How Can I Take Care Of Myself
- Take a pain-relief medicine such as acetaminophen. Take other medicine as prescribed by your healthcare provider.
- Put cool, moist washcloths on the rash.
- Rest in bed during the early stages if you have fever and other symptoms.
- Try not to let clothing or bed linens rub against the rash and irritate it.
- You develop worsening pain or fever.
- You develop a severe headache, stiff neck, hearing loss, or changes in your ability to think.
- The blisters show signs of bacterial infection, such as increasing pain or redness, or milky yellow drainage from the blister sites.
- The blisters are close to the eyes or you have pain in your eyes or trouble seeing.
- You have trouble walking.
What Are The Complications Of Shingles
Shingles gets better without any complications in many people. In others several complications can occur. These include:
- ongoing nerve pain
- shingles occurring in the eye area can result in temporary or permanent vision loss. Your doctor may refer you to an eye specialist for treatment
- the shingles rash can become infected and you might need antibiotics.
Can You Have A Mild Case Of Shingles
The severity of shingles depends on various factors, such as age of the patient, general health condition of the patient, and the part of the body where shingles develops. For some people, the symptoms are mild with mild pain and itching. Whereas other patients may present with intense pain, itching, and complications.
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Who Should Get Vaccinated
The Centers for Disease Control and Prevention reports that people who should receive the shingles vaccine include:
- Adults who are healthy, aged 50 and older
- People who have not had shingles
- Those who are unsure if they have had chickenpox. Studies show that over 99% of Americans over age 40 have had chickenpox, this includes those who cant remember having the disease.
- People who have had shingles . Studies have shown that some people can get shingles twice, or even three times and the risk of getting shingles again is about the same as the chances of getting them in the first place.
- Those who received Zostavax .
How Well Does Shingrix Work
Two doses of Shingrix provides strong protection against shingles and postherpetic neuralgia , the most common complication of shingles.
- In adults 50 to 69 years old who got two doses, Shingrix was 97% effective in preventing shingles among adults 70 years and older, Shingrix was 91% effective.
- In adults 50 to 69 years old who got two doses, Shingrix was 91% effective in preventing PHN among adults 70 years and older, Shingrix was 89% effective.
Shingrix protection remained high in people 70 years and older throughout the four years following vaccination. Since your risk of shingles and PHN increases as you get older, it is important to have strong protection against shingles in your older years.
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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 , 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
What Are The Symptoms Of Shingles
Usually, shingles develops on just one side of the body or face, and in a small area. The most common place for shingles to occur is in a band around one side of the waistline.
Most people with shingles have one or more of the following symptoms:
- Fluid-filled blisters
- Tingling, itching, or numbness of the skin
- Chills, fever, headache, or upset stomach
For some people, the symptoms of shingles are mild. They might just have some itching. For others, shingles can cause intense pain that can be felt from the gentlest touch or breeze. Its important to talk with your doctor if you notice any shingles symptoms.
If you notice blisters on your face, see your doctor right away because this is an urgent problem. Blisters near or in the eye can cause lasting eye damage and blindness. Hearing loss, a brief paralysis of the face, or, very rarely, inflammation of the brain can also occur.
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How To Prevent Shingles
There are multiple shingles vaccines available in Canada and they are recommended for people over 50. While you can still get shingles even if you are vaccinated, the chances are four to 12 times less likely than if you are not. People with a weakened immune system, those receiving cancer treatment like chemotherapy or radiation, or people who have had cancer in their bone marrow, like leukemia or lymphoma, shouldnt get the vaccine.
While the cause of the rising cases of shingles are not clear, Dr. Shelly McNeil, chair of Immunize Canada and head of the infectious disease division at the Nova Scotia Health Authority, told Global News that aging baby boomers who are now in a high-risk demographic, as well as lower numbers of chickenpox among vaccinated kids which lowers adult immunity may be two factors driving the increase.
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How Long Does Shingles Last
How long shingles lasts will depend on the individual, but Dr. Wild tells us it usually lasts around three to five weeks.
