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What is Shingles (Herpes Zoster)?

Shingles, also known as herpes zoster, is an infectious disease that causes a painful rash to appear on the skin. It’s primarily caused by the varicella-zoster virus, the same viral agent that leads to chickenpox. 

This skin infection is more common among people who have previously had chickenpox. After recovering from chickenpox, the virus enters the nerve tissue and remains dormant in your nervous system for years. It can eventually reactivate along the nerve pathways in the skin and produce the physical symptoms of shingles. 

The shingles rash is usually localized and affects only one section of the body. It typically appears as a band or strip of blisters that goes from the spine around the front to the breastbone. In some cases, shingles can be widespread and appear on the neck, nose, and forehead.

What Causes Shingles?  

Varicella-zoster is a herpes virus that commonly causes chickenpox. This viral infection usually occurs among children under the age of 10, and those who have had this chickenpox virus can experience shingles breakout later in their adult years. It is said that one in three adults who have had chickenpox can develop this infectious disease. 

It’s not clear what exactly activates the varicella-zoster virus in your system. It can be due to a weakened immune system as you grow older. Living with compromised immunity can make you more vulnerable to getting frequent infections and illnesses with severe symptoms. Additionally, if you have existing chronic diseases, you may be more prone to having viral infections. 

The virus may also be reactivated when you have close contact with a person who has active shingles or chickenpox virus. It is possible to acquire the virus through airborne transmission but the most common way to get infected is through direct skin-to-skin contact with rashes or blisters on the skin. 

Another possible cause of virus reactivation is chronic emotional stress. When you’re always stressed, the body releases hormones that can suppress your immune system responses. Some doctors suggest that stress and anxiety put the body in a weakened state which can contribute to the development of shingles. 

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At Dermatology & Skin Health, we offer world-class services done by award-winning doctors who have proven their knowledge and skills in this field. Start your journey towards achieving your best skin by contacting us today.

Is It A Contagious Disease? 

An infected person cannot technically pass shingles rash but it is still a contagious disease. The varicella-zoster virus that causes shingles and chickenpox can be easily spread from one person to another.

If you’ve had chickenpox in your younger years, the virus would develop into herpes zoster after your exposure to an infected person. But if you haven’t been infected with chickenpox or have not yet received the vaccine, you’d get the classic symptoms of the varicella virus. 

An infected person remains contagious as long as they have open sores or fluid-filled blisters on the skin. It is best to avoid any contact with a person with visible shingles rash until their lesions have dried and crusted. 

Given the nature of shingles, this disease appears most frequently among older adults and those with weakened immune systems. Generally, a patient can only get shingles once in their lifetime with a low risk of recurrence. 

Risk Factors for Shingles  

Any individual who has experienced chickenpox can have herpes zoster virus. Additionally, those who have not had the chickenpox vaccine are at high risk for contracting the virus and developing shingles. Other factors that can increase your chances of having shingles are: 

  • Being of advanced age - People who are over the age of 50 have weaker immunity which is why they are more prone to experiencing the symptoms of shingles. 
  • Medical history - Individuals who are diagnosed with certain diseases such as asthma, inflammatory bowel disease, cancer, rheumatoid arthritis, chronic kidney disease, pulmonary disease, and HIV/AIDS are at an increased risk for acquiring varicella-zoster viruses. 
  • Stress and depression - Chronic stress and untreated depression are also shown to decrease the effectiveness of the chickenpox and shingles vaccine. Individuals who are diagnosed with this condition have lower immune system responses and are more susceptible to herpes zoster symptoms. 
  • Cancer treatment -  Radiation therapy and chemotherapy can trigger the inactive virus and develop shingles. 
  • Medications - Taking certain drugs and prolonged use of steroids can increase your risk of shingles. 

What Are the Common Signs of Shingles?  

The symptoms of shingles include the appearance of rashes on one area of the body or face. They commonly develop as a single stripe of blisters covering one side of your torso or around the waistline. The rashes appear localized as a result of the viruses traveling and sending signals to specific nerves, and it doesn’t always spread all over the body. 

The shingles rash may be accompanied by other signs such as: 

  • Fever 
  • Chills
  • Headache 
  • Upset stomach 
  • Severe fatigue
  • Increased sensitivity to light 
  • Severe pain, burning, numbness, or tingling on one side of the body 
  • Skin redness on the affected area 

In some cases, shingles commonly begins with an intense pain that can be confused with other medical conditions affecting the heart, lungs, or kidney. Other individuals can only develop shingles pain as their primary symptom without getting any skin rashes.  

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Shingles Rash vs Eczema: What’s The Difference?  

It is easy to mistake a shingles rash with other itchy bumps or patches that suddenly appear on the skin. One of the most common inflammatory skin conditions that can be confused with shingles is eczema. There are many types of eczema but the most commonly diagnosed is atopic dermatitis. 

Similar to shingles, eczema can be triggered by viral infections. It can also develop as a result of a weakened immune system, family history, exposure to irritants in the environment, and other external stressors. 

