What does a shingles rash look like. How long does shingles last. Is shingles contagious. What are the early signs of shingles. How is shingles diagnosed and treated.

Understanding Shingles: Causes and Risk Factors

Shingles, also known as herpes zoster, is a viral infection caused by the reactivation of the varicella-zoster virus – the same virus responsible for chickenpox. After a person recovers from chickenpox, the virus remains dormant in the body’s nerve tissues for years or even decades. Under certain circumstances, it can reawaken and travel along nerve fibers to the skin, resulting in the characteristic shingles rash.

Who is at risk for developing shingles? The risk increases significantly with age, particularly for individuals over 60 years old. Other factors that can elevate the risk include:

• Weakened immune system due to conditions like cancer or HIV
• Certain cancer medications
• Long-term use of steroid medications
• Prolonged stress or physical trauma

It’s important to note that even healthy individuals can develop shingles. In fact, approximately 25% of adults will experience a shingles outbreak at some point in their lives.

Recognizing the Early Signs and Symptoms of Shingles

Identifying shingles in its early stages is crucial for prompt treatment and prevention of complications. The initial symptoms typically appear 1-5 days before the characteristic rash develops. These early warning signs often manifest in the area where the rash will eventually appear:

• Itching or tingling sensation
• Burning pain
• Heightened skin sensitivity

Are there other symptoms associated with shingles? Yes, some individuals may experience additional symptoms such as:

• Fever and chills
• Headache
• Upset stomach
• Fatigue

If you notice any of these symptoms, particularly if you have a history of chickenpox, it’s advisable to consult a healthcare professional promptly.

The Distinctive Shingles Rash: Appearance and Progression

The hallmark of shingles is its distinctive rash, which typically appears as a band or strip on one side of the body or face. The term “shingles” itself is derived from the Latin word for belt, reflecting this characteristic pattern.

How does the shingles rash develop and progress? The rash evolution usually follows these stages:

1. Red patches appear on the skin
2. Fluid-filled blisters form within the red areas
3. Blisters break open and crust over
4. Scabs form and eventually fall off

The entire process typically takes 2-4 weeks, with the blisters usually scabbing over within 7-10 days. It’s important to note that the rash is usually confined to a specific dermatome – an area of skin supplied by a single spinal nerve.

Common Locations for Shingles Rash

While shingles can occur anywhere on the body, certain areas are more commonly affected:

• Around the waistline on one side of the body
• On one side of the face or around one eye
• On the neck or shoulder
• On the lower back

Diagnosing Shingles: When to Seek Medical Attention

How is shingles diagnosed? In most cases, a healthcare provider can diagnose shingles by visually examining the characteristic rash. However, in some instances, additional tests may be necessary to confirm the diagnosis or rule out other conditions.

When should you see a doctor if you suspect shingles? It’s crucial to seek medical attention as soon as possible if you experience the following:

• A painful, blistering rash, especially if it’s on one side of your body
• Rash near your eye, as this can potentially lead to vision problems
• You’re over 60 years old or have a weakened immune system
• The pain or rash is severe or widespread

Early diagnosis and treatment can help reduce the severity of the outbreak and lower the risk of complications.

Treatment Options for Shingles: Managing Symptoms and Preventing Complications

While there is no cure for shingles, several treatment options can help manage symptoms, shorten the duration of the outbreak, and reduce the risk of complications.

Antiviral Medications

What are the primary treatments for shingles? Antiviral medications are the cornerstone of shingles treatment. These medications work by slowing the reproduction of the virus, thereby reducing the severity and duration of the outbreak. Commonly prescribed antivirals include:

• Acyclovir (Zovirax)
• Famciclovir (Famvir)
• Valacyclovir (Valtrex)

For maximum effectiveness, antiviral treatment should be started as soon as possible after the onset of symptoms, ideally within 72 hours of the rash appearing.

Pain Management

How can the pain associated with shingles be managed? Several options are available for pain relief:

• Over-the-counter pain relievers such as acetaminophen or ibuprofen
• Topical numbing agents or pain-relieving creams
• In severe cases, prescription pain medications or nerve blocks

Symptomatic Relief

Additional measures to alleviate symptoms and promote healing include:

• Applying cool compresses to the affected area
• Using calamine lotion to soothe itching
• Taking cool baths with colloidal oatmeal
• Wearing loose-fitting, natural fiber clothing

Potential Complications of Shingles: Long-term Effects and Risks

While many people recover from shingles without significant issues, the condition can lead to complications in some cases. Understanding these potential long-term effects is crucial for proper management and follow-up care.

