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Shingles is a painful viral infection that can affect anyone who has had chicken pox. It is not possible to pass on shingles.
Chicken pox is a viral infection that occurs when a person is exposed to the varicella-zoster virus (VZV). This is a type of herpes virus.
A person with the VZV may develop chicken pox. After the symptoms of chicken pox go away, the virus stays latent in the body. Later, it can reactivate as herpes zoster, which is shingles.
For years, the virus can remain inactive. It stays dormant in a dorsal root ganglion of the peripheral nervous system, sensory nerve tissue close to the spinal cord. At some point, the VZV can reactivate and trigger the symptoms of shingles.
Over 99% of people born in the United States before 1980 have had chicken pox. In other words, nearly everyone in that age group has the VZV.
The risk of the virus reactivating increases with age. Overall, about 1 in 3 people in the country will develop shingles at some point.
Shingles can also lead to a number of potentially severe complications.
For this reason, health experts recommend vaccinating children to protect them from chicken pox and shingles. Adults who have already had chicken pox can still have a vaccination to prevent shingles.
Shingles involves a painful rash. It often develops on one side of the body, and it can affect the face, back, abdomen, mouth, and internal organs.
When a person has shingles, they usually first experience a tingling, burning, or numb sensation in the skin, usually on one side of the body.
After a few days, clusters of small, fluid-filled blisters appear, surrounded by red skin. The blisters continue to appear for up to a week, then they dry up and crust over.
Between the time when the blisters appear and when they dry up and crust, another person can catch the virus if they come into contact with the pus in the blisters.
Exposure to this fluid will not cause shingles, but it may cause chicken pox. This can only happen in people who have never had chicken pox or received the varicella (chicken pox) vaccination.
Before the blisters appear and after they have crusted, there is no risk of transmitting the virus.
A person with shingles may also experience common symptoms of a viral infection, such as a fever, chills, fatigue, and a headache. If they do not have active blisters, the person will not pass on the virus.
If shingles does not develop in the oral cavity, coughing or sneezing will not spread the virus. Only contact with the fluid from the blisters can transmit the virus.
Tips for stopping the virus from spreading to other people include:
- avoiding touching or scratching the rash, especially before it has dried and crusted
- covering the rash with a loose dressing
- practicing good hand hygiene by frequently washing both hands
Who should avoid contact with shingles?
Anyone with an active shingles rash should avoid coming into contact with:
Pregnant women who have never had chicken pox or its vaccination
If a pregnant woman develops chicken pox, especially 5–21 days before giving birth, it can be dangerous for the unborn child.
Children who have not had chicken pox or its vaccination
Children should avoid contact with blisters of chicken pox or shingles until they have had the vaccination, to reduce the risk of illness and complications.
People with weak immune systems
- infants born early or with a low birth weight
- people with certain health conditions, such as HIV, leukemia, or lymphoma
- people who take medications that suppress their immune systems, such as chemotherapy
- people who have had organ transplants
If a person in any of these groups comes into contact with the varicella virus, their immune system may not be able to defend them adequately against the effects. This means that they have a higher risk of developing chicken pox if they have not had it before.
Once a person with a weak immune system has the chicken pox virus, they have a higher risk of developing shingles and its complications. They are also likely to have these diseases for longer, and the symptoms may be more severe.
People who are at risk of developing shingles include:
- anyone who has had chicken pox, which includes almost everyone born before 1980
- people with weakened immune systems
- people over the age of 60, as the risk increases with age
Others who may have a higher risk of shingles include people with:
- rheumatoid arthritis
- chronic obstructive pulmonary disease, or COPD
- systemic lupus erythematous
- diabetes mellitus
Also, experiencing physical trauma and using medications called statins can each increase the risk of shingles.
Anyone who has concerns about developing shingles should speak to a doctor, who can advise about vaccination and other ways to reduce the risk.
The main symptom of shingles is a painful rash that can develop on:
- the waist, back, or chest, often as a stripe on one side of the body
- the face, including the ears, eyes, and mouth
- internal organs, such as those in the digestive tract or arteries in the brain
Blisters appear as the rash develops. After 7–10 days, the blisters start to dry up. Symptoms usually disappear after 2–4 weeks.
Apart from the rash and symptoms of a viral infection, shingles can lead to complications, some of which can be severe, long-lasting, or both.
- a loss of vision, if shingles occurs in or near the eye
- hearing and balance problems if shingles appears in or around the ear
- muscle weakness
- facial paralysis
- encephalitis, which is inflammation of the brain
A person with PHN will have prolonged pain in the area of the rash after it has gone away. The pain can be severe, and it can last for several years.
A doctor will usually diagnose shingles after looking at the rash and asking the person about their symptoms. In some cases, they need to test for the virus.
It is not possible to cure shingles or remove the virus from the body. However, antiviral medications can help manage symptoms, shorten the duration of the illness, and reduce the risk of complications.
- acyclovir (Zovirax)
- valaciclovir (Valtrex)
- famciclovir (Famvir)
Ways of managing symptoms include:
- using over-the-counter or prescription medications to relieve pain
- applying wet compresses to soothe the skin and help the rash resolve
- taking lukewarm colloidal oatmeal baths or applying calamine lotion to reduce itchiness
- using topical treatments, such as lidocaine cream, gel, skin patches, or spray
- keeping the rash clean and dry
- covering the rash with a loose dressing for protection
- wearing loose-fitting clothing for comfort
One way of preventing shingles is to avoid contact with people who have the disease while their blisters are active.
If a person has chicken pox, they usually only have it once. The same is true for shingles. A person who has had it before is unlikely to have it again.
Vaccinations are available that can:
- protect people from chicken pox and, therefore, shingles
- protect people from shingles when they have already had chicken pox or shingles
The Centers for Disease Control and Prevention (CDC) recommend that children have the varicella (chicken pox) vaccination in two doses:
- the first dose at 12–15 months of age
- the second dose at 4–6 years
Teens and adults aged 13 years or older who have never had chicken pox or the vaccine, but who would like to, should receive two doses of the varicella vaccination at least 28 days apart.
Some people should not have the chicken pox vaccine. They include pregnant women and people who currently have a moderate or severe illness.
The shingles vaccine is available to people who meet these criteria, regardless of whether they have already had shingles.
The options available are:
Two doses of Shingrix administered 2–6 months apart will provide at least 90% protection from shingles and PHN.
Some people should not have the vaccine. They include pregnant or breastfeeding women and people who currently have active shingles.
Anyone who is unsure whether they should receive the shingles vaccine can consult a healthcare provider.
Is it a good idea to vaccinate? Find out here.
It is not possible to catch shingles from another person.
However, a person can transmit the virus through the fluid within shingles blisters. A person who has never had chicken pox may develop it, and later shingles, after coming into contact with this fluid.
This transmission is not possible before the shingles blisters develop or after they dry up and scab.
Anyone who has had chicken pox can develop shingles. They cannot catch shingles from another person, but certain risk factors may cause the dormant virus to reactivate.
People with weakened immune systems have a higher chance of developing shingles and related complications. They also have a higher risk of developing shingles more than once.
Receiving the varicella vaccination during childhood is the best way to reduce the risk of developing chicken pox and shingles.
Older people who have already had chicken pox should consider having herpes zoster vaccination from the age of 50 years. This reduces the risk of developing shingles and related complications.
As a child I had chicken pox, and now I take immunosuppressants following a kidney transplant. Is there anything I can do to protect myself from shingles?