How to recognize shingles symptoms herpes zoster symptoms

This article was medically reviewed by Daniel Wozniczka, MD, MPH. Dr. Wozniczka is an Internal Medicine Physician, who is focused on the intersection of medicine, economics, and policy. He has global healthcare experience in Sub Saharan Africa, Eastern Europe, and Southeast Asia. He serves currently as a Lieutenant Commander in the U.S. Public Health Service and a Medical Officer for the Epidemic Intelligence Service in the CDC. He completed his MD at Jagiellonian University in 2014, and also holds an MBA and Masters in Public Health from the University of Illinois at Chicago.

There are 10 references cited in this article, which can be found at the bottom of the page.

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Experts say shingles (herpes zoster) causes a painful, blistering skin rash that typically wraps around one side of your torso or face. During a flare-up, you may also experience fever, headache, upset stomach, and chills. [1] X Trustworthy Source Centers for Disease Control and Prevention Main public health institute for the US, run by the Dept. of Health and Human Services Go to source Research shows that shingles is caused by the same virus that causes chicken pox, which is the varicella zoster virus (VZV). Once you catch chicken pox, the virus remains in your body and may cause a shingles flare-up later in life. [2] X Trustworthy Source Mayo Clinic Educational website from one of the world’s leading hospitals Go to source While there’s no cure for shingles, your doctor can give you medication to help you recover faster.

Articles On Shingles

  • What Is Shingles?
  • Symptoms
  • Diagnosis
  • Complications
  • Treatments
  • Slideshow: Pictures of Shingles

If you had chickenpox as a child, you might recall the itchy, spotted rash that popped up on your face and body. The varicella zoster virus that causes chickenpox stays inside your body for many years.

Once you’re older, that same virus can wake up and cause shingles, also called herpes zoster. It gives you a rash, too, but it’s often more painful than itchy.

A blistering rash on one side of your body can be a sign you have it. See your doctor to find out for sure. Once you’ve been diagnosed, you can get treated to help relieve your rash and other symptoms.

The Telltale Signs

Your doctor will first ask whether you’ve had chickenpox and look at your symptoms. A rash is the main sign of shingles. Often your doctor can tell that you have it from your skin alone.

  • Appears on one side of your body and/or face
  • Stings, burns, and/or itches
  • Starts as red bumps that form into blisters

Other conditions also cause rashes that look like shingles. Your doctor might check to see if you have:

Contact dermatitis: A skin reaction caused by an allergy to latex, metals, chemicals, or drugs

CandidaВ infection: It comes from a type of yeast called Candida

Dermatitis herpetiformis: A rash that some people with celiac disease can get

Impetigo: A skin infection caused by bacteria

Insect bites: Sometimes, they can look like shingles

Folliculitis: The tiny holes that hairs grow out of can get inflamed

Scabies: A skin condition caused by a small bug called a mite

One way to tell shingles from these conditions is by the other symptoms that come with it. You can also have:

  • Fever
  • Headache
  • Chills
  • Nausea

Tests

Doctors rarely test for shingles unless the rash alone isn’t enough to make a diagnosis. Some people get tested because they’re at higher risk for complications. You might have a test done if you:

  • Are about to have an organ transplant
  • Have a weakened immune system
  • Are going to begin a drug that lowers your immune system

Doctors use two types of tests to diagnose chickenpox or shingles:

Antibody: When you’re exposed to varicella zoster, your immune system makes proteins to fight it. Your doctor can look for these proteins, called antibodies, in a sample of your blood. They take the sample from a vein in your arm. These tests might be able to tell whether you have chickenpox now or have had it in the past, but the results are often hard to interpret.

Viral detection: This test can find out if varicella zoster virus is present in the rash. Your doctor can collect samples from scabs from blisters that have crusted over.

Your doctor should have the results in 1 to 3 days. You might need to have a second test if the results aren’t clear.

Your symptoms and test results will show whether you have shingles. Once you’ve been diagnosed, you can start on treatment to help you feel better.

Show Sources

AACC: “Chickenpox and Shingles Tests.”

American Academy of Family Physicians: “Shingles Overview.”

CDC: “Shingles Diagnosis & Testing,” “Shingles Signs & Symptoms.”

Daniels, R. Delmar’s Manual of Laboratory and Diagnostic Tests, July 2009.

National Foundation for Infectious Diseases: “Facts About Chickenpox and Shingles for Adults.”

