Shingles is a skin infection through a virus named, varicella-zoster. It is the same virus that leads to chickenpox/. Even after you are recovered from chickenpox, this virus remains in your nervous system and leads to shingles. The infection is also referred as herpes zoster. It is a kind of infection that is mostly characterized by red skin rash with burning sensation and pain.
It mostly looks like a line of blisters on a side of your body, typically on your neck, face or torso. One must know about the shingles symptoms to understand if that rash on your body is a viral infection. It occurs once in a person and goes away in 2 to 3 weeks on treatment. In this blog, we have discussed everything about the infection, from its symptoms, signs, diagnosis, risk factors to complications and treatment. According to the CDC (Centers for Disease Control and Prevention), 1 out of every 3 people in the U.S will get infected by shingles once in their lifetime.
Shingles Symptoms
The first symptoms of shingles are tingling, burning, stinging or itching in an area where the rash will develop. At times, the pain caused can be severe and people might complain of high sensitivity of skin. The discomfort caused but this infection is felt a few days before the rash shows up. There are rare cases where the rash doesn’t appear. It is a condition known as zoster sine herpete.
Other noted symptoms of shingles include:
- headache
- fever
- chills
- malaise
- nausea
- body aches
- swollen lymph glands
Stages of shingles
After a few days of discomfort or a few weeks (though rare), the rash will appear. It starts as a bunch of small red patches that ultimately grows into little blisters. The blisters are filled with fluid which breaks open and the sores eventually start drying and scabbing. After a few weeks, the crusts of the rash falls off and the rash clears up mostly after 2-4 weeks. In the rarest of cases, scarring of the infected skin or skin discoloration is possibly seen.
The area of shingles might vary from person to person. Though it can affect any part of your body, but usually it is the face and the torso getting infected. You will typically see shingles in the area of your waist or ribcage. The rash looks like a band-like pattern or in stripes that affects only a side of the body, be it left or right. Commonly, it doesn’t cross the midline. There are cases in which the characteristic rash affects the adjacent dermatomes and it might even affect three or even more dermatomes. It is a condition called disseminated zoster, which mostly happens in people having a compromised or weak immune system.
Right time to see a doctor
You must see a doctor immediately if you notice any signs or symptoms of shingles, but mainly in situation like:
- The rash or pain shows up near the eyes. When left untreated, it can result in permanent eye damage.
- When you are over 60 years of age as your age increases the risk of severe complications (which we will talk about later in the blog).
- You or any of your family members have a compromised immune system due to a chronic illness or cancer medications.
- The rash is spreading with increasing pain.
Causes of Shingles
Shingles is the result of the same virus that causes chickenpox, varicella-zoster virus. So, if you have been affected by chickenpox in your life, you are at a risk of this skin infection. When you are recovered from chickenpox, this virus moves to the nervous system and lives there in a dormant state for years before showing up as shingles. But not everyone affected by chickenpox develops shingles.
The main cause of shingles is still unclear. But, the studies make us believe that it is a result of low immunity against infections, mostly as you grow older. Shingles are seen to be mostly in older adults and people with weak immune systems.
Talking about the virus, varicella-zoster virus is a part of herpes viruses, a group of viruses that causes genital herpes and cold sores. This fact gives it another name, herpes zoster. However, it is not the virus leading to genital herpes and cold sores.
Contagious period of shingles
Varicella-zoster virus, virus causing shingles can be transmitted from one body to another through direct contact. If you come in direct contact with the fluid breaking out from the blistering rash, you are likely to get infected. So, if anyone around you is infected by shingles, avoid direct or indirect contact with them, until the infection is gone. Pregnant woman are advised to keep away from people having active shingles, mainly the immune-compromised woman and the ones who never got chickenpox. It doesn’t get transmitted through sneezing or coughing. A person is not contagious until the blisters show up. As soon as the rash has developed crusting and dried completely, it is not considered contagious.
There are a few things to keep in mind that if you have never had chickenpox or you missed out taking the chickenpox vaccine, you should not come in direct contact with a person having active shingles. In case you do, there are chances of getting affected by chickenpox, but not with shingles. However, you might develop shingles later in life. Another thing to consider is that, if you have had chickenpox and get exposed to the shingles virus, it will not be transmitted to your body.
Risk factors of shingles
As you now know, anyone who have had chickenpox is at a risk of developing shingles. It is noted that most U.S. adults had chickenpox in their early years, mainly before the introduction of chickenpox vaccination that protects against the viral infection.
The main factors that increase your risk of developing shingles are:
- Having specific diseases: If you have diseases that weaken the immune system such as, cancer and HIV/AIDS, you can increase the risk of shingles.
- Cancer treatments: Chemotherapy or radiation can decrease your ability to resist diseases and may lead to shingles.
- More than 50 in age: Shingles is seen affecting people over 50 years of age. The risk of the infection increases with growing age. Experts have also inferred in their studies that adults at or over 80 years of age develop shingles.
- Taking some specific medications: Prolonged use of steroids or drugs that prevent rejection of transplanted organs can put you at a risk of shingles.
Complications of shingles
Some major complications from shingles are:
Skin infections: if the blisters are not treated properly on time, it can lead to bacterial skin infections
Postherpetic neuralgia: Some individuals can experience continuous pain even after the blisters have cured and this condition is termed as postherpetic neuralgia. It happens when the damaged nerve fibers send exaggerated and confused messages of pain to your brain.
