If you had chickenpox as a child, you may be at risk for shingles as an adult.
Shingles is caused by the varicella-zoster virus — the same virus that causes chickenpox. If you had chickenpox as a child, the virus already lives in your body.
Shingles occurs when something reawakens the varicella-zoster virus. The reactivated virus then enters a nerve along your spinal cord and causes a painful rash to form.
Doctors can prescribe steroids to lessen the length and severity of the condition. However, shingles can still last several weeks to months.
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What Is Shingles?
Shingles is a painful rash caused by the varicella-zoster virus. This is the same virus that causes chickenpox. If you had chickenpox as a child, the virus already lives in your body, and you can develop shingles.
Shingles can occur years — even decades — after chickenpox when something reawakens the virus in your body.
A weakened immune system can cause the virus to become active. Common culprits include stress, illness, injury, and certain medications, including chemotherapy. The reactivated virus then enters a nerve along your spinal cord.
Shingles begins with a pain or tingling under the skin before skin lesions appear. Some people can have flu-like symptoms as well, including fever, fatigue, and headache.
Doctors can prescribe antiviral medication to lessen the length and severity of shingles if you are seen within the first few days of symptoms. Steroids are also used to help lessen the symptoms. However, symptoms can still persist for several weeks or months. Sometimes, shingles can result in long-term nerve pain.
People over 50 and those with weakened immune systems are most at risk of developing shingles. Two doses of the shingles vaccine can help to lessen this risk. You can get this vaccine at your local pharmacy, and you do not need a prescription for it.
The Shingrix vaccine is about 90% effective in preventing shingles. For the 10% of people who do develop shingles after having the vaccine, the symptoms are much milder.
What are the stages of shingles?
If you’ve had chickenpox, you can develop shingles. The condition follows a predictable pattern:
- First, you will notice tingling, itching, or pain under your skin.
- A rash begins to form in a line where you felt the tingling. On lighter skin, the rash can appear pink or red, while on darker skin, it may look purple or brown. The rash often burns, itches, or even causes shooting pain.
- Sometimes people will experience flu-like symptoms, such as fever, headache, muscle aches, and fatigue.
- Finally, fluid-filled blisters will begin to appear in clusters on the rash. Because the shingles virus attacks a nerve in the spine, the rash and blisters follow nerve patterns on one side of the body. Shingles can commonly occur on one side of your face.
- Eventually, the blisters will scab and the rash will heal, but this can take several weeks. During this time, you should avoid contact with children, pregnant women, people with weakened immune systems, and people who have never had chickenpox. Shingles aren’t contagious, but you can pass along the varicella-zoster virus, which will cause chickenpox.
How common is shingles?
Shingles is very common. About 1 million people get shingles in the United States each year, and about 1 in 3 people will get shingles in their lifetime.
What causes shingles?
Shingles is caused by the varicella-zoster virus. This is the same virus that causes chickenpox. If you had chickenpox as a child, the virus already lives in your body, and you can develop shingles.
Shingles occurs when something awakens the varicella-zoster virus when you have a weakened immune system. Often, this happens years or even decades after you had chickenpox. Common triggers include:
- Chemotherapy
- Illness
- Injury
- Some medications
- Stress
Once the virus has been reactivated, it enters a nerve along your spinal cord and causes the painful rash to form in the coordinating area on your body. This usually occurs on one side of the torso or one side of the face, but it can also occur on the legs at times.
Shingles risk factors
You may be at higher risk of developing shingles if you:
- Are an older adult. About half of shingles cases occur in people older than 60.
- Have had chickenpox. More than 99% of people born before 1980 had chickenpox as children. They are at higher risk because the virus that causes both chickenpox and shingles already lives in their bodies.
- Have a medical condition that keeps your immune system from working properly, such as HIV and certain cancers.
- Take drugs that keep your immune system suppressed, like steroids or drugs given after an organ transplant.
Shingles complications
The most common complication of shingles is long-term nerve pain known as postherpetic neuralgia, or PHN. People who have PHN typically experience pain and sensitivity near the site of their shingles rash. The older you are when you develop shingles, the more likely you are to get PHN.