University of Maryland Medical Center, “Varicella-zoster virus.”

The NINDS supports research on viral proteins and virus defense mechanisms in neurons to understand why the varicella-zoster virus establishes latency uniquely in neurons and not in other cell types. Other studies focus on how VZV travels along sensory nerve fibers, or axons, and its role in latency and viral reactivation. Scientists also hope to identify molecular mechanisms that regulate the expression of latent viral genes, which may lead to targeted therapy to prevent reactivation. Other studies hope to better understand cellular changes that lead to persistent pain.

Information from the National Library of Medicine’s MedlinePlus
Shingles

Shingles (herpes zoster) is an outbreak of rash or blisters on the skin that is caused by the same virus that causes chickenpox — the varicella-zoster virus. The first sign of shingles is often burning or tingling pain (which can be severe), or sometimes numbness or itch,generally on one side of the body. After several days or a week, a rash of fluid-filled blisters, similar to chickenpox, appears in one area on one side of the body. Shingles pain can be mild or intense. Some people have mostly itching; some feel pain from the gentlest touch or breeze. The most common location for shingles is a band, called a dermatome, spanning one side of the trunk around the waistline. Anyone who has had chickenpox is at risk for shingles. Scientists think that some of the virus particles from the original exposure to the varicella-zoster virus,leave the skin blisters and move into the nervous system. When the varicella-zoster virus reactivates, the virus moves back down the long nerve fibers that extend from the sensory cell bodies to the skin. The viruses multiply, the tell-tale rash erupts, and the person now has shingles.

The severity and duration of an attack of shingles can be significantly reduced by immediate treatment with antiviral drugs, which include acyclovir, valcyclovir, or famcyclovir. Antiviral drugs may also help stave off the painful after-effects of shingles known as postherpetic neuralgia. Other treatments for postherpetic neuralgia include steroids, antidepressants, anticonvulsants (including pregabalin and gabapentin enacarbil), and topical agents. The varicella zoster virus vaccines Shingrix and Zostavax have been approved by the Food and Drug Administration for adults age 50 and older. Researchers found that giving older adults the vaccine reduced the expected number of later cases of shingles by half. And in people who still got the disease despite immunization, the severity and complications of shingles were dramatically reduced. The shingles vaccine is a preventive therapy and not a treatment for those who already have shingles or long-lasting nerve pain (postherpetic neuralgia).

For most healthy people who receive treatment soon after the outbreak of blisters, the lesions heal, the pain subsides within 3 to 5 weeks, and the blisters often leave no scars. However, shingles is a serious threat in immunosuppressed individuals — for example, those with HIV infection or who are receiving cancer treatments that can weaken their immune systems. People who receive organ transplants are also vulnerable to shingles because they are given drugs that suppress the immune system.

A person with a shingles rash can pass the virus to someone, usually a child, who has never had chickenpox, but the child will develop chickenpox, not shingles. A person with chickenpox cannot give shingles to someone else. Shingles comes from the virus hiding inside the person’s body, not from an outside source.

What are the signs and symptoms of shingles?

Shingles causes a painful, blistering rash on your skin. If you get shingles, you may notice the following:

Before the rash appears: For 1 to 2 days before the rash appears, you may have pain, burning, or tingling on an area of skin where the rash will develop. Some people say they felt an “electrical sensation” on their skin before getting the rash.

Rash appears: A painful, blistering rash appears. It usually appears on one side of your body, often on the torso; however, it can appear anywhere on your skin. Some people get more blisters after the rash appears, so it can seem that the rash is spreading.

Rash starts to clear: As the rash clears, the blisters may crack open, bleed, and scab over. For most people, the rash will clear within 2 to 4 weeks.

Although the rash will clear on its own, treatment is important. Taking medication within 3 days of getting the shingles rash can:

Decrease the amount of time you have shingles

Reduce your risk of developing other health problems, such as long-lasting nerve pain, pneumonia, or hearing loss

Shingles rash on the face

If you have a shingles rash on your face, immediately seeing a doctor for treatment could save your eyesight.

How to recognize shingles symptoms herpes zoster symptoms

Pictures of the shingles rash

If you have a rash of blisters on your skin or a rash that looks like any shown below, see your doctor immediately for a diagnosis. If you have shingles, it’s important to get treatment, preferably within 2 to 3 days.

If you’ve had the rash for longer than 2 to 3 days, it’s still important to see your doctor.