Neurological problems: Depending on the nerves affected, the infection can lead to encephalitis (inflammation of the brain), balance problems, hearing issues and facial paralysis.
Loss of vision: If shingles occur around or in an eye, it can cause serious eye infections that may cause permanent loss of vision.
Prevention of shingles
There are two vaccines that help prevent shingles – the varicella-zoster vaccine or shingles vaccine and varicella vaccine or chickenpox vaccine.
Varicella-zoster or shingles vaccine
If you are looking forward to get the shingles vaccine, there are two options – Shingrix and Zostavax.
FDA approved Shingrix in the year 2017 and it is considered as a perfect alternative to Zostavax. As per studies, shingrix provides protection against shingles for more than five years. It is a non-living vaccine composed of a virus component. This vaccine is given in two doses, between a gap of six months.
Shingrix is recommended and approved for people above the age of 50, which also includes the people who have got Zostavax previously.
There are some side effects of shingles vaccine such as tenderness, itching, swelling, pain, redness at the injection site. It might also cause headaches.
Like chickenpox vaccine, shingles vaccine doesn’t give a guarantee that you won’t get shingles. But, it will definitely reduce the severity and course of the infection and minimize the risk of postherpetic neuralgia.
The shingles vaccine is a prevention strategy used against the infection. It doesn’t work as a treatment for shingles. For that, you need to talk to your doctor and get an appropriate treatment.
Chickenpox vaccine
The varicella vaccine or Varivax is considered as a routine childhood immunization in order to prevent chickenpox. It is also recommended for adults who have not had chickenpox ever in their life. Though it doesn’t guarantee 100% prevention of shingles or chickenpox, it has the ability to reduce the complications and severity of the infection.
Diagnosis of Shingles
Many cases of shingles can be easily diagnosed by a physical examination of blisters and rashes. Your doctor may ask you about your medical history and some health-related questions.
In some rarest of cases, the doctor may do a test of the fluid from the blisters or your skin. The test includes collecting a sample of the fluid or the skin tissue using a sterile swab. The samples are sent to the medical laboratory to confirm if the virus is present in your skin.
Treatment for shingles
There is no particular cure for shingles, but early treatment can prevent the complications and quicken the recovery process. If shingles is confirmed in an individual, he/she must e treated within 3 days of the development of symptoms. Your doctor might prescribe you some medicines that will help relieve the symptoms and decrease the length of the infection.
Medication
The medication for shingles varies from one case to another, but some of the common medications may include:
| Type | Purpose | Drug frequency | Method | |
| antiviral medications, including acyclovir, famciclovir and valacyclovir | to minimize pain and speed recovery | 2 to 5 times daily or as prescribed by the physician | oral | |
| anti-inflammation drugs that include ibuprofen | to ease swelling and pain | In gap of 6 to 8 hours | oral | |
| gels, numbing creams or patches like lidocaine | to minimize pain | apply as required | topical | |
| analgesics or narcotic medications | to minimize pain | Once or twice daily | oral | |
| capsaicin (Zostrix) | to help reduce the risk of a nerve pain called postherpetic neuralgia, which occurs after recovery from shingles | Apply as required | topical | |
| tricyclic antidepressants or anticonvulsants | for prolonged pain | once or twice daily | oral | |
| Antihistamines like diphenhydramine (Benadryl) | to give relief from itching | every 8 hours | oral | |
Shingles mostly goes away in a few weeks and doesn’t always recur. In case your symptoms don’t seem to be reducing in 10 days, you must call your doctor for re-evaluation and follow-up.
Shingles home remedies
There are some easy home remedies that you can use to reduce the symptoms of shingles, some of which include:
- Applying wet, cold compresses over the rash to reduce itching and pain
- Taking cold showers and baths to soothe and clean the infected area.
- Eating foods rich in Vitamins B12, C, A and E, and amino acid lysine for a stronger immune system.
- Taking oatmeal baths to reduce itching and pain
- Applying a paste prepared with cornstarch or baking water and water, calamine lotion to get relief from continuous itching
Is it airborne?
The shingles’ virus or varicella-zoster virus is not airborne. It doesn’t spread through sneezing and coughing by a person affected with active shingles, or by sharing glass or dishes.
The only way it can be contagious is direct contact with the blister of a person having shingles. You might not immediately get shingles from direct contact, but you will be at a risk of chickenpox in case you never had it previously.
Shingles and pregnancy
Even though it is a rare case to get shingles during pregnancy, but it is possible. When you come in direct contact with a person affected by shingles or chickenpox, you are likely to develop chickenpox if you are not vaccinated or you never had the disease previously.
Depending on your trimester, chickenpox can lead to several congenital disabilities. Doctors recommend taking the chickenpox vaccine before pregnancy to protect the baby from any health issues.
Shingles does not always create complications, but it is not at all a pleasant experience. So, you should meet your doctor if you notice any rashes on your skin during pregnancy.
There are anti-viral medications that can treat shingles safely during pregnancy. You can also reduce itching and pain by taking antihistamines (for itching) and acetaminophen (for pain).
The Bottom Line
Shingles is a type of skin infection developed due to a virus, varicella-zoster, which is also the reason behind chickenpox. The main symptoms of shingles include pain, red rashes, itching and oozing blisters. You must see a doctor if these symptoms doesn’t seem to be reducing with 72 hours.
