Identify signs of shingles | Ada

What is shingles?

Shingles is an infection that usually produces a painful skin rash, but the painful tingling sensations which characterize the condition can also occur when no rash is present. Shingles is caused by the varicella zoster virus (VZV).

VZV is the same virus that causes chickenpox, a very common childhood infection. After a person has had chickenpox, VZV remains dormant in their body for the rest of their lifetime. If the virus reactivates, which can happen decades later, most often due to a weakened immune system, the resulting condition is called shingles. Although anybody who has already had chickenpox can develop shingles, the condition most commonly affects adults, typically those over 50 years of age.

The early signs of shingles are typically sensations of itching, numbness or a burning pain on the skin of the face, chest or back; in most cases this develops into the condition’s characteristic rash.

The rash develops into blisters on one side of the body, most commonly in one the following areas:

A shingles outbreak typically lasts for three to four weeks. Many people experience only one outbreak of shingles in their lifetime, although the condition can recur.

Good to know: Shingles is also known as herpes zoster, but it is important to note that this condition is not caused by the same virus, called herpes simplex, that results in genital or oral herpes.

Read more about Genital Herpes »
Read more about Herpes Labialis »

Symptoms of shingles

The principal symptom of shingles is a painful skin rash. This looks like red or discolored skin at first and eventually features weeping blisters.

Signs of shingles before the rash appears

Before the rash appears, early warning signs of shingles, which may be present, include:

• Itching, burning pain, numbness, tingling in the place where the rash will develop
• Flu-like symptoms such as chills, fever, headache, feeling fatigued or overly tired
• Upset stomach

After the initial skin complaints develop into the shingles rash, the condition typically lasts for two to four weeks. The pain typically worsens as the rash develops and alleviates as it heals.

What does the shingles rash look like?

The varicella zoster virus which causes shingles lies dormant in the nervous system, so the rash will appear in a dermatomal pattern; a band or area of skin on the body corresponding to a particular set of nerves. The shingles rash usually appears on the face, neck or one side of the torso.

Good to know: If the relevant nerves are affected, it is also possible to experience shingles on the leg. It is relatively unusual, but also possible, to develop the shingles rash in more than one area of the body, i.e. in relation to more than one set of nerves. Even more rarely and especially in people with a compromised immune system, three or more dermatomes may be affected. This is a form of the condition known as disseminated zoster.

As the condition progresses, the rash site develops blisters which fill with clear fluid. Because shingles interacts with a person’s nervous system, the rash is often accompanied by an intense, stabbing pain which worsens as it develops. The area affected by the rash may be hypersensitive to touch, which can render it difficult to dress or to sleep in certain positions.

A person with shingles is contagious to others in the period when their rash is blistering. During this period, a person should avoid physical contact with others, in particular, certain population groups, including:

• Elderly people
• Pregnant people
• People with a weakened immune system
• People who have not had chickenpox in the past

The blistering phase of the rash usually lasts for seven to ten days, and the lesions should then reduce in size as they heal, eventually disappearing.

Subtypes of shingles

Although the painful shingles rash on one side of the face, neck or torso is present in most cases of shingles, the condition can take various other forms.

Less common forms of shingles include:

• Zoster sine herpete; shingles with pronounced pain, but without the rash
• Internal shingles; shingles affecting the internal organs
• Herpes zoster ophthalmicus; shingles affecting the nerve in the eye
• Herpes zoster oticus; shingles which invades the facial nerve

Zoster sine herpete (ZSH): shingles without the rash

It is possible for a person to develop shingles without being affected by the rash, although this is rare. When shingles occurs without the rash being present, this is called zoster sine herpete (ZSH).

When shingles occurs without a rash, the first symptoms of the condition may involve:

• A feeling of numbness in a certain area
• An itchy, burning sensation
• A painful sensation
• Headache
• Fatigue
• Generalized aches
• Hypersensitivity to touch

When shingles is present, even without the rash, sensations will be concentrated in a specific area of the body – commonly the face, neck, one side of the torso or the eyes. However, in the absence of the shingles rash, zoster sine herpete may still rarely lead to neurological and visceral diseases, such as inflammation of the brain (encephalitis), Varizella pneumonia, paralysis of the facial nerves and problems related to keeping one’s balance or problems with hearing.

Because shingles shares characteristics with many other conditions, including herpes simplex, impetigo, dermatitis herpetiformis and contact dermatitis, it can easily be confused with these conditions. In cases where a rash is not present, a laboratory test will usually be necessary to establish the presence of the varicella zoster virus in the body.

Internal shingles

In rare cases, shingles can invade the lungs, nervous system and brain instead of – or as well as – the external areas of the body. This is more likely to happen in cases where a person has a weakened immune system, for example as caused by human immunodeficiency virus (HIV) or by undergoing a course of chemotherapy.

It is rarely possible to have internal shingles without a rash if it only affects internal parts of the body. People, who have a weakened immune system and suspect they may have shingles even though the typical rash is not present, should make their healthcare professional aware of their medical history immediately in order to prevent shingles developing internally.

Symptoms of internal shingles are related to the affected internal organ. If a person has internal shingles affecting the lungs, for example, developing pneumonia is a possible symptom.

Herpes zoster ophthalmicus

Also called ophthalmic herpes zoster, this form of the condition involves shingles invading the nerve in the eye. The first indicator that shingles has spread to the eye is the development of the shingles rash and/or associated sensations in the tip of the nose.

If shingles is suspected in the nasal area, it is advisable to consult an ophthalmologist, a doctor specializing in conditions which affect the eyes, without delay, as this form of shingles can cause visual distortions and even blindness.

Good to know: In some cases of herpes zoster ophthalmicus, Hutchinson’s sign may be present. This involves vesicles (fluid-filled sacs) developing on the tip or side of the nose, due to shingles affecting the nasociliary branch of the trigeminal nerve, which is connected to parts of the nose as well as the cornea in the eye.

Read more about Herpes Zoster Ophthalmicus »

Herpes zoster oticus (HZO)

This type of shingles occurs when shingles affects the facial nerves. Symptoms may vary, depending on which of the cranial nerves in the head is affected. The cranial nerve VII (nervus facialis) is affected in around 90 percent of cases of herpes zoster oticus, resulting in shingles on the face, neck, ear and/or mouth.