A typical shingles rash

Doctors often refer to this rash as the “shingles band” because it looks like a band that appears on one area of your body, as shown here.

How to recognize shingles symptoms herpes zoster symptoms

A rash on one side of the body

A key that you have shingles is that the rash only develops on one side of your body.

How to recognize shingles symptoms herpes zoster symptoms

Close-up of a shingles rash

The shingles rash often causes a cluster of tiny blisters. You may notice that the skin beneath the blisters is red and inflamed, as shown here.

The rash will also feel painful.

How to recognize shingles symptoms herpes zoster symptoms

Blistering shingles rash on a man’s chest

Although the rash can begin in one area, you may notice that a few scattered blisters develop in other areas, as shown here.

How to recognize shingles symptoms herpes zoster symptoms

Shingles rash on the palm of a man’s hand

While shingles tends to develop on your body or face, it can appear anywhere on your skin.

How to recognize shingles symptoms herpes zoster symptoms

Other signs and symptoms of shingles

Along with a painful, blistering rash, some people can also have one or more of the following:

These tend to go away as the rash clears.

Other health problems due to shingles

Some people develop other health problems after the shingles rash clears, which include:

Postherpetic neuralgia (PHN): This is the most common. Occurring where you had the rash, PHN can cause constant tingling, burning, and pain. For others, the pain comes and goes.

Whether the pain is constant or intermittent, it can go on for a long time. You can have PHN for months, years, or the rest of your life. There is no way to know how long it will last.

The pain caused by PHN can become so severe that it interferes with your life, making everyday activities painful. A musician may no longer be able to play an instrument. Some people cannot walk comfortably. It may be difficult to bathe or get dressed. You may have trouble sleeping.

How to prevent PHN: If you have shingles, you can greatly reduce your risk of PHN by getting treated for shingles within 3 days of developing the rash.

Get treated for shingles within 3 days of developing the rash

Taking antiviral medication within 3 days of getting the shingles rash can:
• Reduce your risk of developing PHN
• Ease symptoms of shingles
• Clear the shingles rash more quickly

Other health problems that can develop after the shingles rash clears include:

Blindness or loss of some eyesight (if shingles infects your eyes)

Encephalitis (swelling of the brain)

Although rare, some people die of shingles.

Treatment can prevent these complications.

You can find out if you have a greater risk of developing shingles at, Shingles: Causes.

Images

Images 1,4,5,6: Images used with permission of the American Academy of Dermatology National Library of Dermatologic Teaching Slides.

Images 2,3,7: Getty Images

References
Centers for Disease Control and Prevention (CDC). “Prevent Shingles: Get vaccinated.” Page last reviewed July 23, 2018. Last accessed March 28, 2019.

Dooling KL, Guo A, et al. “Recommendations of the Advisory Committee on Immunization Practices for Use of Herpes Zoster Vaccines.” Morb Mortal Wkly Rep 2018;67:103-8.

Madkan V, Sra K, et al. “Human herpes viruses.” In: Bolognia JL, et al. Dermatology. (second edition). Mosby Elsevier, Spain, 2008:1204-8.

Straus SE, Oxman MN, et al. “Varicella and herpes zoster.” In: Wolff K, Goldsmith LA, et al. Fitzpatrick’s Dermatology in General Medicine (seventh edition). McGraw Hill Medical, New York, 2008: 1885-98.

Yang Q. George MG, et al. “Abstract 39: Effect of herpes zoster vaccination and antiviral treatment on risk of ischemic stroke among older adults.” Presented at: 2019 International Stroke Conference. February 6-8, 2019; Honolulu, HI.

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without prior written permission.

Affiliations

  • 1 Departments of Neurology and Dermatology, Tokuda Hospital Sofia, Bulgaria. Electronic address: [email protected]
  • 2 Departments of Neurology and Dermatology, Tokuda Hospital Sofia, Bulgaria.
  • 3 Department of Dermatology, Medical Faculty, Zagreb, Croatia.
  • PMID: 24767191
  • DOI: 10.1016/j.clindermatol.2013.11.010
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Authors

Affiliations

  • 1 Departments of Neurology and Dermatology, Tokuda Hospital Sofia, Bulgaria. Electronic address: [email protected]
  • 2 Departments of Neurology and Dermatology, Tokuda Hospital Sofia, Bulgaria.
  • 3 Department of Dermatology, Medical Faculty, Zagreb, Croatia.
  • PMID: 24767191
  • DOI: 10.1016/j.clindermatol.2013.11.010

