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Shingles (Herpes Zoster): Symptoms, Vaccine, and Management

Written by
Dr. Vasantha K S
and medically reviewed by iCliniq medical review team.

Published on Jan 29, 2018 and last reviewed on Sep 07, 2018   -  2 min read

Abstract

Abstract

This article talks about shingles, a viral infection, how it is caused, its symptoms, and how it can be prevented.

Shingles (Herpes Zoster): Symptoms, Vaccine, and Management
Contents

Shingles also called as herpes zoster, is an infection of the nerve caused by varicella-zoster virus, the same virus which causes chickenpox. When the virus first attacks a person, it manifests as chickenpox. After the chickenpox infection has run its course, the virus stays dormant (passive) in the nerves close to the spinal cord. After a few years or decades, when certain conditions (like low immunity) makes the conditions favorable, the virus gets reactivated to cause another disease known as Shingles.

Is It Contagious

When the virus is in the active stage, the varicella-zoster can spread from one person to another. Then there are two possibilities:

1. either the person is already immune/ vaccinated against chickenpox which means he is safe, or

2. he has not had natural immunity (chickenpox disease) or vaccination against it. In this case, he can get chickenpox and not shingles as it is his first exposure.

Signs and Symptoms

- A stripe of red rash.

- Fluid-filled blisters.

- Stinging pain.

- Itching.

Causes

Shingles is caused by varicella zoster virus which causes chickenpox as well. So, this means only those who previously had chickenpox disease or the vaccine can get shingles.

Risk Factors

1. Age:

The risk of getting herpes zoster increases with age, especially over the age of 50.

2. Poor immunity:

A weakened immune system due to HIV/AIDS, cancer, chemotherapy, taking immunosuppresive agents after organ transplantation, and prolonged use of steroids.

Prevention

Two vaccines are helpful here - Chickenpox (varicella) vaccine and shingles (varicella zoster) vaccine.

Chickenpox vaccine is reccomended if you are not already vaccinated for chickenpox or never had the chickenpox disease.

Varicella vaccine is recommneded for the elderly who are prone to shingles.

Complications

Sometimes, shingles can cause complications such as postherpetic neuralgia, meaning nerve pain that lasts several months.

Diagnosis

Diagnosis of shingles is based on the visual examination of the characteristic band of fluid-filled blisters and medical history of chickenpox.

Management

There is no cure for shingles and treatment primarily involves the management of pain and itching. Antivirals such as Acyclovir, Famciclovir, and Valacyclovir are prescribed in certain circumstances to reduce pain and speed up the healing process. Symptomatic relief can be obtained with the following steps.

  1. Lactocalamine can be applied to help soothe the blisters.
  2. Keep rashes dry.
  3. Wear loose cotton clothes.
  4. Antihistamines and painkillers provide respite from itching and pain.

For more information consult a shingles specialist online --> https://www.icliniq.com/ask-a-doctor-online/dermatologist/shingles

 

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Frequently Asked Questions


1.

How Long Can Shingles Be Contagious?

If you are affected with shingles, you can spread the disease until the last blister in your body has scabbed over. It will usually occur after a period of about 10 to 14 days.

2.

How Do You Get Affected by Shingles?

Anyone who has been affected by chickenpox is at the risk of developing shingles. After a person completely recovers from chickenpox, the causative virus can enter his or her nervous system and remain dormant for years. As a result, it might reactivate and travel along nerve pathways towards the skin of the patient.

3.

Can Stress Cause Shingles?

Yes, stress is known to cause shingles in a few patients. Stress does not directly lead to shingles, but it can potentially cause the immune system to weaken. A weakened immune system is a potential risk factor for shingles. Shingles is a condition that is caused by the same virus that causes chickenpox.

4.

How Do Shingles Appear Initially?

Shingles are not known to be contagious. The affected person can not spread the condition to another person. However, the varicella-zoster virus is highly contagious, and it might easily reach the person who has never had chickenpox. So, if a person is affected by shingles, he or she can spread the virus to another person. This could lead to the development of chickenpox in that person.

5.

Is It Safe to Live With Someone Who Is Affected With Shingles?

The blisters will commonly scab over and begin to heal, from 1 to 3 weeks. As the blisters heal, they become smaller and less painful. The process commonly takes over a period of 3 to 5 weeks. So if you are affected with shingles, it is necessary to rest and isolate yourself until the blisters scab over. After that, if you feel uncomfortable or ill, you can take additional rest.

6.

How Long Should I Rest When I Am Affected With Shingles?

