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What You Need to Know About Shingles

April 12, 2021

Herpes zoster is a viral infection that can cause a shingles outbreak accompanied by a painful rash or cluster of small blisters on one area of the body. For some, the symptoms can be mild, but for others, symptoms can include intense pain. If you had chickenpox as a child, the varicella-zoster virus remains in the nerve cells of your body long after the physical signs of the viral infection disappear. As a dormant virus, it can remain inactive for years and you may not even know it is there. Unfortunately, in about one out of every three adults, it can suddenly become active. Medical researchers do not fully understand why the virus reappears as shingles virus rather than as a second case of chickenpox. One thing is clear, most of those who catch shingles will seek relief for the pain and discomfort the viral infection is causing, as quickly as they can.

In some people, other dermatologic conditions can cause a rash that looks similar to a shingles outbreak, especially very early on. In fact, an outbreak of eczema can cause oozing bumps that could be mistaken for the shingles rash. A major difference between shingles and other skin rashes is the pattern that shingles develops along the affected nerves of the chest, belly, side, neck, or arms. Moreover, rashes caused by allergic reactions, eczema, or psoriasis may develop anywhere on the person’s body. The earliest sign of shingles virus typically includes symptoms of not feeling well, which can include fever, fatigue, or sensitive areas of skin. Individuals often notice pink blotchy patches on one side of his or her body that may have a painful, burning, or tingling sensation when touched.

Early Diagnosis to Manage Shingles Outbreak

If you have ever had chickenpox, there is a good chance that the virus is still at large in your body. The first indication that it might have developed into shingles would be a burning or shooting pain on one side of the body followed by feeling ill overall. Early symptoms can include upset stomach, headache, abdominal pain, coughing, chills, and fever. These are most often followed by fluid-filled blisters appearing somewhere on the skin. The affected area may seem sensitive to touch with mild itching or tingling sensations that can quickly turn to episodes of intense pain. A rash of blisters usually appears only on one side of the face, neck, arms, or around part of the person’s waist. From the time you first notice symptoms until the rash disappears is normally three to five agonizing weeks.

“On rare occasions, a patient may not have a rash,” says Michael Steppie, M.D., a clinical professor of Dermatology at Florida State University College of Medicine and the President and Medical Director of Associates in Dermatology, “but the individual will present with other symptoms like a fever, chills, headaches, fatigue, upset stomach, or a change in sensitivity to light.” In most cases, patients can benefit from taking antiviral medications, so doctors recommend anyone who notices the early warning signs of shingles speak with a healthcare provider immediately. Should it turn out that you do not have shingles, the dermatologists can diagnose the cause of your symptoms and treat that condition. “If you are diagnosed with shingles, it is important to keep the rash covered to prevent the virus from spreading during the blister phase,” added Dr. Steppie.

Can I Catch Shingles… Again?

Over the years, the biggest myth about shingles is that you can only catch the disease once. Unfortunately, this is not true, but the shingles rash (or blisters) are not likely to repeat at the same place on your body. For most people who have had shingles, his or her immune system will keep the virus in check. However, later in life, it can reactivate and the infected nerves, as well as the skin the nerves pass through, can become inflamed causing a burning or stabbing pain. The good news is, according to an article published by Harvard Medical School, shingles vaccine can greatly reduce your chances of a having the disease a second, or even a third time. Without a shingles vaccination, researchers found that more than 5% of the participants studied were treated for a second shingles episode within eight years of the initial infection.

Another myth is that you can catch shingles virus from someone who actively has the disease. Since shingles is not contagious, this doesn’t happen. However, if you have not had chickenpox, you should stay away from someone who has shingles as you could catch chickenpox from a person who has a shingles infection. Conversely, if you have shingles, you should try and stay away from anyone who has not had chickenpox, as well as older adults who might have a weak immune system and anyone who has been taking immune-suppressing medications. Having had shingles does not provide protection against a recurrence of the viral infection; only a series of two shingle shots can protect you from having it again.

Complications and Lasting Shingles Pain

Anyone who has experienced the burning, stabbing, painful misery of shingles never wants to deal with it again. In a YouTube post, Dr. Chris Mecoli with John Hopkins Rheumatology explains that shingles virus is even more dramatic in patients who already suffer from a rheumatic disease. Medications these patients take put them at an increased risk of developing a more severe case. Moreover, about one in ten adults who get shingles virus will experience long-term pain even after the blisters or rash have disappeared. This pain, called post-herpetic neuralgia (PHN), can last for months or even years. The nerve pain can be debilitating as the person is unable to tolerate even the lightest touch. PHN may cause depression, anxiety, and sleeplessness that can also increase fatigue.

"If you develop any odd symptoms, such as vertigo, buzzing in your ears, double vision, face droop, confusion, or a rapid onset weakness," says Dr. Steppie, "you should schedule an appointment right away." Since there is no cure for shingles, early treatment with antiviral drugs that fight the infection can help the blisters dry up faster, reduce the your overall risk of complications, and limit post-shingles pain. "Although it is uncommon for a shingles patient to be admitted to the hospital, adverse effects of shingles like meningitis, encephalitis, or an eye infection may require admittance for more aggressive treatment protocols," Steppie added. Treating shingles at home, you should stay calm and comfortable, wear loose fitting clothes, and apply a cool washcloth to the patches to ease the pain.

Who Should Get a Shingles Vaccination?

Because shingles virus can strike more than once, everyone should consider getting the vaccine. According to the Centers for Disease Control and Prevention, the chances of getting shingles also increases as you get older. Whether you have had the disease or not, the CDC recommends that all adults over the age of 50 get the shingles vaccination. "Even if you received the vaccine in the past," says Dr. Michael Steppie, one of Orlando's Top Physicians in 2020, "everyone should get two doses about four months apart, which results in being more than 90% effective in preventing the disease." Moreover, protection stays above 85% for at least four years after being fully vaccinated. Although there is no established time frame to get vaccinated after having shingles, you should wait until the rash or blisters have disappeared.

Some people can experience side effects from getting a shingle vaccination. These typically last between two to three days and can be treated with over-the-counter medications to manage fever, muscle pain, headaches, or nausea. The shingles vaccination can also help prevent systemic shingles, or internal shingles, where the viral infection attacks systems other than the skin. When shingles virus affects internal organs, it can cause serious complications with persistent pain and fever that may require urgent medical attention. In addition, if you catch shingles after getting the vaccine, you will likely have a milder case that lasts for a shorter time span. Nonetheless, the greatest value in getting the shingles vaccine may not be in preventing the disease. As anyone who has suffered with shingles pain can tell you, it is all about preventing postherpetic neuralgia.

The reason that shingles rates have been increasing in the United States for a long time are unclear. Even though the occurrence of shingles among older adults has seemingly plateaued, the trend among younger and middle-aged adults is still increasing. Since other skin diseases like measles can cause a rash and mimic the symptoms of shingles virus, it is important to get an accurate diagnosis early on. If left untreated, more severe complications of shingles like pneumonia or encephalitis can cause your body to go into shock or sepsis. For expert dermatologic care, contact one of our seventeen convenient Central Florida locations for an accurate diagnosis, and let our professionals check for uncommon problems to help prevent complications and better manage postherpetic pain.

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