Abstract

Herpes zoster (shingles, zona) is a viral infection commonly affliccting the skin and the nervous system with an overall occurring rate of 3 to 5 cases per 1000 persons per year, with higher rates in middle or later life. With the advancement of medicine, more and more case reports have started to emerge showing different incidences of VZV, some new localizations, clinical presentations, and complications, which break the well-known fact that “VZV affects the skin and nervous system.” Skin lesions are the most important ones for the early and exact diagnosis of herpes zoster (HZ), due to its visibility and well-defined clinical picture of lesions. The most frequent condition following the acute herpes zoster eruption is postherapeutic neuralgia (PHN). There have been other reports of the disease with otorinolaryngologic complications and ophthalmologic ones, such as ophthalmoparesis/plegia. There have also been reports of delayed contralateral hemiparesis/hemiplegia following the infection, as a manifestation of vaculitis due to a direct VZV invasion of the cerebral arteries. Encephalitis and destructive myelitis is similarly rare, but a serious complication. Some authors found that patients with inflammatory bowel disease are at a significantly increased risk for herpes zoster. As a gastroenterologic complication, there have been several instances of HZV infection with symptoms resembling an acute abdomen. The diagnosis is hard to pinpoint, and a vast array of examinations are required to identify it, sometimes even posthumously. Nephrologic representations and complications have also been reported. With more and more skin diseases being acknowledged as systemic ones, this viral infection is a more likely candidate for the same title.

What is shingles?

Shingles, or herpes zoster, is a common infection of the nerves. It is caused by a virus. Shingles triggers a painful rash or small blisters on an area of skin. It can appear anywhere on the body, but it typically appears on only one side of the face or body. Burning or shooting pain and tingling or itching are early signs of the infection. Even after the rash is gone, the pain can continue for months, even years.

What causes shingles?

What are the symptoms of shingles?

However, each person may experience symptoms differently. Symptoms may include:

  • Skin sensitivity, tingling, itching, and/or pain in the area of the skin before the rash appears
  • Rash, which typically appears after 1 to 5 days once symptoms begin and initially looks like small, red spots that turn into blisters
  • Blisters typically scab over in 7 to 10 days and clear up within 2 to 4 weeks

Other early symptoms of shingles may include:

  • Stomach upset
  • Feeling ill
  • Fever and/or chills
  • Headache

The symptoms of shingles may look like other medical conditions or problems. Always talk with your healthcare provider for a diagnosis.

How is shingles diagnosed?

Your healthcare provider will do a complete physical exam and ask about your medical history, specifically about whether you have ever had chickenpox.

Your healthcare provider will likely know right away that it is shingles based on the unique rash. The rash usually appears one area on one side of the body or face. It appears as red spots, small fluid- or pus-filled vesicles, or scabs.

The healthcare provider may also take skin scrapings for testing.

How is shingles treated?

Specific treatment for shingles will be determined by your healthcare provider based on:

  • Your age, overall health, and medical history
  • How long the shingles have been present (some medicines are not as effective if given more than 2 to 3 days after the rash has appeared)
  • Extent of the condition
  • Your tolerance for specific medicines, procedures, or therapies
  • Expectations for the course of the condition
  • Your opinion or preference

There is no cure for shingles. It simply has to run its course. Treatment focuses on pain relief. Painkillers may help relieve some of the pain. Antiviral drugs may help lessen some of the symptoms and reduce nerve damage. Other treatments may include:

  • Creams or lotions to help relieve itching
  • Cool compresses applied to affected skin areas
  • Antiviral medicines (such as acyclovir, valacyclovir, and famciclovir)
  • Steroids
  • Antidepressants
  • Anticonvulsants

What are the complications of shingles?

Symptoms of shingles usually don’t last longer than 3 to 5 weeks. However, complications can happen. The main complications that can result from shingles include:

  • Postherpetic neuralgia (PHN). The most common complication of shingles is called postherpetic neuralgia (PHN). This continuous, chronic pain lasts even after the skin lesions have healed. The pain may be severe in the area where the blisters were present. The affected skin may be very sensitive to heat and cold.
    If you had severe pain during the active rash or have impaired senses, you are at increased risk for PHN. The elderly are also at greater risk. Early treatment of shingles may prevent PHN. Pain relievers and steroid treatment may be used to treat the pain and inflammation. Other treatments include antiviral drugs, antidepressants, anticonvulsants, and topical agents.
  • Bacterial infection. A bacterial infection of the skin where the rash happens is another complication. Rarely, infections can lead to more problems, such as tissue death and scarring. When an infection happens near or on the eyes, a corneal infection can happen. This can lead to temporary or permanent blindness.

