Some medicines used to treat depression also work for nerve pain and are sometimes used for post-herpetic neuralgia. Read more about treatments for post-herpetic neuralgia. The varicella zoster virus causes both chickenpox and shingles.
In post-herpetic neuralgia, the virus causes inflammation of the nerves under the skin of the affected area. Neuralgia is a medical term for pain resulting from nerve inflammation or damage.
It's not clear why some people with shingles develop post-herpetic neuralgia, but increasing age, pain during the early stage of shingles and severe pain throughout an episode of shingles are all associated with an increased risk of the condition.
There's no definite way to prevent post-herpetic neuralgia. But if shingles is treated early with antiviral medicine the risk of complications such as post-herpetic neuralgia is reduced. If you develop symptoms such as pain or a rash that suggests shingles , see your GP as soon as possible to discuss taking an antiviral medicine. Having the shingles vaccination will help you avoid getting the infection in the first place. Shingles, sometimes called herpes zoster, is an infection caused by the varicella-zoster virus.
Learn more here. Once reactivated, the virus spreads to your skin by traveling down your nerves. Where your rash appears depends on which nerve the virus travels. Learn to how to tell shingles vs.
Pulmonary function tests PFTs are a group of tests that measure how well your lungs work. Learn about the different types. Health Conditions Discover Plan Connect. When Does Shingles Pain Peak? Pain stages and timeline Symptoms Duration Post-infection pain Treatments When to seek care Takeaway Shingles is a viral infection that leads to pain and itching that can last 3 to 5 weeks. Pain stages and timeline. Post-infection pain.
When to seek care. The bottom line. Read this next. Is Shingles Contagious? Medically reviewed by Shilpa Amin, M. Can Stress Trigger Shingles? Medically reviewed by Judith Marcin, M. Medically reviewed by Debra Sullivan, Ph. Medically reviewed by Kathy W.
Warwick, R. Medically reviewed by Susan Bard, MD. Shingles vs. Medically reviewed by Emelia Arquilla, DO. Around three-quarters of people given antiviral medication within 72 hours of the start of their symptoms usually make a complete recovery. Those who don't make a full recovery may be left with permanent problems, such as a degree of permanent facial paralysis or hearing loss.
A number of other possible problems can also sometimes develop as a result of shingles, including:. Shingles is rarely life threatening, but complications such as those mentioned above mean that around 1 in every 1, cases in adults over the age of 70 is fatal.
Home Illnesses and conditions Infections and poisoning Shingles. Shingles See all parts of this guide Hide guide parts 1. About shingles 2.
Symptoms of shingles 3. Causes of shingles 4. Diagnosing shingles 5. Treating shingles 6. Complications of shingles. About shingles Shingles, also known as herpes zoster, is an infection of a nerve and the skin around it. Symptoms of shingles The main symptom of shingles is pain, followed by a rash that develops into itchy blisters , similar in appearance to chickenpox.
These early symptoms can include: a headache burning, tingling, numbness or itchiness of the skin in the affected area a feeling of being generally unwell a high temperature fever An episode of shingles typically lasts around two to four weeks, however in some cases the pain may last for many weeks once the rash has disappeared. When to get professional advice. Non-urgent advice: Speak to a pharmacist. Pharmacy First Scotland: Shingles treatment from your local pharmacy Adults 18 years and over with symptoms of shingles can get advice and treatment directly from a pharmacy.
Referral to hospital It's uncommon for someone with shingles to be referred to hospital, but your GP may consider seeking specialist advice if: they suspect a complication of shingles , such as meningitis or encephalitis shingles is affecting one of your eyes — there's a risk you could develop permanent vision problems if the condition isn't treated quickly a diagnosis isn't certain you have an unusually persistent case of shingles that's not responding to treatment you've been diagnosed with the condition more than twice you're pregnant you have a weakened immune system — particularly in severe cases or cases affecting children Causes of shingles Most people have chickenpox in childhood, but after the illness has gone, the varicella-zoster virus remains dormant inactive in the nervous system.
It's possible to have shingles more than once, but it's very rare to get it more than twice. This may be the result of: old age — as you age, your immunity may decrease, and shingles most commonly occurs in people over 70 years old physical and emotional stress — the chemicals released by your body when you're stressed can prevent your immune system working properly HIV and AIDS — people with HIV are much more likely to get shingles than the rest of the population because their immune system is weak recently having a bone marrow transplant — the conditioning you require before the transplant weakens your immune system recently having an organ transplant — you may need to take medication to suppress your immune system so your body accepts the donated organ chemotherapy — chemotherapy medication, often used to treat cancer , can temporarily weaken your immune system However, young people who appear otherwise healthy can also sometimes develop shingles.