The other, less common, forms of herpes zoster oticus are:

• Ramsay Hunt Syndrome; a peripheral facial palsy, characterized by acute pain in one ear and the face. Vesicles may be present in the external ear canal, as well as additional auditory symptoms in some cases.
• HZO affecting cranial nerve VIII; or nervus vestibulocochlearis, which produces vestibular (balance system) symptoms such as dizziness and vertigo in addition to the shingles rash.

If a person suspects they may be affected by herpes zoster oticus, they should consult a healthcare professional immediately, as shingles which affects the facial nerves, indicates a likelihood of developing internal shingles.

Causes of shingles

All people who have been affected by chickenpox and, rarely, people who have been vaccinated against chickenpox and thereby carry VZV ‒ the virus which causes herpes zoster/shingles ‒ in their body, are at risk of developing shingles.

Good to know: If a person who has been vaccinated against chickenpox develops shingles, the infection tends to be significantly less severe than the condition can be when it affects people who do not carry any form of VZV in their body. It is therefore, in general, worthwhile for a person, who has not experienced chickenpox, to be vaccinated against it, even though this is an attenuated vaccine (containing a weakened version of the virus that does not cause the illness), and therefore does not offer total protection against related conditions such as shingles.

Shingles will affect around one in three people in the U.S. during their lifetime. After a person has recovered from chickenpox, VZV remains dormant in their body. It is stored in the nervous system and can reactivate as shingles when a person’s immune system is compromised by aging, illness or stress.

Is shingles (herpes zoster) contagious?

Shingles is only contagious at the point when the rash is blistering. At this time, VZV can be passed from a person with shingles to others via direct bodily contact, passing on traces of infected blister fluids and the sharing of towels, bedding and utensils.

It is only possible to catch the varicella zoster virus, rather than shingles itself: If a person who has never had chickenpox before is infected with VZV by somebody with shingles, they will develop chickenpox ‒ the first infection which VZV causes when it enters the body ‒ as opposed to shingles.

Risk factors

Shingles is most common in adults over 50 years of age. The Center for Disease Control and Prevention recommends that all people over 50 be vaccinated against shingles. The vaccine reduces the overall risk of contracting the condition by around 50 percent, and lessens the duration and severity of shingles if it occurs.

Since 2018, there is a dead vaccine against shingles. Getting the vaccine is recommended for everyone aged 50 or older and has an effectivity of over 90%.

Shingles can also affect people whose immune systems have been weakened by injury or illnesses, such as human immunodeficiency virus (HIV), cancer or the use of certain medicines or treatments which place a lot of stress on the immune system – such as organ transplants and chemotherapy. People of any age, who have previously had chickenpox and are experiencing a prolonged period of severe stress, are also at risk of shingles.

Pregnant people

If a person develops shingles while pregnant, it is usually mild and poses no further risk to the individual or their unborn baby. However, pregnant people who have never had chickenpox, should avoid contact with those affected by chickenpox and those affected by shingles as a precautionary measure.

People with shingles or chickenpox both have the capacity to infect others with VZV, and developing chickenpox whilst pregnant can result in potentially severe health complications for both the pregnant person and the developing fetus.

Diagnosis

Because the shingles rash is instantly identifiable due to its dermatomal pattern, the rash and accompanying pain, usually on one side of the body, are generally the only symptoms which need to be present for a shingles diagnosis to be made. The doctor will usually perform a physical examination and may take a swab from a blister, sending a sample of cells from the aggravated area of skin for a laboratory test in order to confirm the diagnosis.

It is recommended that anyone who thinks that they may be developing shingles seek medical attention as soon as possible to get supportive treatment and decrease the chance of infecting others. Although it is not possible to cure shingles, various pharmaceutical products can be prescribed on diagnosis which can help ease the pain and lessen the duration of the condition. These work most effectively when taken as soon as possible after the onset of shingles. If you suspect that you could be experiencing the first signs of shingles, or are unsure, consult the Ada app for a free symptom assessment.

Treatment

There is no cure for shingles, but by diagnosing the condition early, it is possible to:

• Prevent the spread and severity of shingles
• Reduce associated health complications
• Ease the pain
• Lessen the duration of the outbreak

Following a diagnosis of shingles, a physician will generally advise on a recovery plan designed to alleviate the discomfort associated with the shingles rash.

Recovery plan

Activities which are usually recommended for a swift recovery from shingles may include:

• Resting and relaxing
• Wearing loose-fitting clothes
• Keeping the rash clean and dry in order to dry out the blisters
• Keeping the rash uncovered so that the blisters can progress into the scabbing stage as quickly as possible
• Using cool compresses to alleviate the burning sensation on the skin
• Avoiding sharing bedding, clothing or towels, as this can facilitate the spread of infection to others

Medications to aid recovery

Medications which may be prescribed for alleviating the physical discomfort of shingles and combating the flare-up of the varicella zoster virus may include:

• Painkilling medications such as non-steroidal anti-inflammatory drugs (NSAIDs), paracetamol or opioids in cases of severe pain. In some cases, antidepressants or anticonvulsants may be prescribed for their pain-relieving properties, which can work effectively in combination with other painkillers.
• Antiviral medications

Signs of shingles FAQs

Q: Are there further health risks associated with shingles?
A: If left untreated, shingles is more likely to result in post herpetic neuralgia (PHN), a condition in which a burning pain continues to be felt in the areas affected by shingles for more than three months after the rash and blisters themselves have disappeared. Approximately one fifth of people who are affected by shingles will go on to develop PHN. The likelihood of shingles spreading to internal regions of the body likewise increases in the absence of a promptly initiated treatment and recovery plan.

Q: Are the signs of shingles different in adults to those in children?
A: The signs of shingles in children are largely the same as the signs of shingles in adults. However, shingles in children is generally less severe and lasts for a shorter duration than in adults, and most children recover well with no associated health complications. Shingles rarely affects children under three years of age and can only affect children who have already had chickenpox. Shingles are not common in children. However, having a weakened immune system as a result of an autoimmune disease, other chronic or serious disease or because of being overly stressed, however, can increase the likelihood of a child developing shingles.

Does stress cause shingles?
A: Stress itself does not cause shingles. However, it can, in some cases, make an attack of shingles more likely. This is because stress may weaken the immune system, potentially leaving a person more vulnerable to all types of infection, including the varicella zoster virus.

