Shingles is an infection caused by the varicella-zoster virus, which is the same virus that causes chickenpox. Even after the chickenpox infection is over, the virus may live in your nervous system for years before reactivating as shingles. Shingles may also be referred to as herpes zoster.
^ Coplan P, Black S, Rojas C, et al. (2001). “Incidence and hospitalization rates of varicella and herpes zoster before varicella vaccine introduction: a baseline assessment of the shifting epidemiology of varicella disease”. Pediatr. Infect. Dis. J. 20 (7): 641–45. doi:10.1097/00006454-200107000-00002. PMID 11465834.
Care of the skin rash can be provided at home, and this can offer some symptom relief. Topical calamine lotion can be applied to the rash in order to decrease itching. Cool wet compresses against the rash can sometimes be soothing, and for some individuals, a compress with aluminum acetate solution (Burow’s solution or Domeboro) may also be helpful. For some, colloidal oatmeal baths may also provide relief from the itching. It is important to maintain good personal hygiene, avoid scratching the rash, and to try to keep the affected area clean in order to prevent a secondary bacterial infection of the skin. The rash should be covered to decrease the risk of transmissibility should you come into contact with susceptible individuals.
For those who have already had chickenpox, there is also a shingles vaccine. The Food and Drug Administration approved the shingles vaccine for adults over the age of 50. The CDC recommend adults over the age of 60 who have a history of chickenpox get the vaccine. There is no maximum age for getting the vaccine.
Ramsay Hunt syndrome (also known as herpes zoster oticus) consists of weakness of the face due to infection with the varicella zoster virus. Five cases arise per 100,000 of the population per year in the US. It is more common among those over 60 and rare in children. Other symptoms may include severe ear pain and small blisters on the outer ear or in the mouth. Prompt diagnosis and treatment (ideally within 72 hours of the onset of symptoms) are crucial to secure the best outcomes. In cases where treatment has been started within this time period, facial weakness recovers in up to 75% of patients. Standard treatment is with antiviral therapy (most commonly acyclovir). Corticosteroids are known for their anti‐inflammatory properties and are commonly used together with antivirals to reduce the inflammation in the facial nerve. This is thought to be the cause of the facial weakness. The aim of the review was to see if corticosteroids, used at the same time as antiviral drugs, improved outcomes in patients with Ramsay Hunt syndrome. However the review found no trials matching the inclusion criteria, and no conclusions can be drawn about the effectiveness of using corticosteroids in this way. It is recommended that high‐quality randomised controlled trials be undertaken to address this issue.
Emotional stress is considered a trigger for shingles because it has been shown to weaken the body’s immune system. This can happen in those who have undergone a sudden shock, such as the death of a loved one, or people who face chronic work or life stress. An immune system weakened by stress provides the shingles virus with a window of opportunity. This is particularly true of people who already have challenged immune systems, either because they are older or because they have an immune deficiency or a chronic disease.
The pain of shingles may be relieved by taking over-the-counter (non-prescription) painkillers, but if it’s severe your GP might prescribe more powerful drugs. Always read the accompanying consumer medicine information leaflet and if you have any questions, ask your pharmacist or GP for advice.
Transmission only occurs through direct contact with blisters, and it can cause chickenpox in someone who has never been infected with the virus. During the time before blisters appear and after crusting, there is no risk of viral transmission.
People with Bell’s palsy usually don’t need medical treatment, however, drugs like steroids, for example, prednisone seem to be effective in reducing swelling and inflammation are used when medical is necessary. Most people with Bell’s palsy begin to recover within two weeks after the initial onset of symptoms. Full recovery may take three to six months.
Chest pain is scary but it’s not always a symptom of a heart attack. “Prior to the appearance of vesicles on the chest, patients may experience sharp or burning pain,” says Sylvia Morris, MD, a board-certified internist in Atlanta. According to Dr. Morris, chest pain that feels itchy and painful to the touch could be an early sign of shingles. (Here’s everything you need to know about a shingles diagnosis.)
I cover medical privacy and a variety of other health and nutrition topics for Consumer Reports, where I feel fortunate to spend my time reading, writing, thinking, talking, and tweeting about health—and doing my little bit to help make the world a better place. I’m also a mother/homework-wrangler, beach-lover, collector of vintage Pyrex, insatiable reader, energetic but untalented gardener, and fixer-upper-er of a very old house.
Scientists don’t know exactly why some people develop shingles and others don’t, but there are some common risk factors. It tends to flare up in people with weakened immune systems, including HIV and cancer patients, and organ transplant patients who take immune-suppressing medications to prevent organ rejection. Stress or trauma may play a role. Shingles also may be age-related, since it mostly affects older adults, especially people who are 60 to 80 years old.
Shingles, also called zoster or herpes zoster, is a viral infection that affects the nerves. It typically produces a painful rash with blisters that can be dangerous in some people. The varicella zoster virus that causes chickenpox is the same one that causes shingles. If you’ve had chickenpox, the virus is lurking in your body, and it can remain inactive for many years. While most adults never get shingles, in others the virus reawakens years later, creating a rash in areas of the skin served by the affected nerves.
After someone has had chicken pox, the virus stays in the nerve cells of the person’s spine (called ‘nerve roots’). It does not damage the nerve or the way the nerve works until, for some reason which is not yet clear, the virus starts to grow again, causing shingles.
