertigo, if a cranial nerve is affected
- pneumonia, hepatitis, and other infections, if your internal organs are affected
When to see your doctor
You should see your doctor as soon as you suspect shingles, or when you see a rash. The earlier shingles is treated, the less severe symptoms may become. Early treatment can also reduce your risk for PHN.
If pain persists after the rash has cleared, see your doctor as soon as possible. They can work with you to develop a pain management plan. If your pain is severe, they may refer you to a pain specialist for additional consultation.
If you haven’t already received the shingles vaccine, ask your doctor about getting vaccinated. The Centers for Disease Control and Prevention recommends the shingles vaccine in most all adults over age 60. Shingles can recur.
How to prevent transmission
You can’t catch shingles, and you can’t give shingles to someone else. But you can give others chickenpox.
After you have chickenpox, the varicella-zoster virus stays dormant in your body. If this virus reactivates, shingles occurs. It’s possible to transmit this virus to others who aren’t immune while the shingles rash is still active. You are contagious to others until all areas of the rash are dried up and crusted over.
To catch the varicella-zoster virus from you, a person has to have direct contact with your rash blisters.
You can help prevent your transmission of the varicella-zoster virus by:
- keeping the rash loosely covered
- practicing frequent handwashing
- avoiding contact with people who may not have had chickenpox or who haven’t been vaccinated against chickenpox
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