Is shingles contagious? Preventing the spread of the virus If you have shingles, you're contagious until the last blister has dried and scabbed over. If you have shingles, avoid: women who are pregnant and haven't had chickenpox before as they could catch it from you, which may harm their unborn baby people who have a weak immune system, such as someone with HIV or AIDS babies less than one month old, unless it's your own baby, in which case your baby should have antibodies proteins that fight infection to protect them from the virus Treating shingles Although there's no cure for shingles, treatment is available to relieve the symptoms until the condition resolves.
Treatment for shingles can include: covering the rash with clothing or a non-adherent non-stick dressing to reduce the risk of other people becoming infected with chickenpox - as it's very difficult to pass the virus on to someone else if the rash is covered painkilling medication, - such as paracetamol , ibuprofen or codeine antiviral medication to stop the virus multiplying - although not everyone will need this Read more about treating shingles Complications of shingles Shingles can sometimes lead to complications, such as postherpetic neuralgia.
Read more about the complications of shingles The shingles vaccine It's not always possible to prevent shingles, but a vaccine called Zostavax can reduce your chances of developing the condition. Read more about shingles vaccination Ophthalmic shingles Some cases of shingles can affect one of the eyes and are known as ophthalmic shingles.
Symptoms can include: a rash over your forehead, nose and around your eye conjunctivitis — inflammation of your eye that causes it to become red and watery with a sticky coating on your eyelashes a red eye problems with your vision.
Symptoms of shingles An episode of shingles typically lasts around two to four weeks. Early symptoms In some cases, shingles may cause some early prodromal symptoms that develop a few days before the painful rash first appears. These early symptoms can include: a headache burning, tingling, numbness or itchiness of the skin in the affected area a feeling of being generally unwell a high temperature fever Not everyone will experience these prodromal symptoms. Pain Eventually, most people with shingles experience a localised "band" of pain in the affected area.
Rash The shingles rash usually appears on one side of your body and develops on the area of skin related to the affected nerve. When to seek medical advice Shingles is not usually serious, but you should see your GP as soon as possible if you recognise the symptoms. Causes of shingles Shingles is caused by the reactivation of the varicella-zoster virus, which is the virus that causes chickenpox.
This can happen as a result of: old age — as you age, your immunity may decrease, and shingles most commonly occurs in people over 70 years old physical and emotional stress — the chemicals released by your body when you are stressed can prevent your immune system working properly HIV and AIDS — people with HIV are much more likely to get shingles than the rest of the population because their immune system is weak recently having a bone marrow transplant — the conditioning you require before the transplant will weaken your immune system recently having an organ transplant — you may need to take medication to suppress your immune system so your body accepts the donated organ chemotherapy — chemotherapy medication, often used to treat cancer , can temporarily weaken your immune system However, young people who appear otherwise healthy can also sometimes develop shingles.
Catching chickenpox The blisters that develop as a result of shingles contain virus particles. Preventing the virus spreading If you have the shingles rash, do not share towels or flannels, go swimming, or play contact sports.
If you have shingles, avoid: women who are pregnant and have not had chickenpox before as they could catch it from you, which may harm their unborn baby people who have a weak immune system, such as someone with HIV or AIDS babies less than one month old, unless it is your own baby, in which case your baby should have antibodies proteins that fight infection to protect them from the virus Once your blisters have dried and scabbed over, you are no longer contagious and will not need to avoid anyone.
Diagnosing shingles Your GP or pharmacist will normally be able to diagnose shingles from your symptoms and the appearance of your rash. Referral It is uncommon for someone with shingles to be referred to a specialist for further assessment and treatment, but your GP may consider seeking specialist advice or referring you if: they think you may have a complication of shingles , such as meningitis or encephalitis shingles is affecting one of your eyes — there is a risk you could develop permanent vision problems if the condition is not treated quickly you have a weakened immune system — particularly in severe cases or cases affecting children you are pregnant a diagnosis is not certain You may also be referred to a specialist if you have an unusually persistent case of suspected shingles that is not responding to treatment, or if you have been diagnosed with the condition more than twice.
Who might I see? Who you are referred to will depend on your circumstances. It could be: a paediatrician a specialist in the care of babies and children if your child is affected an ophthalmologist a doctor who specialises in treating eye conditions if shingles is affecting one of your eyes your own consultant a specialist in a particular area of medicine if you have one for an existing medical condition such as HIV or AIDS.
Treating shingles There is no cure for shingles, but treatment can help ease your symptoms until the condition improves.