Postherpetic Neuralgia (PHN)

What is the most common complication of shingles? Postherpetic neuralgia (PHN) is a condition characterized by persistent pain in the area where the shingles rash occurred, even after the rash has healed. This chronic pain can last for months or even years and can significantly impact quality of life.

How common is PHN? The risk of developing PHN increases with age. Approximately 10-18% of people who get shingles will experience PHN, with the risk rising to 33% in those over 60 years old.

Ophthalmic Shingles

When shingles affects the eye area, it can lead to a condition known as ophthalmic shingles. This can result in various eye-related complications, including:

• Eye infections
• Temporary or permanent vision loss
• Chronic eye inflammation

Immediate medical attention is crucial if shingles appears near the eye to prevent potential vision loss.

Other Potential Complications

In rare cases, shingles can lead to more severe complications, including:

• Hearing or balance problems if the virus affects the ear
• Encephalitis (inflammation of the brain)
• Pneumonia
• Bacterial skin infections

These complications are more likely to occur in individuals with weakened immune systems.

Prevention Strategies: Vaccines and Lifestyle Measures

While it’s not always possible to prevent shingles, there are steps you can take to reduce your risk or lessen the severity of an outbreak.

Shingles Vaccines

What is the most effective way to prevent shingles? Vaccination is currently the best method for preventing shingles or reducing its severity. Two vaccines are available:

• Shingrix: A recombinant zoster vaccine recommended for adults 50 and older, even if they’ve had shingles or received the older vaccine.
• Zostavax: An older live vaccine, no longer available for use in the United States as of November 18, 2020, due to the superiority of Shingrix.

How effective is the shingles vaccine? Shingrix is more than 90% effective at preventing shingles and postherpetic neuralgia in people 50 and older.

Lifestyle Measures

In addition to vaccination, certain lifestyle measures may help support your immune system and potentially reduce your risk of shingles:

• Managing stress through relaxation techniques or exercise
• Maintaining a healthy diet rich in fruits, vegetables, and whole grains
• Getting adequate sleep
• Exercising regularly
• Avoiding excessive alcohol consumption

Living with Shingles: Coping Strategies and Support

Dealing with a shingles outbreak can be challenging, both physically and emotionally. Implementing effective coping strategies can help manage the condition and improve quality of life.

Pain Management Techniques

Beyond medication, several non-pharmacological approaches can help manage shingles-related pain:

• Relaxation techniques such as deep breathing or meditation
• Gentle exercises like stretching or yoga
• Distraction techniques like reading or listening to music
• Application of hot or cold packs (whichever provides more relief)

Emotional Support

The pain and discomfort of shingles can take an emotional toll. Consider the following support options:

• Joining a support group for individuals with shingles or chronic pain
• Seeking counseling or therapy if you’re struggling emotionally
• Communicating openly with friends and family about your condition

Lifestyle Adjustments

Making certain lifestyle adjustments can help manage symptoms and promote healing:

• Wearing loose, comfortable clothing to minimize irritation to the affected area
• Maintaining good hygiene to prevent bacterial infections of the rash
• Getting plenty of rest to support your immune system
• Avoiding scratching or picking at the rash to prevent scarring and infection

Remember, while shingles can be a challenging condition, with proper care and support, most people recover fully. If you’re struggling with shingles or its aftermath, don’t hesitate to reach out to your healthcare provider for additional guidance and support.

What the Shingles Rash Looks Like

Medically Reviewed by Carol DerSarkissian, MD on September 05, 2021

If you’ve ever had the chickenpox — and almost all adults have or have at least been exposed to it– there’s a good chance the virus is still at large in your body. The varicella zoster virus can lie dormant for decades without causing any symptoms. In some people, the virus wakes up and travels along nerve fibers to the skin. The result is a distinctive, painful rash called shingles.

The shingles rash can be a distinctive cluster of fluid-filled blisters — often in a band around one side of the waist. This explains the term “shingles,” which comes from the Latin word for belt. The next most common location is on one side of the forehead or around one eye. But shingles blisters can occur anywhere on the body.