If the pain of PHN is causing you to feel anxious or lose sleep, you should see your medical provider. PHN isn't curable, but it is treatable, and it usually lessens over time.
Other complications are rare, but more likely if you leave shingles untreated. They include:
- Vision problems, including vision loss.
- Hearing problems.
- Pneumonia.
- Brain inflammation.
- Death.
How can I reduce my risk of developing shingles?
The best way to reduce your risk of shingles is to get the shingles vaccine. The Centers for Disease Control and Prevention (CDC) recommends that all people over 50 get two doses of the recombinant zoster vaccine, known as RZV or Shingrix. You should also get the vaccine if you are over 19 and have a weakened immune system.
According to the National Institute on Aging, the shingles vaccine is more than 90% effective at preventing shingles. In the 10% of people who develop shingles after having had the vaccine, the infection is much milder.
If you have not had chickenpox or are not vaccinated, you should also stay away from anyone who has shingles. They cannot pass shingles to you, but they can pass the virus, which will cause chickenpox and, thus, increase your risk of developing shingles later.
What Are the Signs and Symptoms of Shingles?
Although the red, blistering rash is the telltale sign of shingles, there are other warning symptoms. These include:
- Pain, itching, or tingling along one side of your torso or face.
- Fatigue.
- Fever.
- Headache.
When should I see a doctor about my shingles symptoms?
You should see a medical provider as soon as you notice symptoms of shingles. The sooner you can begin taking an antiviral medication, the more effective it will be at shortening the length and severity of your symptoms.
Also, if left untreated, shingles can cause complications, including long-term nerve pain. If you have shingles on your face, you are at greater risk of complications like hearing and vision loss.
How Do You Diagnose Shingles?
Shingles comes with a distinctive red rash of fluid-filled blisters. Doctors can usually diagnose it by simply looking at it. However, if they are unsure, they can test cells from the rash for the virus.
Tests to diagnose shingles
To confirm that your rash is shingles, your doctor may take a sample of cells from the rash and send it to a laboratory to test the sample for the virus.
Shingles outlook
If you’ve known anyone who has had shingles, then you know how uncomfortable the condition can be. The good news is that the pain and itching are usually temporary. Most people fully heal from shingles in three to five weeks.
Complications from shingles are rare, especially if you begin taking an antiviral medication right away. However, shingles can cause long-term nerve pain, vision problems, hearing problems, pneumonia, and other issues if left untreated.
How Do You Treat Shingles?
Shingles causes a rash that is often painful and itchy. In addition to over-the-counter painkillers and at-home remedies to control itching, doctors may prescribe antiviral medications and/or steroids. These help lessen the length and severity of the rash.
Antiviral medicine to treat shingles
Antiviral medications can help to lessen the length and severity of shingles. The sooner you can begin taking the medication, the more effective it will be. Some common antivirals doctors prescribe for shingles include:
- Acyclovir
- Famciclovir
- Valacyclovir
At-home treatments for shingles
While antiviral medications will help to lessen the length and severity of symptoms, they don’t cure them. To help relieve the pain and itching of your shingles rash, you can try:
- Calamine lotion.
- Cold compresses placed on the rash.
- Oatmeal baths to soothe the skin.
- Over-the-counter oral pain relievers.
- Over-the-counter topical pain relievers.
You should also do your best to avoid stress, as it can make the pain worse.
How effective is treatment?
The sooner you see your provider and begin antiviral medication, the more effective that treatment will be at lessening the length and severity of shingles. However, it may still take several weeks for your rash to heal.
How long does it take to recover from shingles?
Even with antiviral medication, your shingles may not completely heal for several weeks.
During this time, you should avoid spreading the virus to others. While shingles aren’t contagious, you can pass along the virus. The virus can cause chickenpox in those who have never had it or who are not vaccinated.
To avoid spreading the virus, you should:
- Avoid touching or scratching the rash (and wash your hands immediately for more than 20 seconds if you do).
- Cover your rash.
You should also stay away from those most at risk of contracting the virus, including:
- Anyone who hasn’t had chickenpox or is not vaccinated.
- Babies and children.
- Pregnant women.
- Those with weakened immune systems.