Self-care If you develop the shingles rash, there are a number of things you can do to help relieve your symptoms, such as: keeping the rash as clean and dry as possible — this will reduce the risk of the rash becoming infected with bacteria wearing loose-fitting clothing — this may help you feel more comfortable not using topical rub-on antibiotics or adhesive dressings such as plasters — this can slow down the healing process using a non-adherent dressing a dressing that will not stick to the rash if you need to cover the blisters — this avoids passing the virus to anyone else Calamine lotion has a soothing, cooling effect on the skin and can be used to relieve the itching.
Antiviral medication As well as painkilling medication, some people with shingles may also be prescribed a course of antiviral tablets lasting 7 to 10 days. These medications cannot kill the shingles virus, but can help stop it multiplying. This may: reduce the severity of your shingles reduce how long your shingles lasts prevent complications of shingles , such as postherpetic neuralgia although the evidence for this is uncertain Antiviral medicines are most effective when taken within 72 hours of your rash appearing, although they may be started up to a week after your rash appears if you are at risk of severe shingles or developing complications.
Side effects of antiviral medication are very uncommon, but can include: feeling sick vomiting diarrhoea abdominal tummy pain headaches dizziness Who may be prescribed antiviral medication?
You may also be prescribed antiviral medication if you have: shingles that affects one of your eyes a weakened immune system moderate to severe pain a moderate to severe rash Pregnancy and antiviral medication If you are pregnant and have shingles, it is likely your GP will discuss your case with a specialist to decide whether the benefits of antiviral medication significantly outweigh any possible risks.
Children and antiviral medication Antiviral medication is not usually necessary for otherwise healthy children because they usually only experience mild symptoms of shingles and have a small risk of developing complications.
Painkilling medication To ease the pain caused by shingles, your GP or pharmacist may recommend painkilling medication. Paracetamol The most commonly used painkiller is paracetamol , which is available without a prescription.
However, NSAIDs may not be suitable if you: have stomach, liver or kidney problems, such as a stomach ulcer , or had them in the past have asthma are pregnant or breastfeeding Ask your GP or pharmacist if you are unsure about whether you should take NSAIDs.
Opioids For more severe pain, your GP may prescribe an opioid, such as codeine. Antidepressants If you have severe pain as a result of shingles, you may be prescribed an antidepressant medicine. Side effects of TCAs can include: constipation difficulty urinating blurred vision dry mouth weight gain drowsiness If you have shingles, you will usually be prescribed a much lower dose of TCAs than if you were being treated for depression.
Anticonvulsants Anticonvulsants are most commonly used to control seizures fits caused by epilepsy , but they are also useful in relieving nerve pain. Gabapentin is the most commonly prescribed anticonvulsants for shingles pain.
Side effects of these medications can include: dizziness drowsiness increased appetite weight gain feeling sick vomiting As with antidepressants, you may need to take anticonvulsants for several weeks before you notice it working. Complications of shingles Complications can sometimes occur as a result of shingles. Some of the main complications associated with shingles are described below. Postherpetic neuralgia Postherpetic neuralgia is the most common complication of shingles.
Types of pain experienced by people with postherpetic neuralgia include: constant or intermittent burning, aching, throbbing, stabbing, or shooting pain allodynia — where you feel pain from something that should not be painful, such as changes in temperature or the wind hyperalgesia — where you are very sensitive to pain Postherpetic neuralgia sometimes resolves after around three to six months, although it can last for years and some cases can be permanent.
Eye problems If one of your eyes is affected by shingles ophthalmic shingles , there is a risk you could develop further problems in the affected eye, such as: ulceration sores and permanent scarring of the surface of your eye cornea inflammation of the eye and optic nerve the nerve that transmits signals from the eye to the brain glaucoma — where pressure builds up inside the eye If not treated promptly, there is a risk that ophthalmic shingles could cause a degree of permanent vision loss.
Ramsay Hunt syndrome Ramsay Hunt syndrome is a complication that can occur if shingles affects certain nerves in your head. Ramsay Hunt syndrome can cause: earache hearing loss dizziness vertigo the sensation that you or the environment around you is moving or spinning tinnitus hearing sounds coming from inside your body, rather than an outside source a rash around the ear loss of taste paralysis weakness of your face Ramsay Hunt syndrome is usually treated with antiviral medication, corticosteroids and painkilling medication.
If treatment is delayed, only about half of those treated will recover completely. Other complications A number of other possible problems can also sometimes develop as a result of shingles, including: the rash becoming infected with bacteria — see your GP if you develop a high temperature, as this could be a sign of a bacterial infection white patches a loss of pigment or scarring in the area of the rash inflammation of the lungs pneumonia , liver hepatitis , brain encephalitis , spinal cord transverse myelitis , or protective membranes that surround the brain and spinal cord meningitis — these complications are rare, however Shingles is rarely life threatening, but complications such as those mentioned above mean that around 1 in every 1, cases in adults over the age of 70 is fatal.
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