The first symptoms of shingles appear one to five days before the rash. These early warning signs are usually felt in the location where the rash will develop:

• Itching
• Tingling
• Burning
• Pain

While the localized pain and rash are the tell-tale signs of shingles, other symptoms may include:

• Fever
• Chills
• Headache
• Upset stomach

Small blisters that appear only on the lips or around the mouth may be cold sores, sometimes called fever blisters. They’re not shingles, but are instead caused by the herpes simplex virus. Itchy blisters that appear after hiking, gardening, or spending time outdoors could be a reaction to poison ivy, oak, or sumac. If you aren’t sure what’s causing your rash, see your healthcare provider.

The varicella zoster virus is the culprit behind both chickenpox and shingles. The first time someone is exposed to the virus, it causes the widespread, itchy sores known as chickenpox. The virus never goes away. Instead, it settles in nerve cells and may reactivate years later, causing shingles. It’s also called herpes zoster, but it’s not related to the virus that causes genital herpes.

A doctor can usually diagnose shingles just by looking at the rash. If you have shingles symptoms, see your healthcare provider even if you think you’ve never had chickenpox. Many childhood cases of chickenpox are mild enough to go unnoticed, but the virus can still linger and reactivate. To help prevent complications, it’s important to start treatment as soon as possible after the shingles rash appears.   

Shingles blisters usually scab over in 7-10 days and disappear completely in two to four  weeks. In most healthy people, the blisters leave no scars, and the pain and itching go away after a few weeks or months. But people with weakened immune systems may develop shingles blisters that do not heal in a timely manner.

Anyone who has ever had chickenpox can get shingles, but the risk increases with age. People older than age 60 are up to 10 times more likely to get shingles than younger people. Other factors that increase your risk include:

• Some cancer medicines
• Steroid medicines
• Long-term stress or trauma
• A weak immune system from illnesses such as cancer or HIV

A quarter of adults will develop shingles at some point, and most are otherwise healthy.

Yes, but not in the way you may think.  Your shingles rash will not trigger an outbreak of shingles in another person, but it can sometimes cause chickenpox in a child.   People who’ve never had chickenpox, or the vaccine to prevent it, can pick up the virus by direct contact with the open sores of shingles. So keep a shingles rash covered and avoid contact with infants, as well as pregnant women who have never had chickenpox or the varicella vaccine and people who may have weak immune systems such as chemotherapy patients.

In some people, the pain of shingles may linger for months or even years after the rash has healed. This pain, due to damaged nerves in and beneath the skin, is known as postherpetic neuralgia. Others feel a chronic itch in the area where the rash once was. In severe cases, the pain or itching may be bad enough to cause insomnia, weight loss, or depression.

If the shingles rash appears around the eye or forehead, it can cause eye infections and temporary or permanent loss of vision. If the shingles virus attacks the ear, people may develop hearing or balance problems. In rare cases, the shingles virus may attack the brain or spinal cord. These complications can often be prevented by beginning treatment for shingles as soon as possible.

While there is no cure for shingles, antiviral medications can put the brakes on an attack. Prompt treatment can make a case of shingles shorter and milder.  Doctors recommend starting prescription antiviral drugs at the first sign of a shingles rash. Options include acyclovir (Zovirax), famciclovir (Famvir), or valacyclovir (Valtrex).

Over-the-counter pain relievers and anti-itch lotions, such as calamine, can help relieve the pain and itching of the shingles rash. If the pain is severe or the rash is concentrated near an eye or ear, consult your doctor right away. Additional medications, such as corticosteroids, may be prescribed to reduce inflammation.

Colloidal oatmeal baths are an old standby for relieving the itch of chickenpox and can help with shingles, as well. To speed up the drying out of the blisters, try placing a cool, damp washcloth on the rash (but not when wearing calamine lotion or other creams. ) If your doctor gives you the green light, stay active while recovering from shingles. Gentle exercise or a favorite activity may help keep your mind off the discomfort.

The CDC recommends that healthy adults ages 50 and older get the shingles vaccine, Shingrix, which provides greater protection than Zostavax. The vaccine is given in two doses, 2 to 6 months apart. Zostavax is still in use for some people ages 60 and older.

Do not get the shingles vaccine if:

Since the late 1990s, most children in the U.S. have received the varicella vaccine to protect against chickenpox. This vaccine uses a weakened strain of the varicella zoster virus that is less likely to settle into the body for the long haul. 

