While most shingles clear up independently, some people can develop long-term nerve pain called postherpetic neuralgia. Over-the-counter medications can help relieve the pain and itching. Soothing baths or soaking the rash in ground-up oatmeal can ease itching, too.

Your doctor can usually tell if you have shingles by examining the rash and your medical history. They may also test fluid from the blisters. Click the Erie Shingles to learn more.

Shingles occur when the varicella zoster virus that causes chickenpox is reactivated in your body. The virus usually stays in nerve cells in your body after you get the chickenpox, and when conditions are right, it can be reactivated. It can affect anyone who has had chickenpox, and it’s more common in adults over 50. It’s also more common in people who have certain medical conditions that weaken the immune system, such as cancer, leukemia, lymphoma, HIV infection, or taking drugs to suppress the immune system, like steroids or medicines used after an organ transplant.

Symptoms of shingles include pain, itching, or tingling in an area of your skin that starts to develop a red bump that can then turn into fluid-filled blisters. Often the rash forms in a stripe on either the left or right side of your body, although it can spread to other areas of your body. The rash and blisters typically scab over in 7 to 10 days. Pain can continue for months or even years in some cases. This is called postherpetic neuralgia, and it occurs when damaged nerve fibers send confusing or exaggerated messages of pain from the skin to your brain.

Some people with shingles get a complication called herpes zoster oticus, which is when the virus damages nerves in your ears. This can cause pain, weakness on the affected side of your face, and itching in the ear canal. You can treat this with steroid creams or oral anti-seizure medications, such as gabapentin and pregabalin.

Anyone who has had shingles can have it again. But you’re less likely to get a repeat outbreak if you’ve had the chickenpox vaccine. The CDC recommends two doses of the shingles vaccine, Shingrix, for adults over 50. The vaccine also can reduce the severity of symptoms and risk of complications. Getting shingles while pregnant is dangerous for both the mother and baby. Pregnant women who get shingles should see a doctor immediately. They should not breastfeed until all the blisters have scabbed over. If the woman has a low immune system, she may need treatment with antiviral medication and pain-control medicine.

Symptoms

Shingles typically begin with pain or a tingling sensation in one area of the body, often on the chest or torso. This is followed by a red rash that develops into fluid-filled blisters and then scab over in about a week. The blisters are usually painful and itchy. The pain can also have a stinging quality, particularly if it occurs near the eye. This may cause permanent eye damage if left untreated. Shingles most commonly occur in people over 50 or anyone with a weak immune system, which can be due to illness, pregnancy, cancer treatments, or medications.

The rash typically occurs in a band on the side of the body or face, matching where the nerve travels in the skin. A few days after the rash begins, it will turn into fluid-filled blisters that then scab over in about a few weeks. In people with healthy immune systems, the sores become scabs and are no longer infectious by days 7 to 10, and they clear up within two to four weeks.

If you think you have shingles, see your doctor right away. They will do a physical exam and ask about your health history. Then they will likely know it’s shingles right away based on the rash and your history of chickenpox. They may test fluid from your blisters or take a blood sample to see if you have the shingles virus.

If you have a severe case of shingles, your doctor might put you in an isolation room. This is to keep the virus from spreading to other people. They might also ask you to stay away from babies, newborns, and people who have never had chickenpox or the shingles vaccine. This is to protect them from getting the disease and potentially developing serious complications like pneumonia or brain inflammation (encephalitis). Your doctor might give you medicine to reduce pain and prevent complications. These medicines are called antivirals and include valacyclovir, famciclovir, or acyclovir. They work best when started early, within 72 hours of the rash appearing. They won’t cure the rash, but they can help reduce pain and speed healing.

Diagnosis

The first sign of shingles is usually a pain, tingling or itching in a specific area of skin. That pain may occur several days before a rash appears. The rash is often in a stripe of blisters around the left or right side of the body, or on the face. In some cases, the rash is more widespread and looks like a chickenpox rash. The rash usually lasts 2-4 weeks and you will be contagious until all of the sores have crusted over.

Your healthcare provider can tell you have shingles from the symptoms and unique pattern of the rash. A physical exam and your medical history will also help. Your healthcare provider can give you medicine to fight the virus and help reduce your pain, itching and swelling. The medicines can’t cure the virus, but they can decrease your symptoms and shorten how long you have a rash.

A rash from shingles does not cause any serious health problems in most people, but it can be very uncomfortable and you may need to stay off of work until the rash has completely healed. You can get a shingles vaccine, which is recommended for anyone over 50. It can lower your risk of getting a rash and complications from shingles, and it’s especially important for people with weak immune systems.

After the rash has cleared, you can help your rash heal faster by keeping it clean and covering it when possible. You can use calamine lotion or a cool, wet washcloth on the rash and take oatmeal baths to ease the pain and itching. Avoid scratching the blisters because you can cause scarring.

The most common complication of shingles is postherpetic neuralgia (PHN), which is severe pain in the areas where the rash was. This pain may last for months and can interfere with your daily life. In very rare cases, shingles can lead to pneumonia or brain inflammation (encephalitis). In both of these cases, you should seek emergency care.

Treatment

Shingles often start with itching or burning pain in a specific area of skin on one side of the body. Then a rash develops with blisters that scab over in 7 to 10 days. The rash usually occurs on the chest or back, but it may be on the neck or face. It may look like a chickenpox rash. It’s most common for the rash to form a stripe that wraps around either the left or right side of the torso. It’s less common for the rash to form on the head or face.

A weakened immune system can make your shingles symptoms more severe. Stress, some illnesses and medications, and injury can all weaken your immune system.

If you’re infected with shingles, our doctors will prescribe antiviral medicines to decrease the length of your illness and help you get better faster. Your doctor may also prescribe numbing medicine to control your pain. Medicines can include capsaicin cream (be careful not to get it in your eyes), or a topical anesthetic such as lidocaine (Lidoderm, Xylocaine).

You should avoid scratching the rash and scabs because it can prolong the healing process and cause scarring. Use cool, wet compresses or oatmeal baths to ease the pain and itching. Drink plenty of fluids to keep your skin hydrated.

Some people who get shingles experience nerve pain that lasts for months or even years after the rash and blisters go away. This is called postherpetic neuralgia and it’s more common in adults over 50. Medicines can include an anti-depressant or an acyclovir.

Everyone over the age of 50 should get two doses of the shingles vaccine called Shingrix to help prevent a shingles outbreak and reduce the chances of postherpetic neuralgia. Talk to your Baylor St. Luke’s Medical Group physician about the best timing for you to receive your vaccination.