Shingles often starts with burning or tingling pain a few days before the rash. The early signs, why antiviral treatment works best when started within 3 days, pain relief and the vaccine.
What is shingles?
Shingles is caused by the same virus as chickenpox (varicella-zoster). After chickenpox, the virus stays inactive in the nerves for life, and it can wake up years later as shingles. About 1 in 3 people in the US will get shingles. The risk rises after age 50 and in people with a weakened immune system.
Symptoms
Before the rash – usually 1 to 5 days earlier – many people feel pain, burning, tingling, itching or numbness in one area of skin, on one side of the body. Some also have a fever, headache, chills or an upset stomach.
The rash:
- Appears as a band or strip on one side of the body or face – most often around the waist, chest or back
- Starts as red patches that turn into fluid-filled blisters
- The blisters crust over in about 7–10 days, and the rash usually clears within 2–4 weeks
- It can be very painful, even to a light touch
Shingles near the eye is an emergency for your sight. See a doctor the same day if the rash is on your forehead, around your eye or on the tip of your nose.
Treatment
Antiviral medicines – acyclovir, valacyclovir and famciclovir – make shingles shorter and less severe. They work best when started as soon as possible, ideally within 3 days of the rash appearing, so don't wait to see a doctor. A typical acyclovir course for shingles is 800 mg five times a day for 7 days. PharmacyFarm dispenses acyclovir 800 mg after our pharmacist has verified your prescription.
For pain and itching:
- Acetaminophen or ibuprofen, following the label
- Cool, damp compresses, calamine lotion or a lukewarm oatmeal bath
- Loose, soft clothing over the rash
If the pain is severe, your doctor can prescribe stronger pain relief or a medicine for nerve pain.
Is shingles contagious?
You can't catch shingles from someone. But the virus in the blisters can give chickenpox to someone who has never had chickenpox or the chickenpox vaccine. Until the blisters have crusted over, keep the rash covered and avoid contact with pregnant women who haven't had chickenpox, premature or newborn babies, and people with a weakened immune system.
Complications
The most common complication is postherpetic neuralgia – nerve pain that lasts for months or even years after the rash has gone. It's more likely in older adults. Shingles can also cause eye problems and, rarely, pneumonia, hearing problems or inflammation of the brain.
The shingles vaccine
The shingles vaccine (Shingrix) is recommended for all adults aged 50 and over, and for adults 19 and over with a weakened immune system. It's given as 2 doses, 2 to 6 months apart, and is more than 90% effective at preventing shingles. You should get it even if you've already had shingles, once the rash has gone. Ask your doctor or local pharmacy – most US pharmacies offer it.
When to see a doctor
See a doctor as soon as you think you have shingles – ideally within 3 days of the rash appearing – and the same day if it's near your eye. Also see a doctor if you have a weakened immune system, the rash is widespread or the pain is severe. Call 911 if you have confusion, a severe headache, a stiff neck, weakness on one side or loss of vision.