IMAGES PROVIDED BY:

(1) CNRI / Photo Researchers, Inc.
(2) Bart’s Medical Library / Phototake
(3) Steve Pomberg / WebMD
(4) Thinkstock
(5) Interactive Medical Media, LLC; Scott Camazine / Phototake; John Kaprielian / Photo Researchers
(6) Peggy Firth and Susan Gilbert for WebMD
(7) N. M. Hauprich / Photo Researchers, Inc
(8) N. M. Hauprich / Photo Researchers, Inc
(9) Hans Neleman / Stone
(10) Dr. P. Marazzi / Photo Researchers
(11) David Mack / Photo Researchers
(12) SPL / Photo Researchers, Inc.
(13) Steve Pomberg / WebMD
(14) Denis Felix / Stone
(15) Steve Pomberg / WebMD
(16) Getty Images
(17) Thinkstock
(18) Thinkstock
 

REFERENCES:

American Academy of Dermatology: “Lip and Mouth Care” and “Poison Ivy: Signs and Symptoms.”
Centers for Disease Control and Prevention: “Shingles: Signs & Symptoms;” “Shingles: Transmission;” “Shingles (Herpes Zoster): Prevention and Treatment;” “Shingles Vaccination: What You Need to Know;” “Shingrix Recommendations;” and “What Everybody Should Know about Zostavax.”
National Institute of Allergy and Infectious Diseases: “”Shingles Symptoms,” “Shingles Diagnosis,” “Shingles Treatment.”
National Institute of Neurological Disorders and Stroke: “Shingles: Hope Through Research. “
 

© 2021 WebMD, LLC. All rights reserved. View privacy policy and trust info

Shingles: Symptoms with Pictures

Early signs of shingles can include tingling and localized pain. You may also develop a blistering rash that can itch, burn, or hurt.

Shingles, also known as herpes zoster, occur when the dormant chickenpox virus, varicella zoster, is reactivated in your nerve tissue.

Typically, the shingles rash lasts 2 to 4 weeks, and most people make a complete recovery.

Doctors are often able to quickly diagnose shingles from the appearance of the skin rash.

Share on PinterestShingles rash, shown here on a darker skin tone, appears as tiny red blisters in a group or cluster.
Anukool Manoton/ShutterstockShare on PinterestA viral infection causes shingles and a painful rash (shown on a lighter skin tone).
Photography by DermNet New Zealand

Prior to the rash starting, you may develop a burning sensation, itchiness, or tingling on one side of the body, often on the trunk. You may also develop:

• a headache
• sensitivity to light
• general fatigue

When the rash starts, you may notice pink or red blotchy patches on one side of your body. These patches cluster along nerve pathways. Some people report feeling shooting pain in the area of the rash.

During this initial stage, shingles is not contagious.

The rash quickly develops fluid-filled blisters like chickenpox. They may be accompanied by itching. New blisters continue to develop for several days. In most cases, according to the Centers for Disease Control and Prevention (CDC), blisters appear over a localized area, but widespread blistering is possible.

Blisters are most common on the torso and face, but they can occur elsewhere. In rare cases, the rash appears on the lower body. Some possibly may not develop a rash at all.

It’s not possible to transmit the shingles virus to someone. However, if you’ve never had chickenpox or the chickenpox (varicella) vaccine, it’s possible to get chickenpox from someone with shingles through direct contact with active blisters since the same virus causes both shingles and chickenpox.

Once a rash starts, it’s important to consult with your doctor within 3 days, according to the American Academy of Dermatology (AAD). In the first 3 days, they can prescribe an antiviral, which can help speed up recovery and reduce symptom severity.

Share on PinterestAs shingles heals, the rash will start to scab over (shown on a darker skin tone).
abdmalekmd/Getty Images

Share on PinterestIn most cases, shingles rash leaves no scars and fully heals (shown on a lighter skin tone).
helovi/Getty Images

Blisters sometimes erupt and ooze. They may then turn slightly yellow and begin to flatten. As they dry out, scabs form. Each blister can take 7 to 10 days to crust over, per the National Institute on Aging.

During this stage, your pain may ease a little, but it can continue for months, or in some cases, years.

Once all blisters have completely crusted over, there is a low risk of transmitting the virus.

Shingles often appears around the rib cage or waist, and may look like a “belt” or “half belt. ” You might also hear this formation referred to as a “shingles band” or a “shingles girdle.”

This classic presentation is easily recognizable as shingles. The belt can cover a wide area on one side of your midsection. Its location can make tight clothing particularly uncomfortable.

Share on PinterestIn some cases, shingles rash can present near the eye. This is known as ophthalmic shingles.
VideoBCN/Shutterstock

Ophthalmic shingles, also known as herpes zoster ophthalmicus, occurs around the eye. Often, it starts out as a burning or tingling sensation on the scalp, cheeks, or forehead.