Good to know: People who have a weakened immune system, and who have never been infected by VZV before, will develop chickenpox the first time they catch the virus, rather than its subsequent form, shingles.

Q: Can herpes zoster cause encephalitis?
A: This rare condition occurs when the brain becomes inflamed, which is usually caused by the spread of an infection in the body to the brain. Viral infections, including the herpes simplex virus causing oral and genital herpes and VZV, which causes shingles, are more associated with developing encephalitis than bacterial infections. The possibility of developing encephalitis due to the spread of VZV or another virus is greater in people with a weakened immune system; for example, if a person’s immune system is compromised due to another underlying health condition, such as human immunodeficiency virus (HIV).

Early signs of encephalitis include flu-like symptoms such as headaches, fever, aching muscles and nausea,. More serious symptoms include drowsiness, seizures and difficulty speaking.Immediate medical attention should be sought if encephalitis is suspected, as it can be life-threatening and should be treated as soon as possible. Diagnostic tests for encephalitis will involve an MRI or ct scan to visualize the extent of the inflammation and a lumbar puncture to determine its cause. This will allow doctors to decide on the best course of treatment. If encephalitis is caused by the herpes simplex of VZV virus, treatment will involve a course of antiviral medication.

Q: What are the signs of shingles healing?
A: Normally, the blisters that feature in the shingles rash will burst around five days after they first develop. At this point, the stages of shingles healing are as follows: they will weep, turn into crusty scabs and begin to heal thereafter. From the time they burst, the scabbing and healing process takes approximately two weeks. Signs that shingles is healing as normal during this time include the size of the scabs diminishing, and, correspondingly, the severity of the pain associated with the rash reducing.

Q: Should I get the shingles vaccine?
A: The Centres for Disease Control and Prevention recommend the shingles vaccine for all people over 50 years of age, whether they have had chickenpox or not. The vaccine reduces the overall risk of contracting the condition by around 50 percent, and lessens the duration and severity of shingles if it occurs.

Since 2018, there is a dead vaccine against shingles. Getting the vaccine is recommended for everyone aged 50 or older and has an effectivity of over 90%.

The shingles vaccine is not recommended for certain population groups, including people who are:

• Pregnant. A person who has had the shingles vaccine should wait a minimum of four weeks before trying to become pregnant
• Affected by a condition which weakens the immune system, such as HIV
• Affected by any type of cancer affecting bone marrow or the lymphatic system
• Using immunosuppressive medications such as steroids
• Undergoing radiation therapy or chemotherapy
• Receiving an organ or bone marrow transplant in less than 4 weeks time, just having received it or while being on immunosuppressive medication after receiving one

How to Tell the Difference Between Shingles and Other Rashes

It could be nothing. ..or it could be serious. Learn how to tell the differences between shingles and other skin conditions.

iStock

Picture this: You wake up one morning, roll out of bed, walk into the bathroom, and look in the mirror. Uh oh—something’s up with your skin. There’s a strange red rash creeping up your chest, and a tingling feeling along with it. What’s going on? Unexplained skin changes can be disconcerting, not to mention seriously uncomfortable. But should you be worried? Stick with us while we break down the possible causes of your skin situation, from chickenpox to shingles, hives, or even eczema. Then follow these tips to help you get the treatment you need to feel better ASAP.

Is It Chickenpox?

First thing to know: Chickenpox is a skin condition caused by the virus varicella zoster. This virus is a member of the herpes family, says Anna Wald, M.D., head of the allergy and infectious disease division at the University of Washington School of Medicine in Seattle. “There are eight different viruses in the herpes family,” she explains, including the herpes simplex viruses (which cause oral and genital herpes), Epstein-Barr virus (which causes mononucleosis), and more.

Say you don’t remember getting the chickenpox as a kid, and you never got the vaccine—could this virus be the root of your suddenly itchy skin? This may clear things up: Most people (as in more than 99%) born before 1980 in the United States have had chickenpox, according to the Centers for Disease Control and Prevention (CDC)—yes, even if you don’t remember it! And thankfully, it’s super rare to get chickenpox more than once.

But what if you’re younger than 40? Or what if you’re convinced you are part of the 1% of people who never got chickenpox? Let’s take a look at the symptoms of this skin condition.

“Chickenpox gives you a rash all over your body,” rather than hanging out in one isolated area, Dr. Wald says. That rash turns into fluid-filled blisters that are seriously itchy. These eventually scab over and heal after about four to seven days. While an itchy rash is the main sign of chickenpox, other symptoms include fatigue, fever, headache, and loss of appetite.

Even if you have some of these symptoms, it’s worth noting that the illness typically strikes when you’re young, says Edward Jones-Lopez, M.D., infectious disease expert with Keck Medicine at the University of Southern California in Los Angeles. “Typically, this infection occurs in childhood,” he says. “It’s one of those viruses that is transmitted between kids’ saliva and close contact.” That said, technically speaking anyone can get chickenpox. Unfortunately, if you do get it as an adult, it’s usually more severe than a childhood infection.

A final word on the pox: Even if you got the chickenpox vaccine when you were a kid, it’s possible (though not probable) that you can still get the infection. The good news is that cases tend to be much milder (think rash but no blisters).

Could It Be Shingles?

If you’re an older adult and experiencing a blistery rash, the most likely answer is that you’ve got shingles, a. k.a. herpes zoster, which affects one in three people in their lifetime, according to the CDC. Shingles is what’s known as a “reactivation” virus that usually affects older adults, says Dr. Jones Lopez. Basically, once you’ve had chickenpox, the varicella zoster virus stays in your body. “After the initial infection, the virus goes into dormant state for potentially decades,” he says. “Much later in life, when your immunity goes down, it can reactivate as shingles.”

Unlike a chickenpox rash, the shingles rash is usually confined to a specific area of the body and appears in a single band, rather than spreading indiscriminately. “It typically happens somewhere on the chest or back,” says Dr. Jones-Lopez, although the head and other parts of the body can sometimes be affected. “The key thing that distinguishes the shingles rash is that it doesn’t cross the midline. If it spreads across your body, it’s not shingles.” For example, if you’ve got a rash on left side of your face but another on the right side of your back, you can probably rule out this illness.

In addition to a rash (or before a rash even appears), you may have some pain, itching, or tingling on your skin. You may also have flu-like symptoms (fever, chills, upset stomach, and headache). Like chickenpox, shingles rashes may itch—but they are mostly known for causing pain.

