Shingles

What is Shingles

Shingles which is also known as herpes zoster, is an infection that causes a painful skin rash and fluid-filled blisters. It is caused by a virus.

Shingles only develops in people who:

  • Have had chickenpox.
  • Have been given a medicine to protect against chickenpox (have been vaccinated). Shingles is rare in this group.

What are the causes?

Shingles is caused by varicella-zoster virus (VZV). This is the same virus that causes chickenpox. After a person is exposed to VZV, the virus stays in the body in an inactive (dormant) state. Shingles develops if the virus is reactivated. This can happen many years after the first (initial) exposure to VZV. It is not known what causes this virus to be reactivated.

What increases the risk?

People who have had chickenpox or received the chickenpox vaccine are at risk for shingles. Shingles infection is more common in people who:

  • Are older than age 60.
  • Have a weakened disease-fighting system (immunesystem), such as people with:
    • HIV.
    • AIDS.
    • Cancer.
  • Are taking medicines that weaken the immune system, such as transplant medicines.
  • Are experiencing a lot of stress.

What are the signs or symptoms?

Early symptoms of this condition include itching, tingling, and pain in an area on your skin. Pain may be described as burning, stabbing, or throbbing.

A few days or weeks after early symptoms start, a painful red rash appears. The rash is usually on one side of the body and has a band-like or belt-like pattern. The rash eventually turns into fluid-filled blisters that break open, change into scabs, and dry up in about 2–3 weeks.

At any time during the infection, you may also develop:

  • A fever.
  • Chills.
  • A headache.
  • An upset stomach.

How is this diagnosed?

This condition is diagnosed with a skin exam. Skin or fluid samples may be taken from the blisters before a diagnosis is made. These samples are examined under a microscope or sent to a lab for testing.

How is this treated?

The rash may last for several weeks. There is not a specific cure for this condition. Your health care provider will probably prescribe medicines to help you manage pain, recover more quickly, and avoid long-term problems. Medicines may include:

  • Antiviral drugs.
  • Anti-inflammatory drugs.
  • Pain medicines.
  • Anti-itching medicines (antihistamines).

If the area involved is on your face, you may be referred to a specialist, such as an eye doctor (ophthalmologist) or an ear, nose, and throat (ENT) doctor (otolaryngologist) to help you avoid eye problems, chronic pain, or disability.

Follow these instructions at home:

Medicines

  • Take over-the-counter and prescription medicines only as told by your health care provider.
  • Apply an anti-itch cream or numbing cream to the affected area as told by your health care provider.

Relieving itching and discomfort

  • Apply cold, wet cloths (cold compresses) to the area of the rash or blisters as told by your health care provider.
  • Cool baths can be soothing. Try adding baking soda or dry oatmeal to the water to reduce itching. Do not bathe in hot water.

Blister and rash care

  • Keep your rash covered with a loose bandage (dressing). Wear loose-fitting clothing to help ease the pain of material rubbing against the rash.
  • Keep your rash and blisters clean by washing the area with mild soap and cool water as told by your health care provider.
  • Check your rash every day for signs of infection. Check for:
    • More redness, swelling, or pain.
    • Fluid or blood.
    • Warmth.
    • Pus or a bad smell.
  • Do not scratch your rash or pick at your blisters. To help avoid scratching:
    • Keep your fingernails clean and cut short.
    • Wear gloves or mittens while you sleep, if scratching is a problem.

General instructions

  • Rest as told by your health care provider.
  • Keep all follow-up visits as told by your health care provider. This is important.
  • Wash your hands often with soap and water. If soap and water are not available, use hand sanitizer. Doing this lowers your chance of getting a bacterial skin infection.
  • Before your blisters change into scabs, your shingles infection can cause chickenpox in people who have never had it or have never been vaccinated against it. To prevent this from happening, avoid contact with other people, especially:
    • Babies.
    • Pregnant women.
    • Children who have eczema.
    • Elderly people who have transplants.
    • People who have chronic illnesses, such as cancer or AIDS.

Contact a health care provider if:

  • Your pain is not relieved with prescribed medicines.
  • Your pain does not get better after the rash heals.
  • You have signs of infection in the rash area, such as:
    • More redness, swelling, or pain around the rash.
    • Fluid or blood coming from the rash.
    • The rash area feeling warm to the touch.
    • Pus or a bad smell coming from the rash.

Get help right away if:

  • The rash is on your face or nose.
  • You have facial pain, pain around your eye area, or loss of feeling on one side of your face.
  • You have difficulty seeing.
  • You have ear pain or have ringing in your ear.
  • You have a loss of taste.
  • Your condition gets worse.

Summary

  • Shingles, which is also known as herpes zoster, is an infection that causes a painful skin rash and fluid-filled blisters.
  • This condition is diagnosed with a skin exam. Skin or fluid samples may be taken from the blisters and examined before the diagnosis is made.
  • Keep your rash covered with a loose bandage (dressing). Wear loose-fitting clothing to help ease the pain of material rubbing against the rash.
  • Before your blisters change into scabs, your shingles infection can cause chickenpox in people who have never had it or have never been vaccinated against it.
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