Can shingles be prevented?

Two different vaccines are available to prevent shingles. Experts recommend vaccination for all adults 50 and older, even if you’ve had shingles before. Talk with your healthcare provider about the most appropriate time for you to get vaccinated, and which vaccine is best for you.

When should I call my healthcare provider?

To reduce the severity and shorten the length of the illness, treatment must be started as soon as possible. If you think you have shingles, call your healthcare provider as soon as possible.

Key points about shingles

  • Shingles is a common viral infection of the nerves. It causes a painful rash or small blisters on an area of skin.
  • Shingles is caused when the chickenpox virus is reactivated.
  • It is more common in people with weakened immune systems, and in people over the age of 50.
  • Shingles starts with skin sensitivity, tingling, itching, and/or pain followed by rash that looks like small, red spots that turn into blisters.
  • The rash is typically affects just one area on one side of the body or face.
  • Treatment that is started as soon as possible helps reduce the severity of the disease.

Next steps

Tips to help you get the most from a visit to your healthcare provider:

  • Know the reason for your visit and what you want to happen.
  • Before your visit, write down questions you want answered.
  • Bring someone with you to help you ask questions and remember what your provider tells you.
  • At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you.
  • Know why a new medicine or treatment is prescribed, and how it will help you. Also know what the side effects are.
  • Ask if your condition can be treated in other ways.
  • Know why a test or procedure is recommended and what the results could mean.
  • Know what to expect if you do not take the medicine or have the test or procedure.
  • If you have a follow-up appointment, write down the date, time, and purpose for that visit.
  • Know how you can contact your provider if you have questions.

What Is Shingles?

Shingles is a very painful disease caused by the same herpes virus that causes chicken pox (varicella zoster virus). Like other herpes viruses, the varicella-zoster virus has an initial infectious stage, (chicken pox) followed by a dormant stage. Then, with no warning, the virus becomes active again.

About 20% of people who have had chicken pox will eventually develop shingles. This reactivation of the virus is most likely to occur in people with a weakened immune system. This includes people with HIV disease, and anyone over 50 years old.

Herpes zoster lives in nerve tissue. Outbreaks of shingles start with itching, numbness, tingling or severe pain in a belt-like pattern on the chest, back, or around the nose and eyes. In rare cases, herpes can infect the facial or eye nerves. This can cause outbreaks around the mouth, on the face, neck, and scalp, in and around the ear, or at the tip of the nose.

Shingles outbreaks are almost always on just one side of the body. Within a few days, a rash appears on the skin area related to the inflamed nerve. Small blisters form and fill with fluid. Later they break open and develop crusty scabs.

If the blisters are scratched, someone with shingles might develop a skin infection. This could require treatment with antibiotics and might cause scars.

In most cases, the rash goes away within a few weeks, but in some cases, severe pain can last for months or even years. This condition is called “post herpetic neuralgia.”

Shingles and HIV

Shingles is not one of the infections that leads to a diagnosis of AIDS.

Shingles can occur in people with HIV shortly after they start taking strong antiviral medications. These cases of shingles are believed to be a sign of immune restoration syndrome (see Fact Sheet 483).

A recent study found that A CD4 cell count (see Fact Sheet 124) below 500 and a detectable viral load (see Fact Sheet 125) are risk factors for shingles in people with HIV.

Having HIV increases the risk of complications from shingles. These include pain (post herpetic neuralgia.) Also, if you notice any blurred vision, see your health care provider immediately. Also, as more people with HIV reach higher ages, they may be more likely to develop shingles.

How Is It Transmitted?

Shingles can only occur after someone has had chickenpox. If someone who has already had chickenpox comes into contact with the fluid from shingles blisters, they will not “catch” shingles. However, people who have not had chickenpox could become infected with herpes zoster and develop chickenpox. They should avoid contact with the shingles rash or with anything that may have touched the shingles rash or blisters.

How Is Shingles Treated?

Several types of drugs are used to treat shingles. They include anti-herpes drugs, and several types of treatment for pain.