Maybe It’s Hives?

Hives, officially called urticaria, are a common cause of skin rashes. Unlike chickenpox and shingles, hives are not caused by a virus. Instead, they are usually the result of an allergic reaction—to insect bites or stings, medicines, food, or other environmental triggers, according to the American College of Allergy, Asthma, and Immunology (ACAAI). Sometimes, the cause is unknown.

While hives and shingles both appear as rashes, the similarities stop there. “Shingles doesn’t look like hives—the onset is very different,” says Dr. Wald. “There’s usually much more pain with shingles.” Meanwhile, if your prominent symptom is itching, it’s more likely to be hives.

The rash appearances are different as well. In lieu of shingles’ blistery surface, hives appear as red, raised bumps called welts or wheals that can vary in size and pop up anywhere on the body; if you press down on the center of one, it will turn white.

Another clue as to whether your rash is hives has to do with duration. Chickenpox lasts about a week; shingles lasts up to a month. Hives, though, are short-term: They typically appear and disappear within a few days (although in rarer cases they can be chronic).

Do I Have Eczema?

Still stumped on the source of your skin outbreak? Another non-viral cause of itchy rashes is called eczema, a.k.a. atopic dermatitis. This condition affects 10% to 20% of kids, but only 1% to 3% of adults, making it less likely to be the culprit, as most people outgrow eczema with age.

Compared with the other rashes, eczema’s appearance tends to be on the dryer, scalier side of things, with plenty of redness and itchiness as well. Eczema can be the result of an allergic reaction to things like dust mites or pet dander, along with other environmental triggers like certain soaps or perfumes.

To distinguish eczema from hives, look for small bumps filled with fluid, says the ACAAI. These bumps can leak liquid that is clear or yellow. Unlike chickenpox, shingles, or hives, eczema is a chronic condition that requires treatment to keep it under control.

The Bottom Line

In addition to chickenpox, shingles, hives, and eczema, there are other possible causes for that itchy skin rash. And while most rashes are mild and don’t cause long-term harm, it’s always a good idea to check with your doctor if there’s something strange going on with your skin. Shingles, for one, responds infinitely better to antiviral treatments if you get them right away, says Dr. Wald. Seek the care of your family doctor or dermatologist if your skin rash persists or comes with other painful or concerning symptoms—they can give you an accurate diagnosis and put you on the road to relief.

Meet Our Writer

Lara DeSanto

Lara is a health writer, trauma-informed art therapist, and registered associate marriage and family therapist practicing in Los Angeles. She is also a former digital editor for HealthCentral, covering Sexual Health, Digestive Health, Head and Neck Cancer, and Gynecologic Cancers. In a past life, she worked as the patient education editor at the American College of OB-GYNs and as a news writer/editor at WTOP.com.

Shingles (Herpes Zoster) | Loma Linda University Health

Shingles

What is shingles?

Shingles (herpes zoster) is a
common infection of the nerves. It is caused by a virus. Shingles triggers a painful
rash or small blisters on an area of skin. It can appear anywhere on the body, but
it
typically appears on only one side of the face or body. Burning or shooting pain and
tingling or itching are early signs of the infection. After the rash is gone, the
pain
usually resolves. But it can continue for months, even years. This is called
postherpetic neuralgia.

What
causes shingles?

Shingles is caused when the
chickenpox virus is reactivated. After a person has had chickenpox, the virus lies
dormant in certain nerves for many years. Shingles is more common in people with a
weak
immune system and in people over age 50. The risk goes up with each decade of life
after
that.

What
are the symptoms of shingles?

Symptoms may include:

• Skin
  sensitivity, tingling, itching, or pain in the area of the skin before the rash
  appears
• Rash, which typically appears 1 to 5
  days after symptoms start. At first, the rash looks like small, red spots that turn
  into blisters.
• Blisters typically scab over in 7 to
  10 days and clear up within 2 to 4 weeks.

Other
early symptoms of shingles may include:

• Stomach
  upset
• Feeling
  ill
• Fever or
  chills
• Headache

The
symptoms of shingles may look like other health conditions. Always talk with
your healthcare provider for a diagnosis.

How is shingles diagnosed?

Your healthcare provider will do a
complete physical exam and ask about your health history. Specifically, they will
ask
about whether you have ever had chickenpox.

Your healthcare provider will
likely know right away that it is shingles based on the unique rash. The rash usually
appears in one area on one side of the body or face. It appears as red spots, small,
fluid- or pus-filled vesicles, or scabs.

The
healthcare provider may also take skin scrapings for testing.

How is
shingles treated?

Antiviral medicines may help ease
some of the symptoms of shingles, shorten the course, and lessen the chance of nerve
damage and postherpetic neuralgia. Other treatments focus on pain relief and preventing
infection. Painkillers may help ease some of the pain. Other treatments may include:

• Creams
  or lotions to help ease itching
• Cool
  compresses put on affected skin areas
• Antibiotics for the skin (topical) or taken by mouth (oral) or IV (intravenous) if
  there are signs of bacterial infection in the involved area
• Steroids
• Antidepressants for nerve pain
• Anticonvulsants for nerve pain

What are possible complications of shingles?

Symptoms of shingles usually don’t
last longer than 3 to 5 weeks. But complications can happen. The main complications
that
can result from shingles include:

• Postherpetic neuralgia (PHN). This is the most common
  complication of shingles. This continuous, chronic pain lasts even after the skin
  sores have healed. The pain may be severe in the area where the blisters were
  present. The affected skin may be very sensitive to heat and cold. If you had severe
  pain during the active rash or have impaired senses, you are at increased risk for
  PHN. Elderly adults are also at greater risk. Early treatment of shingles may prevent
  PHN. Pain relievers and steroid treatment may be used to treat the pain and
  inflammation. Other treatments include antiviral medicines, antidepressants,
  anticonvulsants, and medicines for the skin.
• Bacterial infection. A bacterial infection of the skin
  where the rash happens is another complication. Rarely, infections can lead to more
  problems, such as tissue death and scarring.
• Vision problems. When an infection happens near or on the
  eyes, a corneal infection can happen. This can lead to temporary or permanent
  blindness.

How can
I help prevent shingles?

The recombinant zoster vaccine
(RZV) vaccine is available to prevent shingles or make it less painful.