“Your skin may be painful or uncomfortable after the rash has gone, however, this usually settles over time,” she adds.
People with shingles should stay away from pregnant women who have not had chickenpox before, people with a weakened immune system, and babies less than one month oldunless it’s your own baby.
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Zoster Sine Herpete : 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 .
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
- Generalized aches
- Hypersensitivity to touch
When shingles is present, even without the rash, sensations will be concentrated in a specific area of the body â 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 , Varizella pneumonia, paralysis of the facial nerves and problems related to keeping oneâs 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.
Shingles Symptom: Painful Blisters
It can sometimes be difficult to figure out why you might have painful blisters on your body. You might think a painful rash is due to an allergy, or maybe even bug bites. But painful blisters can sometimes be a sign of shingles, a reactivation of the varicella-zoster virus that can be extraordinarily painful. Some people mistake shingles blisters for spider bites, says Dr Tracy Lippard. Getting care quickly is important, as the medication to treat shingles works best if its started within three days of the rash.
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What To Do When Shingles Makes You Tired
If youre experiencing fatigue during or after shingles, try out some of the suggestions below to help you cope.
- Set up a sleep routine. Pain from shingles or PHN can make it hard to sleep. However, setting up a regular sleep routine may help you get to sleep a little easier. Try setting a firm bedtime, or doing something relaxing before going to sleep.
- Reduce stress. Stress can really sap your energy. Additionally, if you have shingles, stress may make your symptoms worse. Because of this, try to find ways to effectively reduce your stress levels.
- Eat often. Eating often may help you keep your energy levels up while youre feeling tired. Try to space out meals and healthy snacks out so that youre eating something every few hours.
- Stay hydrated. Dehydration can make you feel fatigued or sluggish, so make sure youre getting enough fluids.
- Reach out. Try to reach out to family and friends for their support and understanding. If fatigue is significantly affecting your mood and daily life, it may also be beneficial to engage with a support group or a mental health professional.
Seek Treatment Right Away
Many people have the mistaken impression that, like poison ivy, shingles is a nuisance rash that fades on its own. But in fact a shingles rash should alert people, especially in middle or old age, to seek immediate medical help, says Dr. Oaklander.
Rapid treatment with one of three antiviral drugs, acyclovir , valacyclovir , or famciclovir , can shorten a shingles attack and reduce the risk of serious damage, such as:
- Long-term pain. Pain that lingers in the area of a healed shingles rash is called postherpetic neuralgia. This often-disabling pain can last several months to a year.
- Prolonged itching. Many people are left with an itchy area from their shingles, which can be as disabling as chronic pain. It is most common on the head or neck.
- Damage to vision and hearing. Pain and rash near an eye can cause permanent eye damage and requires an urgent ophthalmological exam. When the nerve to the ear is affected, it can permanently damage hearing or balance.
- Strokes and heart attacks. A PLOS Medicinestudy that tracked about 67,000 people ages 65 and older who were newly diagnosed with shingles found that stroke risk more than doubled in the first week after the shingles diagnosis. The same study reported an increased risk for heart attacks in the three months after shingles, but the additional risk dissipated after six months.
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Preventing The Virus Spreading
If you have the shingles rash, do not share towels or flannels, go swimming, or play contact sports. This will help prevent the virus being passed on to someone who has not had chickenpox.
You should also avoid work or school if your rash is weeping and cannot be covered.
Chickenpox can be particularly dangerous for certain groups of people. If you have shingles, avoid:
- women who are pregnant and have not had chickenpox before as they could catch it from you, which may harm their unborn baby
- people who have a weak immune system, such as someone with HIV or AIDS
- babies less than one month old, unless it is your own baby, in which case your baby should have antibodies to protect them from the virus
Once your blisters have dried and scabbed over, you are no longer contagious and will not need to avoid anyone.
When To Seek Medical Advice
Shingles is not usually serious, but you should see your GP as soon as possible if you recognise the symptoms. Early treatment may help reduce the severity of your symptoms and the risk of developing complications.
You should also see your GP if you are pregnant or have a weakened immune system and you think you have been exposed to someone with chickenpox or shingles and haven’t had chickenpox before.