Here are some of the differences between shingles and eczema symptoms: 

Shingles RashEczema Rash 
It happens among people who have previously contracted the chickenpox virus. Eczema can be triggered by allergens, bacteria, and other irritants. It can appear at any time and happen more than once in your lifetime. 
The painful rash typically appears after a few days of severe pain, burning, or tingling on the skin. The rash can often feel itchy but it won't be accompanied by any nerve pain or tingling. 
Shingles are localized and form on one side of the body. Dermatitis is usually widespread and can form on both sides and cover a larger area of the body. 
Shingles can cause skin irritation and cause the surrounding area to feel tender and sensitive to touch. Eczema is not particularly painful but it can cause dryness and flaky skin.
Herpes zoster typically comes with extreme fatigue and other flu-like symptoms.Fever, fatigue, and other flu-like symptoms are not usually associated with eczema rash. 
Most cases of herpes zoster can clear up within 3 to 5 weeks, with some patients experiencing chronic nerve pain after recovering. Eczema is a chronic skin condition, and you can get occasional flare-ups even after the rashes fade away.

How Long Can You Have Shingles?  

Most patients can experience the symptoms of shingles for about 3 to 5 weeks before the rashes completely disappear. Here’s an overview of the different stages of a shingles outbreak: 

  • Early signs - If you’ve been exposed to the shingles virus, you’d first feel itching or burning pain in one area of the skin. 
  • Rashes - The red rashes will typically form within five days after the severe pain. They will appear on one side of your waistline, neck, trunk, arms, or legs. Some cases of shingles can develop on the face. 
  • Blisters - After three to five days, the rashes may turn into small, fluid-filled blisters. 
  • Crusting of the open blisters - As you’re nearing the healing stage, the blisters will begin to dry and form crusty scabs. This also indicates that your rashes are no longer contagious. They will completely fade away within 2 to 3 weeks after scabbing over.

What Are The Long-Term Complications of Shingles?  

Around 10% to 15% of herpes zoster patients may experience postherpetic neuralgia after the rashes disappear. Postherpetic neuralgia is a condition that causes long-term nerve pain once the blisters from shingles have been treated. It occurs as a result of the damaged nerve fibers sending mixed pain signals to the brain. 

Other possible long-term side effects of shingles are 

  • Neurological disorders - Some cases of shingles may cause brain inflammation or encephalitis, facial paralysis, or hearing and balance problems as a result of the virus affecting certain nerves. 
  • Vision loss - If the shingles develop on the face and spread around the eyes, it can cause eye infections and possibly lead to loss of vision. 
  • Skin infections - A bacterial infection can occur if you have an untreated shingles rash. 
Schedule Your Consultation Now at Dermatology & Skin Health

At Dermatology & Skin Health, we offer world-class services done by award-winning doctors who have proven their knowledge and skills in this field. Start your journey towards achieving your best skin by contacting us today.

How to Diagnose Shingles

Most doctors can diagnose shingles based on your medical history and a visual examination of the existing rash and blister. In some cases, tissue scraping or culture testing of the fluid from the blisters may be done to get a more accurate diagnosis. 

If you suspect that you have shingles and experience severe pain before the rashes, it’s important to contact your healthcare provider as quickly as possible. Early treatment is recommended to manage the symptoms and reduce the severity of the episode.

Treatment Options for Shingles 

There’s currently no cure for shingles but there are medications that can help provide relief from its symptoms. Here are the common types of medication that are prescribed to treat shingles: 

  • Antiviral medication - Taking an antiviral medicine like acyclovir, valacyclovir, and famciclovir can help alleviate the shingles symptoms. They can also help manage the pain from postherpetic neuralgia. 
  • Over-the-counter pain relief medication - Common pain relievers such as ibuprofen and acetaminophen can also be effective in reducing shingles pain. Topical skin-numbing agents like lidocaine, anticonvulsants, antidepressants, and anti-inflammatory drugs can also be recommended for shingles treatment. 

Tips to Prevent Shingles  

The best way to reduce your risk for shingles is to get a varicella zoster vaccine to protect against the virus. The U.S. Food and Drug Administration has approved the Zostavax vaccine to prevent shingles among adults. It’s typically administered to adults aged 60 and above who have had chickenpox. The injection of the vaccine essentially serves as a booster dose of chickenpox. 

Another shingles vaccine that can help is the Shingrix vaccine. This has been approved by the US FDA in 2017, and it’s said to offer protection against herpes zoster for more than 5 years. This recombinant zoster vaccine is usually given in two doses, with a 2 to 6 months interval between the injections. 

Although the vaccine doesn’t completely eliminate your risk of having shingles, it can reduce the severity of its symptoms and lessen your risk of having postherpetic neuralgia. Here are other tips to avoid getting infected and limit the spread of the varicella-zoster virus: 

  • Immediately isolate and stay at home if you notice the warning signs of shingles.
  • Keep away from anyone who has chickenpox or those who have not had the vaccine. 
  • Cover your rash to avoid transmission of the virus particles. 
  • Don’t touch or scratch the itchy rash. 
  • Wash your hands to avoid transferring the virus to any surface or person. 

Let Our Specialists Help You Manage Your Shingles Symptoms  

Get relief from your shingles pain and rashes with help from our team at Dermatology and Skin Health. Our board-certified dermatologists can provide expert care and treatment to improve your viral infection and bring back optimal skin health. Contact us today and request your first appointment to get started on your shingles treatment.