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Shingles is a viral infection caused by the same virus that causes chickenpox. Shingles is also called herpes zoster. If you’ve had chickenpox, the virus lies quietly near the spinal cord. It can come out again later in life. This causes shingles. Clinicians are currently not sure why the virus comes out again. It is more common in older people and in people who are immunocompromised (a weak immune system). Not everyone who has had chickenpox gets shingles. You can lower your chance of getting shingles by getting the shingles vaccines.
If someone has shingles, the virus from the rash can spread to people who have never had chickenpox. If it spreads from the person with shingles to another person, that other person can get a chickenpox infection. The other person can get it by touching an oozing blister of a person with shingles. Shingles doesn’t spread by coughing. Once a person’s blisters have scabbed over, they are no longer contagious.
Symptoms and Diagnosis
Shingles is fairly easy to diagnose, and your clinician will probably start by looking at your skin. The main symptom of shingles is a painful rash on one side of the body that looks like a cluster of blisters, usually on your body or face. Sometimes it is on the arm or leg.Other symptoms include:
- Pain or burning feeling in the area of the rash before it develops
- Stabbing or shooting pain, burning, numbness, itching, or tingling around the rash
- Fluid-filled blisters that break open and crust over
- Fever
- Headache
- Sensitivity to light
- Fatigue
- Chills
You should always contact your clinician if you have shingles symptoms. It is especially important if:
- The rash is near your eye, as this can lead to permanent eye damage if not treated
- You are over age 60
- You have a weakened immune system
Complications
Some complications can occur after a shingles infection. The most common complication is post-herpetic neuralgia. This is a pain that stays even after your rash has healed.Other complications include:
- Vision loss if the rash is near your eyes
- Neurological problems, depending on what nerves are affected. These include inflammation of the brain, facial paralysis, and hearing, and balance problems.
- Bacterial skin infections if blisters are not treated properly
Treatment of Shingles
After seeing your clinician, there are a few ways you can care for your shingles infection at home:- Keep the rash clean and dry
- Bathe in cool water to calm any itching
- Apply a wet, cool cloth to your blisters to reduce pain and itching
- Apply calamine lotion to your rash to reduce itching
- Remember not to scratch your rash
- Antivirals can help lessen the rash if taken in the first three days (72 hours) of having symptoms. Antivirals can also lower your chance of developing complications. The sooner, the better.
- Painkillers, including acetaminophen (Tylenol), ibuprofen (Motrin or Advil), and naproxen (Aleve)
- Capsaicin cream or a numbing cream for rash pain
- Benadryl to treat the itching
- Antibiotics if the rash causes a skin infection
- Tricyclic antidepressants can help with lingering pain after the rash has healed
Prevention and Vaccination
The Shingrix vaccine can lower your risk of developing shingles and may lessen your chance of having complications from the infection.The shingles vaccine is given in two doses, with 2-6 months between the two shots. The vaccine is 90% effective in people with healthy immune systems and protects you from shingles for at least five years.
After getting the vaccine, you may experience short-term side effects like a fever or headache, which typically resolve in 2-3 days. You can take ibuprofen or acetaminophen to help ease these side effects. Serious side effects from the shingles vaccine are very rare.
The vaccine is recommended for people 50 and up, even if:
- You received the Zostavax vaccine (a shingles vaccine no longer available in the U.S.)
- You have had chickenpox
- You received the chickenpox vaccine
- You have already had shingles, as you can get shingles multiple times
Remember that the chance of getting shingles goes up with age. Ask your clinician about your risk of developing shingles and when you should get the shingles vaccine. If you have any other questions about shingles, how it is treated, your symptoms, or how to schedule a shingles vaccine, please contact your Atrius Health provider.