Experts recommend the vaccine for
all adults 50 and older, even if you’ve had shingles before. Two doses of the RZV
vaccine are recommended. You should get the second RZV dose 2 to 6 months after the
first. The vaccine makes it less likely that you will develop shingles. If you do
develop shingles, your symptoms will likely be milder than if you hadn’t been
vaccinated. RZV is also advised even if you had the older shingles vaccine (zoster
live
vaccine, ZVL) in the past. That’s because the RZV vaccine works better and protects
you
from shingles longer.

Talk with your healthcare provider
about the best time for you to get vaccinated, along with the benefits and side
effects. 

When should I call my healthcare provider?

To
reduce the severity and shorten the length of the illness, treatment must be started
as
soon as possible. If you think you have shingles, call your healthcare provider as
soon
as possible.

Key
points about shingles

• Shingles
  is a common viral infection of the nerves. It causes a painful rash or small blisters
  on an area of skin.
• Shingles is caused when the chickenpox virus is reactivated.
• It is more common in people with a
  weak immune system and in people over the age of 50.
• Shingles starts with skin sensitivity,
  tingling, itching, or pain, followed by a rash that looks like small, red spots that
  turn into blisters.
• The rash typically affects just one
  area on one side of the body or face.
• Starting treatment as soon as possible
  helps reduce the severity of the disease.

Next steps

• Know the
  reason for your visit and what you want to happen.
• Before
  your visit, write down questions you want answered.
• Bring
  someone with you to help you ask questions and remember what your provider tells
  you.
• At the visit, write down the name of a
  new diagnosis and any new medicines, treatments, or tests. Also write down any new
  instructions your provider gives you.
• Know why a new medicine or treatment
  is prescribed and how it will help you. Also know what the side effects are.
• Ask if
  your condition can be treated in other ways.
• Know why
  a test or procedure is recommended and what the results could mean.
• Know
  what to expect if you do not take the medicine or have the test or procedure.
• If you
  have a follow-up appointment, write down the date, time, and purpose for that
  visit.
• Know how you can contact your provider
  if you have questions.

5 Things You Need to Know About Shingles

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Shingles is a painful skin rash caused by the same virus that causes chickenpox. Learn about the disease, its symptoms, treatment, and prevention.

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Transcript

Shingles is a disease that causes a painful skin rash. About 1 in 3 people will get shingles, and your risk increases as you age. It comes from the same virus that causes chickenpox. Although there is no cure, shingles can be prevented and treated.

Here are 5 things you need to know about shingles:

1. Anyone who has recovered from chickenpox, and even children, can get shingles.
2. Symptoms of shingles include burning or shooting pain, tingling or itching, chills, fever, headache, upset stomach, and rashes or blisters that develop on one side of the body, usually on your face or around your waist. There are medicines that may help.
3. Healthy adults age 50 and older should talk to their healthcare professional about getting the shingles vaccine to reduce their risk.
4. Generally shingles is not contagious, but a person with active shingles can spread the virus when the rash is in the blister phase. It’s important to keep the rash covered.
5. Most cases of shingles last 3-5 weeks. Most people get shingles only one time, but, it is possible to have it more than once.

If you think you might have shingles, talk to your doctor as soon as possible. Learn more about shingles.

Shingles – UptownDerm

Shingles is a painful, blistering rash that is caused by the same virus that causes chickenpox, the varicella-zoster virus (VZV).  Shingles can only occur in people who have had chickenpox.

Although the symptoms of chickenpox usually go away after the recovery from the initial childhood infection, the virus remains hidden in nerve cells. In some people it remains dormant forever, yet in others it attacks again. The second episode of chickenpox virus infection is called shingles.

Shingles is sometimes referred to as “herpes zoster” or “zoster” because it belongs to the same family of viruses. However, it is not caused by the herpes virus that causesgenital herpes or cold sores.

Symptoms

The first sign of shingles is often burning or tingling pain, or itch, in one particular location on only one side of the body.

Before the rash develops, there is often pain, itching, or tingling in the area where the rash will develop. Other symptoms of shingles can include fever, headache, chills, and upset stomach.

After several days or a week, a rash of fluid-filled blisters, similar to chickenpox, appears in one area on one side of the body.

Shingles pain can be mild or intense. Some people have mostly itching; some feel pain from the gentlest touch or breeze. The most common location for shingles is a band, called a dermatome, spanning one side of the trunk around the waistline. The second most common location is on one side of the face around the eye and on the forehead. However, shingles can involve any part of the body. The number of lesions is variable. Some rashes merge and produce an area that looks like a severe burn. Other patients may have just a few scattered lesions that don’t cause severe symptoms. Mild cases of shingles with only a few lesions are common.

For most healthy people, the blisters start to scab over after 3-5 days. The rash usually clears within 2 to 4 weeks. The pain and itch that accompany the lesions fade away, and the blisters leave no scars. Other people may have sensory symptoms that linger for a few months.

Are There Any Long-Term Effects From Shingles?

Very rarely, shingles can lead to pneumonia, hearing problems, blindness, brain inflammation (encephalitis) or death. For about 1 person in 5, severe pain can continue even after the rash clears up. This pain is called post-herpetic neuralgia. As people get older, they are more likely to develop post-herpetic neuralgia, and it is more likely to be severe.

How Often Can A Person Get Shingles?

Most commonly, a person has only one episode of shingles in his/her lifetime. Although rare, a second or even third case of shingles can occur.

Can Shingles Be Spread To Others?

A person with a shingles rash can pass the virus to someone, usually a child, who has never had chickenpox, but the child will develop chickenpox, not shingles. The child must come into direct contact with the open sores of the shingles rash during the blistering phase. Once the rash has developed crusts, the person is no longer contagious.

Merely being in the same room with a shingles patient will not cause the child to catch chickenpox because during a shingles infection the virus is not normally in the lungs and therefore can’t be spread through the air.

What Can Be Done To Prevent The Spread Of Shingles?

The risk of spreading shingles is low if the rash is covered. People with shingles should keep the rash covered, not touch or scratch the rash, and wash their hands often to prevent the spread of the chickenpox virus (varicella). Once the rash has developed crusts, the person is no longer contagious.

A shingles vaccine is available for use in people 60 years old and older to prevent shingles.

The older a person is, the more severe the effects of shingles typically are, so all adults 60 years old or older should get the shingles vaccine. The shingles vaccine is specifically designed to protect people against shingles and will not protect people against other forms of herpes, such as genital herpes. The shingles vaccine is not recommended to treat active shingles or post-herpetic neuralgia (pain after the rash is gone) once it develops.

