Shingles causes a painful rash, itching, and burning skin followed by oozing blisters. Shingles usually lasts 3–5 weeks, and the blisters typically take around 10 days to heal. After it heals, most people will not have shingles again.
Shingles is a viral infection that affects approximately 1 in 3 adults in the United States. Around half of all shingles cases occur in adults over 60 years old.
It can occur in anyone who has had chickenpox, as the varicella-zoster virus (VZV) causes both conditions. This virus remains in the body after chickenpox has cleared and can reactivate at any time, leading to shingles.
Shingles symptoms tend to develop on one side of the face or body. They often affect just a small area. The most common location is on the side of the waist, although they can occur anywhere.
This article explains the symptoms, duration, potential complications, and treatment of shingles.
Timeline of symptoms
A person in a doctor’s waiting room waiting to speak with someone about shingles.-2
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Before a rash appears, shingles may cause skin sensitivity or pain. Other early symptoms include:
general discomfort
hot skin
irritation
itching
numbness
tingling
Within the next 1–5 daysTrusted Source, a red rash will form around the sensitive area. A few days later, fluid-filled blisters will develop at the site of the rash.
The blisters will ooze before drying up, typically within 10 days of appearing. At this point, scabs will form on the skin, tending to heal within 2 weeks.
Other potential symptoms
There may be other symptoms accompanying the skin sensitivity and rash, including:
chills
fatigue
fever
headache
malaise or feeling of being unwell
nausea
sensitivity to light
A person’s vision may be affected if the shingles occurs near the eyes.
Shingles symptoms can range from mild to severe, with some people experiencing itching and mild discomfort and others having intense pain.
Potential complications
Most cases of shingles resolve without causing long-term effects. However, potential complications include:
Post-herpetic neuropathy (PHN)
Postherpetic neuralgia (PHN) is a commonTrusted Source complication of shingles. It refers to nerve damage that causes pain and burning that persists after the shingles infection is gone.
According to the United Kingdom’s National Health Service (NHS), 1 in 5 people with shingles develop PHN. Older adults may be especially at risk.
Treating PHN is difficult, and the symptoms can last for years or a lifetime. However, many people fully recover within 12 months.
Researchers do not know why some people with shingles develop PHN. However, risk factors for PHN includeTrusted Source:
a severely weakened immune system
having pain during the early stages of a shingles infection
older age
eye involvement
diabetes
Other complications
Other potential complications of shingles includeTrusted Source:
bacterial infections of the skin
hearing loss or problems
pneumonia
vision problems
death
However, the above complications are uncommon.
The National Institute on Aging recommends that people seek medical treatment no later than three daysTrusted Source after the rash appears. Early treatment can limit pain, help the rash heal quicker, and may reduce scarring.
Once a doctor confirms shingles, they may suggest the following treatments:
Antiviral drugs
These ease symptoms, speed up recovery, and may prevent complications. A course of antiviral medications should start within 3 days of the shingles rash appearing. Options includeTrusted Source:
acyclovir (Zovirax)
famciclovir (Famvir)
valacyclovir (Valtrex)
Painkillers and antihistamines
Over-the-counter (OTC) or prescription medications may reduce pain and skin irritation. Options include:
anti-inflammatory drugs, such as ibuprofen (Advil)
antihistamines for itching, including diphenhydramine (Benadryl)
corticosteroids or local anesthetics for severe pain
numbing products, including lidocaine (Lidoderm)
Antidepressants
According to the NHS, doctors may prescribe certain antidepressant drugs for people with severe shingles pain or PHN. This may include:
amitriptyline (Elavil)
duloxetine (Cymbalta)
It can take several weeks before antidepressants work for nerve pain.
Anticonvulsant medications
Although typically used to treat epilepsy, some anticonvulsant drugs may reduce nerve pain. Again, these can take several weeks to take effect. Commonly prescribed anticonvulsants for shingles include:
gabapentin (Neurontin)
pregabalin (Lyrica)
Managing shingles symptoms
In addition to seeking medical treatment, people can take other steps to alleviate their symptoms and reduce discomfort. These include:
getting enough sleep and rest
using a wet compress on the itchy and inflamed skin and blisters
reducing stress through techniques such as:
regular exercise
meditation
deep breathing exercises
wearing loose-fitting clothing made of natural fibers, such as cotton.
taking an oatmeal bath
applying calamine lotion to the skin
People should avoid scratching the rash and blisters as much as they can. Breaking the skin or bursting the blisters can increase the riskTrusted Source of infection and further complications.
Is shingles contagious?
Shingles is not contagiousTrusted Source but is the reactivation of a virus already present in the body. However, someone with shingles can give chickenpox to someone who has never had the VZV infection before.
Therefore, people with shingles should avoid contact with those who have never had chickenpox until their rash completely heals. To pass the virus, someone must have direct contact with the rash.
To avoid spreading VZV, people with shingles should:
Avoid close contact with people who have never had chickenpox or a vaccination for chickenpox.
Avoid close contact with infants under 1 month old and people with a compromised immune system, such as those on HIV medication or having chemotherapy.
Keep the rash covered with loose clothing to avoid others coming into contact with it.
Wash their hands frequently, especially after touching the rash or applying lotions to the skin.
Vaccinating against shingles
There is a vaccination available to reduce the risk of developing shingles and experiencing long-term complications, such as PHN.
The Centers for Disease Control and Prevention (CDC)Trusted Source recommends that adults ages 50 years and older have two doses of the Shingrex vaccination with a break of 2–6 months between each dose.
The CDC states this vaccine is over 90% effective at preventing shingles and PHN in adults ages 50 and older with strong immune systems.
People who have already had shingles can have the vaccine to prevent future occurrences.
Frequently asked questions
Below are some frequently asked questions about shingles.
How long do shingles last with valacyclovir?
Antiviral medication, such as valacyclovir, can help to shortenTrusted Source the duration and severity of a shingles rash. Treatment should start within 3 days of a shingles diagnosis and may last for 7 days.
How does a person know a shingles rash is healing?
A shingles rash may bleed and scab over as it starts to heal and clear. It typically takes up to 4 weeks for the rash to heal altogether.
How long does it take to recover from shingles?
A shingles rash typically takes up to 4 weeks to heal, although some symptoms, such as pain, may continue after the rash disappears.
What are the last stages of a shingles rash?
As a shingles rash starts to clear, a person may notice the rash blisters crack open and scab over. The blisters may also bleed.
Summary
Shingles affects up to 1 in 3 people in the United States. Symptoms vary in severity and duration. Early intervention is key to reduce symptom severity and avoid complications, such as PHN.
People should see their doctor as soon as possible if they experience skin sensitivity or develop a rash or blisters. Home remedies, such as oatmeal baths or a cool compress, can relieve shingle symptoms alongside medical treatments.
People should consider having the shingles vaccination to reduce their risk of getting shingles and long-term nerve pain.
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