You might not expect that the health of your gut has anything to do with whether or not you’d develop shingles, but the fact is that your microbiome (mostly present within your gut) majorly impacts your ability to stay protected from illnesses of all sorts. How so?
Since 2006, we’ve had Zostavax—approved for those between 50 and 59 but recommended by the CDC for adults 60 and older—as the sole bulwark against shingles. Zostavax offers 70 percent protection against shingles for people between 50 and 59 but only 18 percent in people 80 and older, according to the Pink Sheet, which reports on the pharmaceutical industry.
Chicken Pox Eradicated? Varicella Vaccine Proven To Do The Job Varicella vaccine has been in the market since 1995 and new studies show that it has nearly wiped out deaths from chickenpox in the United States. Read now
So if you have shingles, and you come into contact with somebody else, they cannot “catch” your shingles. But if they have never had chickenpox, it is possible that they could catch chickenpox from you. (And if you had chickenpox, and came into contact with somebody else who had never had chickenpox, they could catch chickenpox. But they couldn’t “catch” shingles from your chickenpox.)
John P. Cunha, DO, is a U.S. board-certified Emergency Medicine Physician. Dr. Cunha’s educational background a BS in Biology from Rutgers, the State University of New Jersey, and a DO from the Kansas City University of Medicine and Biosciences in Kansas City, MO. He completed residency training in Emergency Medicine at Newark Beth Israel Medical Center in Newark, New Jersey.
Shingles is contagious to people who have not previously had chickenpox when there are new blisters forming and old blisters healing. Like with chickenpox, the time prior to healing or crusting of the blisters is the contagious stage of shingles. After all of the blisters are crusted over, the contagious period is over and the virus can no longer be spread.
Many people with shingles wonder if they are contagious. The Varicella zoster virus, which is responsible for chickenpox and shingles, can be spread by direct contact with fluid from the small blistery rash that occurs with shingles. It can cause chickenpox in those who have not previously been infected with Varicella zoster virus.
The CDC also recommend that children, teens, and adults receive the chickenpox shot in two doses. Although there is a very small chance the being infected with Varicella zoster virus despite vaccination, the CDC report that the vaccination may allow for milder chickenpox symptoms if this happens.
Theoretically, it may be possible to spread VZV to other individuals during a zoster outbreak because VZV has been reportedly detected in saliva and nasal secretions in individuals with chickenpox and/or shingles. However, there is little or no data about the frequency of secretion transmission. Such spread of VZV to others is considered to occur rarely.
Children’s Hospital of Philadelphia. “A Look at Each Vaccine: Varicella (Chickenpox) Vaccine.” http://www.chop.edu/service/vaccine-education-center/a-look-at-each-vaccine/varicella-chickenpox-vaccine.html. Accessed June 2014.
Examples are infection of the brain by the varicella-zoster virus, or spread of the virus throughout the body. These are very serious but rare. People with a poor immune system (immunosuppression) who develop shingles have a higher than normal risk of developing rare or serious complications. (For example, people with HIV/AIDS, people on chemotherapy, etc.)
A study published in March 2015 followed 6,043 people for 11 years after their vaccination. It found that the vaccine’s effectiveness declined with time and after eight years no longer worked to prevent disease.
Depending on what trimester you’re in, having chickenpox during pregnancy can result in birth defects. Getting a chickenpox vaccine before pregnancy can be an important step in protecting your child. Shingles is less likely to cause complications, but it can still be unpleasant. See your doctor right away if you develop any rash during pregnancy.
And even if adults want to get their recommended shots, some lose track of which they have already received and when. Pediatricians routinely report the vaccines they provide to state or city vaccination registries that electronically collect and consolidate the information. But the registries are not widely used for adults, who are more likely to get vaccines at various locations, such as a pharmacy or at work, for example.
Senior citizens with shingles are more likely to experience complications than the general population, including more extensive rashes and bacterial infections from open blisters. They are also more susceptible to both pneumonia and brain inflammation, so being seen by a doctor early on for anti-viral treatment is important.
The location of the shingles rash can vary. Though shingles can appear almost anywhere on the body, it most commonly affects the torso and the face (including the eyes, ears, and mouth). It is often present in the area of the ribcage or the waist. This characteristic rash is in a stripe or band-like pattern that affects only one side of the body (the right or the left), and it usually does not cross over the midline. In some cases, the rash can affect adjacent dermatomes (an area of skin that is supplied by a single spinal nerve), and rarely it can affect three or more dermatomes (a condition termed disseminated zoster). Disseminated zoster generally occurs only in individuals with a compromised immune system.
Antiviral medications, such as acyclovir (Zovirax), valacyclovir (Valtrex), and famciclovir (Famvir), can decrease the duration of skin rash and pain, including the pain of PHN. These medications must be started early (up to about 24-72 hours after rash development) in the disease course to have any benefit. The doctor will decide which medications you may need. In special cases (for example, those with suppressed immune function), the antiviral medication may need to be given intravenously in the hospital. Only acyclovir is approved for use in children who get shingles.
When VZV is reactivated, it travels down sensory nerves to infect epithelial cells. This may result in shingles, a skin rash that affects the skin supplied by the specific sensory nerves involved. For this reason, the rash is dermatomal and does not cross the midline. The thoracic, trigeminal, lumbar and cervical dermatomes are the most frequent sites involved.