How Is Shingles Treated?

Shingles attacks can be made less severe and shorter by using prescription antiviral drugs: acyclovir, valacyclovir, or famcyclovir. These medications should be started as soon as possible after the rash appears

Acyclovir is available in a generic form, but the pills must be taken five times a day, whereas valacyclovir and famcyclovir pills are taken three times a day. It is important not to miss any doses and not to stop taking the medication early.

Antiviral drugs can reduce by about half the risk of being left with postherpetic neuralgia, which is chronic pain that can last for months or years after the shingles rash clears.

Doctors recommend starting antiviral drugs at the first sign of the shingles rash, or even if the telltale symptoms indicate that a rash is about to erupt. Even if a patient is not seen by a doctor at the beginning of the illness, it may still be useful to start antiviral medications if new lesions are still forming.

Other treatments to consider are anti-inflammatory corticosteroids such as prednisone. These are routinely used when the eye or other facial nerves are affected.

Who Is At Risk For Getting Shingles?

About 25% of all adults, mostly otherwise healthy, will get shingles during their lifetimes, usually after age 40. The incidence increases with age so that shingles is 10 times more likely to occur in adults over 60 than in children under 10.

People with compromised immune systems from the use of immunosuppressive medications or serious illnesses, such as cancer or HIV, are at special risk of developing shingles. These individuals also can have recurrent shingles and may have shingles that never heal. Most people who get shingles strenghen their immunity to the chickepox virus and will not get the disease for another few decades.

Can Infection With VZV During Pregnancy Harm The Baby?

Many mothers-to-be are concerned about any infection contracted during pregnancy.  Some infections can be transmitted to the baby either across the mother’s bloodstream to the fetus or during the birth process.  Chickenpox virus infection during pregnancy poses some risk to the unborn child, depending upon the stage of pregnancy.  During the first 30 weeks, maternal chickenpox may, in some cases, lead to congenital malformations. Such cases are rare and experts differ in their opinions on how great the risk is. Most experts agree that shingles in a pregnant woman, a rare event, is even less likely to cause harm to the unborn child.

If a pregnant woman gets chickenpox between 21 to 5 days before giving birth, her newborn can have chickenpox at birth or develop it within a few days. But the time lapse between the start of the mother’s illness and the birth of the baby generally allows the mother’s immune system to react and produce antibodies to fight the virus. These antibodies can be transmitted to the unborn child and help fight the infection. Still, a small percent of the babies exposed to chickenpox in the 21 to 5 days before birth develop shingles in the first 5 years of life because the newborn’s immune system is not yet fully functional.

If the mother contracts chickenpox at the time of birth, her immune system has not had a chance to mobilize its forces and create very many antibodies that can fight VZV.  Although some of the mother’s antibodies will be transmitted to the newborn via the placenta, the newborn will have little ability to fight off the attack because its immune system is immature. If these babies develop chickenpox as a result, it can be fatal. They are given zoster immune globulin, a preparation made from the antibody-rich blood of adults who have recently recovered from chickenpox or shingles, to lessen the severity of their chickenpox.

Shingles (herpes zoster)

Last Reviewed: May 2016

What is shingles?

Shingles, also called herpes zoster or zoster, is a painful skin rash caused by the varicella-zoster virus, the same virus that causes chickenpox. After a person recovers from chickenpox, the virus remains inactive in the body. Usually the virus does not cause any further problems; however, the virus may re-emerge years later, causing shingles.

Who gets shingles?

Anyone who has recovered from chickenpox may develop shingles, including children. However, shingles most commonly occurs in people 50 years old or older. The risk of getting shingles increases as a person gets older. People who have medical conditions that keep the immune system from working properly, like cancer, leukemia, lymphoma, and human immunodeficiency virus (HIV) infections, or people who receive drugs that weaken the immune system, such as steroids and drugs given after organ transplantation, are also at greater risk to get shingles.

How is shingles spread?

A person must have already had chickenpox in the past to develop shingles. A person cannot get shingles from a person that has shingles. However, the virus that causes chickenpox and shingles can be spread from a person with active shingles to a person who has never had chickenpox or had the chickenpox vaccine. The person exposed to the virus would develop chickenpox, not shingles. A person with shingles can spread the virus when the rash is in the blister-phase. The blister fluid is filled with virus particles. The virus is spread through direct contact with the rash or through breathing in virus particles that get mixed in the air. Once the rash has developed crusts, the person is no longer contagious. A person is not infectious before blisters appear or if pain persists after the rash is gone (post-herpetic neuralgia).

What are the symptoms of shingles?

Shingles usually starts as a rash on one side of the face or body. The rash starts as blisters that scab after seven to ten days. The rash usually clears within two to four weeks.

Before the rash develops, there is often pain, itching, or tingling in the area where the rash will develop. Other symptoms of shingles can include fever, headache, chills, and upset stomach.

How soon do symptoms appear?

The virus lies dormant in someone who has had chickenpox in the past. It can reactivate many years later.

What are the complications associated with shingles?

Shingles is not usually dangerous to healthy individuals although it can cause great misery during an attack. Anyone with shingles on the upper half of their face, no matter how mild, should seek medical care at once because of the risk of damage to the eye. Very rarely, shingles can lead to pneumonia, hearing problems, blindness, brain inflammation (encephalitis) or death. For about one person in five, severe pain can continue even after the rash clears up. This pain is called post-herpetic neuralgia. As people get older, they are more likely to develop post-herpetic neuralgia, and it is more likely to be severe.

Is there a treatment for shingles?

Several antiviral medicines, acyclovir (Zovirax), valacyclovir (Valtrex), and famciclovir (Famvir), are available to treat shingles. These medications should be started as soon as possible after the rash appears and will help shorten the illness and decrease how severe the illness is. Pain medicine may also help with pain caused by shingles. Call your provider as soon as possible to discuss treatment options.

Does past infection make a person immune?

Usually. Most people who have shingles have only one episode with the disease in their lifetime. Although rare, a second or even third case of shingles can occur.

Is there a vaccine for shingles?