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When Should I Get The Shingles Vaccine
The current shingles vaccine is a safe, easy, and more effective way to prevent shingles than the previous vaccine. In fact, it is over 90% effective at preventing shingles. Most adults age 50 and older should get vaccinated with the shingles vaccine, which is given in two doses. You can get the shingles vaccine at your doctors office and at some pharmacies.
You should get the shingles vaccine if you:
- Have already had chickenpox, the chickenpox vaccine, or shingles
- Received the prior shingles vaccine called Zostavax
- Dont remember having had chickenpox
Medicare Part D and private health insurance plans may cover some or all of the cost. Check with Medicare or your health plan to find out if it is covered.
You should not get vaccinated if you:
- Currently have shingles
- Are sick or have a fever
- Had an allergic reaction to a previous dose of the shingles vaccine
If you are unsure about the above criteria or have other health concerns, talk with your doctor before getting the vaccine.
Who Should Not Have The Vaccine
People who should not have the shingles vaccine without first discussing it with their doctor include those who:
- have an allergy to any component of the shingles vaccine
- have a weakened immune system
- are or might be pregnant
Although anyone who has had chickenpox can develop shingles, some people may be at a higher risk.
Possible risk factors and triggers include:
- older age
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Shingles: A Complete Guide For Clinicians
Replication of the virus in neural ganglia destroys nerve tissue, causing intense pain along corresponding dermatomes. The pain can be stabbing or burning. Sensitivity to touch may develop. The pain may persist for 30 days to more than 6 months, after the lesions heal. The patient can also experience chronic fatigue, anorexia, weight loss, difficulty concentrating, and depression, and they may become inactive. PHN is more common in women and immunocompromised persons.26
Pain management may require the use of acetaminophen, nonsteroidal anti-inflammatory drugs, anticonvulsant agents, topical medications, tramadol, or oxycodone. According to Mallick-Searle et al,27 first-line treatments include gabapentin or pregabalin an antidepressant and the lidocaine 5% patch. Tramadol or oxycodone should be a third-line drug and used judiciously because of the potential for dependence. Topical capsaicin 8% may be used but requires frequent reapplication .13,27,28
Prevention of varicella
The two different types of vaccine used to prevent varicella are Varivax® and ProQuad® . Varivax should be administered subcutaneously to children in two doses: the first dose at age 12 to 15 months and the second dose at age 4 to 6 years. Alternatively, ProQuad can be administered to children aged from 12 months to 12 years. Two doses of MMRV vaccine are recommended and are administered in the same schedule as Varivax.29-31
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 , 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.
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.
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Who Should Not Get Vaccinated
According to the CDC, some people should not be given the shingles vaccine, including those who:
- Have had allergic reactions to the vaccine
- Tested negative for varicella-zoster virus immunity
- Currently have shingles
- Have a severe or moderate illness that is considered acute, such as a respiratory infection
- Have a temperature of 101.3 degrees F or higher
Stay Away From Certain Groups Of People If You Have Shingles
You cannot spread shingles to others. But people who have not had chickenpox before could catch chickenpox from you.
This is because shingles is caused by the chickenpox virus.
Try to avoid:
- pregnant people who have not had chickenpox before
- people with a weakened immune system like someone having chemotherapy
- babies less than 1 month old unless you gave birth to them, as your baby should be protected from the virus by your immune system
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Why Does It Matter How You Manage Fatigue When You Have Been Ill
This guideline aims to give advice to help people after an illness, such as a viral infection, to try to manage and reduce the fatigue that they may be experiencing. There has been very little research done looking at how to manage fatigue in the early stages following an infection. We dont yet confidently know the scientific answer to whether managing fatigue in different ways leads to different outcomes in terms of recovery. Many people who have experienced fatigue for a longer period of time, along with those who have developed ME/CFS, report that they wished they had received good advice earlier on in their illness regarding how to manage fatigue. Fatigue can interfere with every aspect of day to day life so learning how to cope with it, and feeling confident with helpful strategies, may help to reduce the impact of the fatigue.