Like when shingles appears on other areas of the body, the tingling sensation can turn into an itchy, painful rash on the scalp, forehead, or cheeks.

If shingles affects the eyes, it can cause symptoms such as redness and swelling of the eye, inflammation of your cornea or iris, and drooping eyelid. Ophthalmic shingles can also cause:

• mild to severe vision loss
• discharge from the eye
• feeling that a foreign body is in the eye
• light sensitivity

According to the CDC, though less common, people who develop shingles may develop a rash that crosses multiple dermatomes. Dermatomes are separate skin areas that are supplied by separate spinal nerves.

When the rash affects three or more dermatomes, it is called “disseminated or widespread zoster.” In these cases, the rash may look more like chickenpox than shingles. You are more likely to develop widespread shingles if you have a weakened immune system.

A secondary bacterial infection is a possible complication of shingles.

Open sores of any kind are always susceptible to bacterial infection. To lower the possibility of a secondary infection, keep the area clean and avoid scratching.

Severe infection can lead to permanent scarring of the skin. Report any sign of infection to your doctor immediately. Early treatment can help prevent it from spreading. People with weakened immune systems have a higher chance of developing infections or other complications.

Most people can expect the rash to heal within 2 to 4 weeks. Although some people may be left with minor scars, most will make a complete recovery with no visible scarring.

In some cases, pain along the site of the rash can continue for several months or longer. This is known as postherpetic neuralgia.

You may have heard that once you get shingles, you can’t get it again. However, the CDC cautions that shingles can return multiple times in some people.

The varicella-zoster virus causes shingles to occur. If you had chickenpox as a child or got the chickenpox vaccine, you can develop shingles at some point within your life. However, you have a lower risk of developing shingles if you had the vaccine.

The exact reason why the virus resurfaces is still not fully understood. However, as you age and your defense against the virus decreases, you may become more susceptible. The risk of developing shingles and complications increases drastically at 50 years old.

According to the CDC, about 1 in 3 adults will develop shingles at least once in their lifetime. Several factors, including age, can increase your risk of developing shingles at least once in your lifetime.

Possible risk factors include:

• being age 50 years or older
• living with human immunodeficiency virus (HIV)
• being a bone marrow or solid organ transplant recipient
• taking immunosuppressive medications, such as chemotherapy, steroids, or those related to transplants
• living with cancer, particularly leukemia and lymphoma

The CDC notes that other factors may play a part in who develops shingles, but more research is needed to further explain, better understand, and confirm these factors. According to research:

• There’s a higher prevalence of shingles diagnoses in white people compared with Black people.
• People who are assigned female at birth may be more likely to develop shingles than people who are assigned male at birth.

Most doctors can visually examine and diagnose shingles based on the rash and other symptoms. In most cases, the rash:

• appears a few days after other symptoms, such as tingling sensation, start
• develops only on one side of the body
• often occurs around the trunk
• appears only in one or two areas
• develops a blistering effect that lasts about 2 to 4 weeks

Shingles rash vs.

herpes

Share on PinterestCold sores are caused by HSV-1 (shown on a darker skin tone).
BonNontawat/Shutterstock

Share on PinterestHSV-1 spreads by close contact, commonly through kissing (shown on a lighter skin tone).
simarik/Getty Images

Shingles, also known as herpes zoster, is in the same viral family as herpes simplex. At first, it may be difficult to tell the two conditions apart because they both cause blistering rashes.

However, shingles, unlike herpes, typically does not cross the body’s midline and often appears on the trunk. Herpes often appears around the genitals or in the mouth. In both cases, a person may not develop a rash at all or may develop other symptoms that can help a doctor distinguish between the two conditions.

A person should talk with their doctor if they’re not sure which virus may be causing the rash.

For more information on herpes versus shingles rash, click here.

Shingles rash vs. poison ivy

Share on PinterestPoison ivy rash will appear red and inflamed and can be painful (shown on a darker skin tone).
Photo by DermNet New Zealand

Share on PinterestPoison ivy exposure can cause a quick-forming rash on the exposed areas (shown on a lighter skin tone).
Abm6868, CC BY-SA 4.0, via Wikimedia Commons

Poison ivy, oak, or sumac can cause an allergic reaction that results in a painful, itchy rash. When the rash appears, it often appears as a straight line.

One way to distinguish between the two conditions is that poison ivy often appears on exposed areas of skin and on both sides of the body.

You can learn more about the difference between shingles and poison ivy rash here.

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