There are two shingles vaccines currently available, Shingrix and Zostavax. Shingrix vaccine, a newer vaccine, is preferred over Zostavax for the prevention of shingles and its complications. Two doses of Shingrix given 2 to 6 months apart are recommended for healthy adults 50 years of age and older. Shingrix is also recommended for adults who have previously received Zostavax. A single dose of Zostavax may still be used to prevent shingles in certain cases for healthy adults 60 years and older.

What can be done to prevent the spread of shingles?

A vaccine for chickenpox is available and it is hoped that individuals immunized against chickenpox will be less likely to develop shingles in later life.

The risk of spreading the virus that causes shingles is low if the rash is covered. People with shingles should keep the rash covered, not touch or scratch the rash, and wash their hands often to prevent the spread of shingles. Once the rash has developed crusts, the person is no longer contagious.

Senior Health Blog | July 2018

Posted: 7/23/2018 11:19 AM by
Interim HealthCare

6 questions to help you figure out what’s causing that outbreak.

Contributed by Maura Rhodes, a health journalist based in Montclair, New Jersey, who has written about caregiving throughout all ages and stages of life. 

 

Every year, about one in 100 people age 60 or older develops shingles, the dreaded skin condition notorious for causing pain that can be agonizing. According to the National Institutes of Health, about half of all shingles cases affect people 60 and over, and the risk of developing the condition increases greatly by age 70.

 

Shingles, aka herpes zoster, is caused by the same virus that causes chicken pox. The virus lives in the body forever and can reemerge later in life as shingles. Shingles is serious business. It can lead to long-term complications, including post-herpetic neuralgia, which causes burning pain so intense it can make it hard to do simple things like get dressed, cook and even eat. If the rash appears near the eyes or ears, it can result in vision or hearing loss.

 
Early treatment can help shorten an outbreak, so it’s important to know the signs and symptoms.

 
Shingles can look very different in different people — at least to the untrained eye. A doctor usually can identify it by looking at it and evaluating symptoms, but you may not be able to tell the difference between shingles and, say, poison ivy, hives, psoriasis or eczema.  

Any rash that might be shingles should be looked at by a doctor. The sooner shingles is treated, usually with antiviral medication, the milder the rash, the faster it will disappear and the lower the risk of complications.

 

How do you know if it might be shingles? These six questions can help you figure it out.

 
1. Has the person had chickenpox? Shingles can occur only in someone who has had chickenpox, or who has had the chickenpox vaccine (which introduces a weakened form of the virus into the body to trigger an immune response). If they haven’t had either, consider that the rash could be chicken pox.

 
2. Do they have, or have they recently had, cold or flu symptoms? Since shingles is caused by a virus, it often brings on virus symptoms such as fever, headache, muscle pain, chills, upset stomach, sensitivity to light and fatigue.

 
3. Does it hurt? Although shingles, like many other skin conditions, can be itchy, the most common symptom is pain that develops before the rash appears. An area of skin affected by a shingles rash can be so sensitive to touch that the brush of fabric can set off searing pain. If the person complains of burning, tingling or numbness in a specific area of skin that’s still clear, it could be a sign of an oncoming breakout of shingles. Best course of action: Get them to a doctor. Don’t wait.

 
4. Is the rash blistery? The shingles rash starts with a constellation of tiny, fluid-filled blisters that are separate from each other but clustered together. The fluid in the blisters is highly contagious and can cause chickenpox in someone who’s never had it or been vaccinated for it. (Shingles itself isn’t contagious.)

 
5. Where is the rash? Shingles can occur just about anywhere, but it almost always affects only one side of the body or face. The most common areas are the torso (around the waistline or just below the chest), the shoulder, neck or upper back, and the upper side of the face, near the eye or ear or on the forehead. A shingles rash almost always develops as a stripe or band of blisters. This is because the little bumps are running parallel to a line of nerves. In contrast, skin conditions that sometimes are mistaken for shingles, such as plaque psoriasis and eczema, tend to be more widespread and random, or to affect other body parts. Psoriasis, for example, tends to appear on the knees, elbows, back, and scalp and behind or underneath the ears; it also causes flaking, which shingles does not.

 
6. Is the rash scabby? After shingles blisters open, they crust over and form scabs. Poison ivy, poison oak and poison sumac also cause blisters that open and scab over. If the person has been gardening or walking in the woods or other areas where these plants can grow, mention it to the doctor.

 

Considering how unpleasant and potentially dangerous shingles is, it’s worth avoiding. A shingles vaccine is available. The Centers for Disease Control and Prevention recommends that all healthy adults 50 and older get vaccinated. A person can get the vaccine even if they’ve had shingles in the past, to help prevent another episode.

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90,000 Shingles-like rash on the back – Question to the dermatologist

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90,000 What symptoms will warn about coronavirus infection

Doctors from Italy and Spain spoke about a new symptom of the coronavirus. According to them, every fifth patient has a rash on the legs – similar to the one that occurs with smallpox or measles. Basically, this symptom of the disease is manifested in children and adolescents, the doctors emphasized. What other unusual changes in the body signal about COVID-19?Ru “.

A new symptom of coronavirus infection was identified by Italian and Spanish doctors – every fifth patient with COVID-19 develops a rash on the legs. This is reported by the Metro edition.

According to experts, rashes are most often found in children and adolescents. According to the Italian children’s dermatologist Mazzota Troccoli, if the research confirms the relationship with the disease, it will help to quickly identify people with asymptomatic infection.

Doctors recommend that people self-isolate at the first appearance of redness on the legs.If the condition worsens, you must immediately call an ambulance.

“Many people wonder if COVID-19 affects the skin. The answer is yes, ”said Randy Jacobs, Associate Professor of Dermatology at the University of California.

A similar symptom is confirmed by Spanish experts. The Council of Orthopedic Colleges in Spain emphasized that the rash is similar to that that occurs with measles and smallpox. Mostly redness is observed in the area of ​​the toes and gradually heals without leaving marks.

Earlier, the World Health Organization (WHO) said that the coronavirus has learned to disguise itself as a cold or flu. As reported by the Express portal, such diseases are accompanied by cough, shortness of breath and high fever, however, COVID-19 at first only causes nasal congestion, as well as pain in the throat and head. As a result, the alleged infected person may not turn to doctors for help.

Experts emphasize: since the virus is transmitted by airborne droplets, it is possible to get infected from a person who only complains of a runny nose.

Moreover, researchers from Harvard University School of Medicine have found another unusual symptom of coronavirus – loss of smell.

