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Shingles Signs Symptoms and Complications
Pain in one area of the body and a rash with blisters are very common in shingles. By Cathy CassataReviewed: October 29, 2021Fact-CheckedShingles usually begins with pain, itching, or tingling in an area of the body where a rash will later develop.Martin Shields/AlamyWhile shingles is very rarely life-threatening, it can cause a painful rash anywhere on your body. It usually appears as a single stripe of blisters that wraps around one side of your torso, or in some cases on one side of your face, neck, or around one eye.The shingles blisters form over the course of three to five days, progressively dry out and crust over, and clear up in two to four weeks, according to the CDC. There is a vaccine available for people ages 50 and older as well as for people ages 18 and older who are immunocompromised that works to prevent shingles. RELATED: Does Medicare Cover the Shingles Vaccine? What Are the Symptoms of Shingles
Per the CDC, these are some common symptoms of shingles: Pain, itching, or tingling in the area where the rash will later developA rash that may begin a few days after this pain, itching, or tingling occursFeverHeadacheChillsUpset stomach The pain caused by shingles can be mild for some and intense for others. Shingles blisters most often appear on one side of the torso, notes the CDC. It can as also occur on one side of the face, or in or around the eye, or in rare cases, all over the body. And in some instances, there is no pain, says Anne Louise Oaklander, MD, PhD, associate professor of neurology at Harvard Medical School and director of the nerve unit and skin biopsy lab at Massachusetts General Hospital in Boston. What Is Postherpetic Neuralgia
In some instances, people who’ve had shingles may experience postherpetic neuralgia (PHN), in which pain persists well after the blisters go away. This happens because the shingles-damaged nerves continue to send pain signals to the brain.In order to be diagnosed with postherpetic neuralgia, the pain has to last for 90 days or more after the blisters have cleared, according to a cohort study published in July 2016 in Neurology. Research varies, but postherpetic neuralgia has been estimated to affect from 5 to 20 percent of those with shingles, notes MedlinePlus. There are several factors that can lead to postherpetic neuralgia. “Anything that depresses immunity can increase your risk,” says Dr. Oaklander. She adds: “The severity of postherpetic neuralgia gradually eases over time in everyone, but the rate of resolution can vary. As you get older, your postherpetic neuralgia typically lasts longer and longer. Senior citizens, who are the most at risk for zoster, have substantial risk of postherpetic neuralgia lasting over a year, and sometimes for the rest of their lives.” “If you have a lot of pain before the rash, it puts you at much higher risk for postherpetic neuralgia,” adds Joseph Safdieh, MD, professor of neurology at Weill Cornell Medicine in New York City.Here are other factors that may raise your risk for PHN, according to a comprehensive review published in January 2016 in Pain. Severe painSevere rashOlder ageInvolvement of the eyeLymphoma, leukemia, and other diseases that suppress the immune systemAutoimmune conditions, such as inflammatory bowel disease and rheumatoid arthritisHIVDiabetesRecent traumaPersonality disorder Can You Get Shingles in the Eye
Yes. Shingles in or around the eye can be serious. This form of shingles is estimated to account for up to 20 percent of cases, according to MedlinePlus. If you have the shingles rash around your eye, or even felt a shingles-like pain in the area, it's important to see an eye doctor right away. Shingles in the eye tends to show up either inside the eyelid or on the surface of the eyeball. “The cornea is a common place to see shingles,” says Rebecca Taylor, MD, an ophthalmologist with Nashville Vision Associates in Tennessee. “It’s the clear domed tissue that you put contacts on.” Shingles also often appears on the conjunctiva, she adds, which is the clear tissue that covers the whites of your eye and the inside of your eyelid. There’s also a pattern in the rash to look out for, says Dr. Taylor. “If you have blisters on the tip of your nose, that’s a strong predictor of there being inflammation inside the eye.”Prompt antiviral treatment can reduce the risk of chronic eye complications by 20 to 30 percent, according to an article published in March 2020 in Community Eye Health. Steroid eye drops and lubricating tears may also be prescribed. You should also have regular eye exams in the months and years after the episode.But in some cases, shingles in the eye can lead to permanent vision problems, including blindness, notes MedlinePlus. RELATED: What You Need to Know About Eye Exams Does Shingles Increase the Risk of Heart Attack
Yes. In the months after an episode, some may be at a higher risk for having a stroke or a heart attack. In a research letter published in July 2017 in the Journal of the American College of Cardiology, shingles was found to raise the risk of cardiovascular events, such as heart attacks and strokes, by 41 percent. Those younger than 40, say the researchers, were at highest risk for a stroke. RELATED: Think You’re Too Young for a Stroke? Think Again Can Shingles Lead to Other Complications
According to the CDC, in very rare cases, shingles can also lead to: PneumoniaHearing problemsEncephalitis, a virally induced inflammation of brain tissueDeathShingles can also lead to Ramsay Hunt syndrome, which occurs when a shingles outbreak affects the facial nerve near one of your ears, notes Mayo Clinic. Common symptoms of Ramsay Hunt syndrome include:A painful red rash with fluid-filled blisters on, in, and around one earFacial weakness or paralysis on the same side as the affected ear Less common symptoms include:Ear painHearing lossRinging in your ears (tinnitus)Difficulty closing one eyeA sensation of spinning or moving (vertigo)A change in taste perception or loss of tasteDry mouth and eyes Be sure to call your doctor if you experience any symptoms of Ramsay Hunt syndrome. Prompt treatment within three days of symptoms may help prevent complications including permanent hearing loss and facial weakness. Can You Get Secondary Skin Infections
A bacterial infection may occur with the shingles rash, for which antibacterial agents may be prescribed. Additional reporting by Carlene Bauer. Resources We Love
U.S. National Library of Medicine Genetics Home Reference Here you'll find a focus on the role of genetics in shingles. Research has suggested that certain genes may be associated with whether people develop shingles or post-herpetic neuropathy. Centers for Disease Control and Prevention (CDC) The CDC has a comprehensive guide to shingles, including information about symptoms, transmission, complications, treatment, and vaccination. Editorial Sources and Fact-Checking
Shingles (Herpes Zoster) Clinical Overview. Centers for Disease Control and Prevention. October 5, 2020.Shingles (Herpes Zoster) Signs & Symptoms. Centers for Disease Control and Prevention. October 5, 2020.Interview with Anne Louise Oaklander. February 12, 2018.Forbes H, Bhaskaran K, Thomas SL, et al. Quantification of Risk Factors for Postherpetic Neuralgia in Herpes Zoster Patients. Neurology. July 2016.Shingles. MedlinePlus. August 18, 2020.Forbes H, Thomas S, Smeeth L, et al. A Systematic Review and Meta-Analysis of Risk Factors for Postherpetic Neuralgia. Pain. January 2016.Interview with Rebecca Taylor, MD. March 1, 2018.Tuft S. How to Manage Herpes Zoster Ophthalmicus. Community Eye Health. March 30, 2020Kim MC, Yun SC, Lee HB, et al. Shingles Increases Risk of Heart Attack, Stroke. Journal of the American College of Cardiology. July 2017.Shingles (Herpes Zoster) Complications of Shingles. Centers for Disease Control and Prevention. October 5, 2020.Ramsay Hunt Syndrome. Mayo Clinic. October 12, 2021.Show LessNEWSLETTERS Sign up for our Healthy Skin Newsletter
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