Erie Shingles are caused when the varicella-zoster virus, which causes chickenpox, wakes up in your body. The virus travels along nerve fibers to the skin, where a painful rash forms.

Shingles pain can last months or years. Antiviral medicines can help make the attack shorter and less severe.

The varicella zoster virus causes shingles — the same virus that causes chickenpox. Anyone who has had chickenpox has this virus, which lives in the nervous system in a dormant state. Sometimes, the virus reactivates and travels along nerve pathways to the skin. People who have conditions that weaken the immune system — such as cancer, leukemia, lymphoma, HIV infection, or a history of weakened immunity from certain medications (such as steroids) or organ transplantation — are at higher risk for developing shingles. Age also increases the risk. Getting a vaccine can reduce the chance of getting shingles and the severity of the rash.

The first symptom of shingles is pain or tingling in a specific area of the body. Then a rash appears, usually on one side of the body in a swath that wraps around a specific skin nerve (called a dermatome). The rash starts as groups of small bumps that quickly change into fluid-filled blisters that scab over within about 2 weeks. The scabs then heal into a crusty surface that eventually falls off.

Pain from shingles can last for months or years in the area of the rash. This long-term nerve pain is called postherpetic neuralgia and can be very severe. It occurs when damaged nerve fibers send confused and exaggerated messages of pain from the skin to the brain. It affects up to 20 percent of those who get shingles.

Typically, a person gets shingles only once. However, the weakened immune system can make it happen again, and it’s more likely to occur in older adults. Women who are in perimenopause are particularly prone to it, because of hormonal changes that can affect the immune system.

Having the chickenpox vaccine significantly decreases your risk for getting shingles and can reduce the severity of the rash. It’s recommended for everyone over the age of 50. Getting a vaccination before you have shingles can protect against serious complications that can occur with the condition, including vision loss and hearing loss. It can also reduce the likelihood of having long-term nerve pain in the areas where shingles occurred, called postherpetic neuralgia.

Symptoms

The shingles rash is very painful. It usually affects a band of skin on the torso, chest, or face but can also appear on the arms or head. The rash starts as a red, itchy spot and then forms groups of oozing fluid-filled blisters. The blisters then dry up and form scabs that clear after about 10 days. The pain can last for months or even years. Some people may have long-term nerve pain, known as postherpetic neuralgia (PHN), in the area where they had shingles.

The first symptom of shingles is pain, tingling or itchy skin. The virus infects a nerve that runs along the spinal cord. That’s why the rash often appears in a band of skin that corresponds to where the nerve transmits signals. Shingles is more likely to develop in a band on one side of the body because the virus travels in that pathway.

About 48 hours before the rash appears, you may have flu-like symptoms such as headache, fatigue and a general feeling of unwellness. You’re contagious during this period, and you should avoid contact with babies, pregnant women, or anyone with a weak immune system who hasn’t had chickenpox or the vaccine.

If you have a severe case of shingles, a doctor can give you medicine to help relieve the pain. The drug works best if you start taking it within 3 days of the rash first appearing. It’s available from your GP, a pharmacy or via 111.

It’s also possible to get a shingles vaccine. The CDC recommends two doses of the vaccine called Shingrix for adults 50 or older to help prevent shingles and reduce the risk of complications. It’s especially important for adults who have had chickenpox, as well as those with weakened immune systems caused by illness or by certain medications such as steroids or treatments for HIV infection.

If you have had shingles before, you cannot get them again. However, it is possible that the virus can reactivate in later life and cause the disease again. Getting the vaccine will prevent it from happening.

Diagnosis

Shingles is a painful rash that develops fluid-filled blisters. It is caused by reactivation of the varicella zoster virus, which remains in nerve cells after you have had chickenpox. Anyone who has had chickenpox can get shingles, but the risk is higher for people over age 60 and those with weakened immune systems.

A healthcare provider or dermatologist can usually diagnose shingles by examining your symptoms and history. They may also order a PCR test or an antibody blood test to confirm the diagnosis.

The rash of shingles appears as red spots or small fluid-filled vesicles on your skin, and it typically scabs after 7 to 10 days. It typically occurs in a stripe around the body or face, and it can be particularly painful when it happens inside the mouth or eyes (especially in older adults). Often, pain, itching or tingling starts several days before the rash appears, especially in people who have a weak immune system.

During the time your rash is visible, you can protect yourself from spreading the herpes virus by keeping the area covered and not touching the rash or any of the blisters. Applying calamine lotion or an oatmeal bath can help relieve itching and ease the pain. Your healthcare provider may prescribe antiviral medicines to speed up healing and limit your discomfort.

If you have a severe case of shingles, your healthcare provider may put you in a contact isolation room so that others do not contract the herpes from your blisters or open wounds. This is especially important if you are in close contact with someone who has not had chickenpox or the shingles vaccine.

The CDC recommends that healthy adults over 50, regardless of whether they have had chickenpox, receive the shingles vaccine (Shringrix). It is available in pill or shot form and is very effective against shingles and complications from it. The vaccine is not yet available for children. However, doctors are testing a new vaccine that can be given to infants to prevent them from getting the disease. If the test is successful, it will be available soon for everyone.

Treatment

Over-the-counter pain relievers, such as acetaminophen, can help with the pain and itching of shingles. If this does not work, your doctor may prescribe stronger pain medications. Antiviral drugs, such as acyclovir (Zovirax) or valacyclovir (Valtrex), can be taken to speed up healing. They are most effective when started within three days of the appearance of the rash.

The shingles vaccine, Shingrix, is highly recommended for adults 50 or older to prevent a painful shingles outbreak and possible complications. It is also recommended for people 19 and older with weakened immune systems due to illness or certain conditions such as HIV/AIDS, cancer, or a chronic disease like leukemia or lymphoma.

Symptoms of shingles, including pain and itching, usually appear about a week after the virus enters the body. Most people get better within a few weeks after the sores erupt and heal. It is important to avoid contact with anyone who has a blistered rash or open sores. You are contagious until all the sores have crusted over.

Some people have long-lasting nerve pain in the area of the rash, called postherpetic neuralgia, which can last for months or even years after the rash has gone away. A pain specialist can treat this type of pain, using therapies such as a Nerve Block or Epidural injection.

Other symptoms of shingles include inflammation of the ear (herpes zoster oticus), weakness on the affected side of the face, and headaches. In about 2 percent of cases, a shingles rash can spread to the eye, which can cause permanent damage. A health care provider can treat this complication with antiviral medications and steroids.

Home remedies, such as wearing loose clothing, taking warm baths or showers, using cool compresses, eating a nutritious diet, and getting plenty of rest, can also help manage shingles. Some patients find relief from proteolytic enzymes, which are derived from papaya and pineapple, when used in conjunction with antiviral medication. These supplements can have side effects, so it is important to talk with your doctor before starting them.