The blisters will commonly scab over and begin to heal from one or three weeks. As the blisters heal, they become smaller and less painful. The process commonly takes over a period of three to five weeks. So, if you are affected with shingles, it is necessary to rest and isolate yourself until the blisters scab over. After that, if you feel ill, you can get additional rest.

7.

What Is the Best Topical Cream For Shingles?

There are a wide variety of topical treatments available. It includes:
- Topical acyclovir 5% cream.
- Lidocaine.
- Capsaicin. It should be applied at least five times a day. It acts by depleting neurotransmitters at the involved nerve endings.

8.

Does the Pain Associated With Shingles Get Worse at Night?

The pain associated with shingles can be constant or intermittent. They get worse at night or in response to heat or cold. The pain can lead to fatigue, sleep deprivation, anorexia, depression, etc.; this can result in the lowering of the quality of life of the affected individual.

9.

Is It Alright to Be Extremely Tired With Shingles?

Most people affected with shingles experience severe pain and itching. It can leave scars. Fluid-filled blisters develop at the initial course of the disease, which gradually breaks and crusts over a few weeks after an outbreak. It is entirely normal to feel sick or tired, with a slight fever, chills, or headache.

10.

What Are the Risks Associated With Untreated Shingles?

If shingles are left untreated, some complications of shingles can be fatal to the person. That includes
- Pneumonia.
- Encephalitis.
- Stroke.
- Bacterial infections can cause the person to go into shock or sepsis.

11.

Can I Get Rid of Herpes Zoster?

There is no complete cure for shingles. But it can be managed symptomatically by your doctor with the help of antiviral medication, which will help shorten the viral infection course and reduce symptoms. Several natural remedies can also be used to reduce pain and discomfort.

12.

Can Shingles Suppress My Immune System?

There is a clear evidence-based association between shingles and weakened immunity to infection. Though the chickenpox virus is not invading the body for the first time, the immune system still is the reason for keeping it dormant for years. This is why experts claim that shingles depress your immune system.

13.

Does Shingles Recur?

If a person has had shingles once in your lifetime, they probably will not get it again. Rarely herpes zoster, shingles might come back a second or, very rarely, a third time.

14.

How Long Will It Take for Herpes Zoster to Heal?

In Herpes zoster disease, there would be the tingling and burning feeling on the skin. A red rash will start appearing. A few days after that, the rash will change into fluid-filled blisters. After a week or ten days later, the blisters dry up and begin to crust over. A couple of weeks later, the scabs clear up. This is the total time taken by the herpes zoster disease to heal.

15.

Can You Apply Aloe Vera For Shingles?

Once the rash has started to appear, a topical application of aloe vera gel, combined with vitamin E oil, gives significant relief. This combination soothes the skin, and in turn, reduces the pain and itching. It also speeds the healing process. This method also reduces the risk of infection from bacteria on the surface of the affected area.

16.

Will Shingles Go Away by Itself?

Shingles usually clear up in two or four weeks when proper antiviral treatments and remedies are being given. However, this infection can spread to other organs and lead to very serious complications if it is left untreated.

17.

What Are the Other Lesion Shingles Are Confused With?

Shingles can be confused with other skin conditions. It includes:
- Hives.
- Psoriasis.
- Eczema.

18.

How Do I Know If I Am Affected With Shingles?

The shingles can be identified by using the following signs and symptoms.
The rash usually affects only a small section of the unilateral side of the body.
- Severe pain.
- Burning sensation.
- Numbness or tingling.
- Sensitivity to even mild touch.

19.

What Type of Pain is Seen With Shingles?

Shingles are usually present with characteristic pain, which is usually burning, tingling, itching, or stinging in the area where the rash has been developed. Sometimes, this pain can cause susceptible skin.

20.

Can Sleep Deprivation Cause Shingles?

Lack of sleep can weaken the immune system, which in turn reactivates the latent varicella-zoster virus. Evidence-based studies on sleep disorders and the risk of herpes zoster are very less.

21.

How Long Does It Take for the Nerve Pain From Shingles to Reduce?

The pain associated with shingles goes typically away only when the rash goes away. This usually happens after two to four weeks since the onset of the condition. Pain that continues for longer than this period is referred to as the post-herpetic neuralgia.

22.

Is Shingles Pain Progressive?

Depending on the region where shingles develop, it could also cause additional symptoms such as hiccups or even vision loss. For certain people, the symptoms of shingles are very mild. But for the majority of the affected population, shingles cause severe, intense pain that can be felt from the gentlest touch or breeze. This pain keeps progressing over the initial course of the disease and decreases in the latter.

Last reviewed at:
07 Sep 2018  -  2 min read

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