What You Must Know About Shingles

M.A., Health Writer
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Shingles, or herpes zoster, is a painful, blistering skin rash that typically appears later in life. According to the Centers for Disease Control and Prevention (CDC), one in three people will develop shingles during their lifetime. In fact, shingles is becoming more prevalent among adults and experts aren't sure why. To help protect yourself from this uncomfortable and possibly serious illness, see our slideshow to learn how to help prevent shingles.

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Shingles and the chickenpox virus

After you have the chickenpox, the varicella-zoster virus stays in your body, nesting in the cells of your nervous system. Though it usually remains dormant or temporarily inactive, it can reactivate and reappear later in life — usually after age 50 — causing shingles. People with weakened immune systems may also get shingles. Maybe they've had cancer or chemotherapy, have HIV, or are taking medications that suppress the immune system.

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Is shingles contagious?

These two distant cousins — chickenpox and shingles — stay connected throughout your lifetime. According to UpToDate, two people can't pass shingles between one another. However, if you were spared chickenpox and didn't have its vaccine, you can contract it if you touch a shingles blister or inhale the varicella-zoster virus. If you did have chickenpox or the vaccine, don't worry if you're close to a person with shingles — you're safe.

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Shingles is a rash

The rash consists of blisters that scab over after three to five days. Shingles may begin with paresthesia — itching, burning, or tingling with pain located on only one side. Because shingles affects the nerves of your skin, you may feel pain before you see a rash. Then you may develop blisters that resemble "bands" on your skin, known as dermatomes. You can also have a headache or fever, light sensitivity and tiredness — common symptoms of a viral infection.

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How shingles progresses

Most often, the rash affects your chest and back, but in more serious cases, it can break out on your face, near your mouth, eyes, and ears. After several days, blisters change to fluid-filled ulcers, prone to infection. They generally scab over and after a week are not infectious, resolving completely in approximately a month or as little as two weeks. However, they can scar and permanently alter the color of your skin.

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About shingles complications

Just over 10 percent of people with shingles develop complications in addition to infections of the blisters. One of the most common and sometimes severe complications is postherpetic neuralgia or PHN, a strong burning sensation. It generally goes away, says UpToDate, but may persist for months or for years, interfering with sleep, causing weight loss, and depression. Treatments include pain medications, tricyclic antidepressants, anti-seizure medications, and steroid injections.

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Eye and ear complications

An inflamed eye may interfere with vision, cause a droopy eyelid, and combine with sensitivity around the eye and face. You may have a fever and headache with these symptoms. Your retina, located at the rear of the eye, can also become inflamed, causing blurred vision and pain. If you ear is inflamed, you can develop weak facial muscles on the affected side, says UpToDate. You may also suffer hearing loss. That's why it's so important to seek medical care at the first sign of shingles.

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How to treat shingles

There is no cure for shingles, including vaccines, but again, it's very important to see your doctor. If you're diagnosed with shingles, you may be prescribed an antiviral medication such as acyclovir, valacyclovir, or famciclovir. The American Academy of Dermatology says it's most effective when you start it within three days of seeing a rash. Creams aren't usually prescribed due to the chance of spreading a secondary bacterial skin infection, says UpToDate, but your doctor will decide.

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Shingles prevention

Before 2017, the live vaccine Zostavax was recommended. Now the CDC recommends healthy adults 50 and over get two doses of newer, nonliving Shingrix to protect against shingles and its complications. Get them two to six months apart. The new vaccine delivers 97 percent protection to people in their 50s and 60s, and approximately 91 percent to seniors in their 70s and 80s, according to the CDC. In trials, Shingrix was 85-plus percent effective after four years. Yes, you can get Shingrix if you already had Zostavax.

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Stress and shingles

A review of the scientific literature in a 2014 issue of Innovations in Clinical Neuroscience concluded that stress, stressful life events, and depressive symptoms may partially contribute to outbreaks of shingles. It also noted that aging can worsen effects of stress. Try to eat healthy, exercise regularly, get sufficient sleep, and take a break when you're stressed, says the CDC. Avoid drugs and alcohol and talk to others — parents, friends, a counselor, doctor, or pastor to help manage stress.

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Natural relief from shingles discomfort

For discomfort, Medline Plus recommends cool, wet compresses on your skin. Try a colloidal oatmeal bath with protective, water-holding properties to soothe and protect your skin, says an earlier study in the Journal of Drugs and Dermatology. Corn starch and rice starch may also be added. You can also mix corn starch and baking soda into a paste and apply to your rash. Consider calamine lotion or Zostrix, a cream containing capsaicin, which is found in pepper and has a topical analgesic effect.

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Can I get shingles again?

According to Immunize.org, you can, but it is rare. Some people report getting it twice, and even fewer report a third go-round. If you had shingles in the past, you can get Shingrix to help prevent future occurrences of the disease, says the CDC.