Shingles is a painful skin rash that can pop up totally unexpectedly and stay with you for months. The effects of shingles can even last for years. But what, exactly, causes it? Is shingles contagious?
With shingles, symptoms usually appear gradually and begin with a headache, sensitivity to light and sometimes flu-like symptoms. There are three basic stages of shingles:
Stage #1: Prodromal Stage
This is the stage that occurs several days or weeks before a shingles rash appears and can include pain, burning, tingling and numbness. Some people experience flu-like symptoms during this stage and swelling and tenderness in the lymph nodes.
Stage #2: Active Stage
At this stage, a strip or small area of rash appears and blisters begin to form.
Though a rash can pop up anywhere on the body, shingles is unique in that it will appear on only one side. The most common areas are on the trunk, wrapping around the body from the middle of the back toward the chest, or on the face around the eyes. Sometimes more than one rash can appear on the body at the same time.
The rash and blisters associated with shingles can be very painful. Blisters can ooze and will eventually break open and crust over. Typically, the rash and blisters will heal within two to four weeks but can sometimes leave permanent scars.
Stage #3: Postherpetic Neuralgia
The worst stage is the “chronic pain” stage of shingles. Postherpetic Neuralgia (PHN) is the most common complication and can last as little as 30 days to as long as several years. Symptoms during this stage can include a lingering burning or stabbing pain in the area where the rash was, as well as a sensitivity to touch.
There is no cure for postherpetic neuralgia, but there are treatments to reduce the symptoms and alleviate pain. The pain typically improves over time for most patients.
What Causes Shingles?
Shingles, also called herpes zoster, occurs when varicella zoster (VZV) — the virus that causes chickenpox — reactivates within the body. The chickenpox virus lies dormant in the nervous system before reappearing as shingles.
Simply put, if you have ever had chickenpox at any point in your life, the virus never left. It is still in your body and can cause shingles at any time.
Though anyone who has had chickenpox can get shingles, people over the age of 50 are at greatest risk. It is most common in older adults and those with weakened immune systems, underlying medical conditions or those who take certain immunosuppressant medications. Stress can also trigger shingles and unlike chickenpox, which you only get once, you can get shingles multiple times.
So, is shingles contagious? While the bumps or scabs are present, it is possible to pass shingles on to anyone who has either 1) never had chickenpox or 2) has not had the chickenpox vaccine.
The virus can be especially dangerous to small children and pregnant women, so if you are exhibiting any of the symptoms of shingles, don’t ignore them. Make an appointment with your doctor immediately.
“Shingles can be confused with other conditions such as the herpes simplex virus (HSV), poison ivy or even scabies. The pain associated with shingles can be severe, and can even be confused with symptoms of a heart attack or a migraine,” says Kelly Moeller, PA-C, MPAS with U.S. Dermatology Partners of Marshall. “However, if it is shingles, it is imperative to start treatment as soon as possible after symptoms begin.”
Should I Get a Shingles Vaccine?
Shingles is typically treated with a combination of oral antiviral medication and other medications to alleviate pain. A shingles vaccine can also help lessen symptoms and can prevent shingles.
In October 2017, the U.S. Food and Drug Administration (FDA) licensed the vaccine Shingrix® for adults 50 years and older to prevent shingles. The Advisory Committee on Immunization Practices (ACIP) also recommended that adults who have received the older shingles vaccine Zostavax® also get the Shingrix vaccine. Once the Centers for Disease Control and Prevention officially approve the recommendation, Shingrix will be the preferred shingles vaccine.
Currently, the CDC recommends adults 60 years of age or older get the Zostavax vaccine, even if they don’t remember having chickenpox.
There is no maximum age for getting the shingles vaccine. However, Zostavax only protects against shingles for about five years, so those who are vaccinated too early in life may not be protected as they get older and the risk of developing shingles increases.
The newer vaccine — Shingrix — is thought to provide better overall protection against shingles and can be administered to those who have already been vaccinated with Zostavax, as well as those who have already had shingles once.
Some 99% of Americans over the age of 40 have had chickenpox, even if they don’t remember it. The good news is that children in the U.S. began getting the chickenpox vaccine in 1995, which means they are also protected from getting shingles.
To learn more about how to protect yourself against shingles or to treat existing symptoms, make an appointment with one of our board-certified dermatologists today.