It turned out that certain cells in the nasal cavity hide from the virus proteins necessary for infections to enter the host’s body. Infection of these cells, according to scientists, leads to the spread of COVID-19 and the manifestation of symptoms associated with loss of smell.

“These patients may be some of the previously unknown hidden carriers that contributed to the rapid spread of COVID-19.Unfortunately, the symptoms of these patients do not meet the current criteria for testing or self-isolation, ”the British Society of Rhinologists said in a statement.

Also, the researchers suggested that damage to the cells of the connective tissue in the nose can lead to infection. At the same time, the WHO said that they cannot yet confidently recognize this as a sign of the presence of a disease. At the same time, this symptom occurs in many people infected with the coronavirus.

Another unusual symptom of the disease is conjunctivitis.According to experts from the American Academy of Ophthalmology, coronavirus can cause its mild form – this complicates the process of establishing the true viral nature of the disease.

According to doctors, this symptom manifests itself in those who have aerosol contact of the virus with the mucous membrane or conjunctiva – that is, the virus entered the human body through the eyes.

As a result, the infected person manifests an increase in blood vessels in the eyes, burning sensation, the formation of pus, itching and tearing.

Meanwhile, another symptom of coronavirus is diarrhea – this symptom manifested itself in the early stages of the onset of the disease. In a study of 204 patients from hospitals in Wuhan, it was found that 48.5% sought medical help because of digestive problems. At the same time, they had no other signs of the disease.

Another strange symptom was recorded in the USA. There are currently patients in hospitals who test positive for COVID-19 who show only stomach pain of all the signs of illness, according to Dr.Michael Hirsch.

“We see that patients come not so much with complaints of respiratory diseases, but with complaints of pain in the stomach,” the doctor emphasized. He added that this is due to the virus affecting the lower lobes of the lungs, which become inflamed and irritate the diaphragm.

90,000 Spots on the skin similar to lichen: photos, possible diseases, treatment

Lichen is not a separate disease, but a group of fungal skin diseases. Damage to the epidermis is caused by microscopic fungi and viruses, with allergies, metabolic disorders, a rash also appears.Small and large spots on the skin, similar to lichen, occur in patients with eczema, psoriasis. Meanwhile, rashes with shingles are completely different from the manifestations of dermatomycosis (fungal infection). In the case of different types of lichen, specific treatment and general measures will be required – strengthening the immune system, fighting bad habits.

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The name “lichen” – collective

Some people are more susceptible to fungal infection, others do not become infected even through close household and sexual contact with sick or carriers.The spots that appear on the skin, similar to lichen, are usually alarming for those who have at least once encountered fungal diseases.

Many people know that ringworm pathogens are transmitted from a sick person or animal. The characteristic signs of a contagious infection are ring spots, round plaques on the head, limbs, and trunk. Peeling of the skin occurs on the affected area of ​​the skin, severe or moderate itching worries.

Skin spots similar to lichen occur in the following diseases:

1. Trichophytosis of the body and scalp (caused by a fungal infection).
2. Pityriasis or pityriasis versicolor (pathogens – several types of fungi).
3. Mycotic and microbial eczema (caused by fungal and bacterial infection).
4. Lichen planus (causes – viral infection, allergic reactions).
5. Herpes zoster or herpes zoster (causative agent – herpesvirus).
6. Pink lichen (the causative agent is a virus, the causes are associated with allergies).
7. Psoriasis, scab or lichen scaly (autoimmune disease).
8. Microsporia or ringworm (caused by a fungal infection).

It happens that the fungus – the causative agent of trichophytosis – is present and does not manifest itself in anything, it is suppressed by the immune system. The same thing happens with shingles. This is a herpesvirus infection, its causative agent is varicellasoster. Causes chickenpox in childhood, persists in the nerve endings in people who have had chickenpox. The varicellazoster virus, under certain conditions, becomes active again and causes shingles.The disease is sometimes very difficult, the temperature rises, severe pains appear in the chest area.

Signs of lichen and predisposing factors

Regardless of the species of the infectious agent, manifestations of diseases can be common in different patients. For example, spots on the skin, similar to lichen, itch, accompanied by flaking. The pigmentation of the affected areas of the skin is disturbed, they become darker or lighter in color, bright pink, red or brown.

Trichophytosis is characterized by scaly spots, microbial eczema – weeping spots. With shingles, nodules and blisters appear, in the case of psoriasis – plaques, skin tightening. Dermatologists and other physicians claim that certain conditions increase the risk of disease.

Factors increasing the likelihood of infection:

• long-term use of medications for allergies;
• chronic diseases, sluggish current infections;
• hereditary predisposition;
• depressive state of immunity;
• exposure to dampness, cold;
• stressful situations;
• old age.

“Entrance gate” for fungal, bacterial and viral infections – microcracks, abrasions, scratches on the skin. Diseases often develop after fleeting touching the hair or skin of a sick person, his things. Infection is possible through direct contact with infected animals, particles of their wool.

Spots on the body – versicolor or not?

When a rash occurs in the form of spots, nodules or blisters, it is better to consult a specialist. With various infectious and non-infectious diseases, spots appear on the skin similar to lichen, but not versicolor.It could be syphilis or Lyme disease. In each case, a thorough examination and specific antimicrobial therapy will be required.

Pink lichen is very rare in children and old people. The disease mainly affects young people and middle-aged people (20 to 45 years old). Experts noticed that the disease occurs from spring to autumn, and suggested a viral etiology. Scientists name herpes viruses and ARVI as the cause.

At the beginning of the disease, a large “maternal” spot of pink-red color appears.The diameter of the affected area is from 3 to 5 cm. Over time, the spot turns yellow-brown, and a pink “fringe” remains at the edges. After 7-14 days, the appearance of “daughter” spots of a smaller size is observed. They are painted in shades of pink, yellow and brown, and are located along the lines of greatest stretch of the skin on the trunk and limbs. Itching is absent or weak.

The manifestations of lichen rosacea disappear after 1.5–2 months from the moment the first spot appears, regardless of the course of therapy taken by the patient.

It happens that spots on the skin similar to lichen in a child are symptoms of psoriasis or allergic dermatitis. If plaques or spotty rashes are of psoriatic origin, then the use of ointments to treat other diseases can worsen the clinical picture. It is recommended to give the child antipruritic and sedative medications to avoid scratching the spots.