Antiviral drugs: The standard treatment for shingles is the drug acyclovir, which can be given orally (in pill form) or intravenously in more severe cases. Two newer drugs have been approved for the treatment of shingles: famciclovir and valacyclovir. Both famciclovir and valacyclovir are taken three times each day, compared to five times for acyclovir. All of these drugs work best when they are started within the first three days after the shingles pain begins.

Nerve blockers: Doctors often prescribe various pain medications for people with shingles. Because the pain of shingles can be so intense, researchers have looked for other ways to block the pain. Injections of anesthetic drugs and/or steroids are being studied as nerve blockers. These can be injected either into peripheral nerves, or into the spinal column (central nervous system).

Skin Treatments: Several creams, gels and sprays are being studied. These provide temporary relief from pain. Capsaicin, the chemical that makes chili peppers hot, has shown good preliminary results. In addition, in 1999 the FDA approved a patch form of the anesthetic lidocaine. The patch, called Lidoderm, provides pain relief for some people with shingles. Because it is applied to the skin, it has less risk of side effects than pain medications taken in pill form. A newer skin treatment is Qutenza. It is a highly concentrated form of capsaicin. It is applied in a doctor’s office for 60 minutes. One application can provide 3 months of relief.

Other Pain Medications: Some drugs normally used to treat depression, epilepsy, or severe pain are sometimes used for the pain of shingles. These can have a variety of side effects. Nortriptyline is the antidepressant most frequently used for shingles pain. Pregabalin is an epilepsy medicine also used for pain after shingles.

Can Shingles Be Prevented?

Currently, there is no way to predict an outbreak of shingles.

Researchers have shown that giving older people a stronger form of the chicken pox vaccine used for children can boost the type of immunity believed necessary to hold the virus in check.

Zostavax, a shingles vaccine developed by Merck, has been approved by the FDA. An initial study in people with HIV showed that Zostavax was safe and effective.

The Bottom Line

Shingles is an unpredictable, very painful disease. It is caused by a re-activation of the virus that causes chicken pox. Although not directly linked to HIV, shingles seems to occur more frequently in people with AIDS.

Although shingles may disappear within a couple of weeks, severe pain may continue for several months.

A shingles vaccine has been approved by the FDA. An initial study in people with HIV found that Zostavax was safe and effective.

The disease has been treated with acyclovir, taken five times daily, or given intravenously in severe cases. Two newer drugs, famciclovir and galaciclovir, seem to be more effective against the pain of shingles and need to be taken only three times each day.

It can be very difficult to deal with the pain of shingles. A newer treatment is an anesthetic patch that can be applied directly to the skin.

In this Article

  • What Is Cat Herpes?
  • What Are the Symptoms of Cat Herpes?
  • How Do Cats Get Herpes?
  • Which Cats Are Prone to the Herpes Virus?
  • Can Human Beings or Dogs Catch Herpes from Cats?
  • How Is Cat Herpes Treated?
  • How Can Cat Herpes Be Prevented?
  • What Should I Do If I Think My Cat Has Herpes?
  • How Can I Reduce Flare-Ups?
  • How Can I Help My Infected Cat Feel Better?

What Is Cat Herpes?

Cat herpes is a contagious virus. It can cause cat flu and other respiratory infections in both wild and domestic cats.

What Are the Symptoms of Cat Herpes?

There are many different symptoms of feline (cat) herpes. Most symptoms can last two to three weeks but the virus may lay dormant inside the cat’s body for years.

In many cats, this causes no problems. But sometimes feline herpes returns occasionally throughout the cat’s life, especially in times of illness or stress.

Some of the signs of feline herpes include the following.

Upper Respiratory Infection

Upper respiratory infections may include symptoms like:

  • Eye discharge
  • Pink eye
  • Sneezing
  • Nasal discharge
  • Drooling
  • Pain or irritation in the throat
  • Exhaustion
  • Loss of appetite
  • Fever
  • Coughing

Keratitis

Keratitis is uncommon, but long-term feline herpes may cause infection and inflammation in the front of the eyes of a cat.

FHV-Associated Dermatitis

FHV-associated dermatitis is a rare infection of the feline herpes virus that affects the skin. This infection can cause inflammation and ulcers around the cat’s nose and mouth and sometimes in other areas like the front of the legs.

How Do Cats Get Herpes?

Cats can get herpes in several different ways. Some of the most common ways the virus is transmitted include:

  • Direct contact (when cats make contact with saliva, eye, or nasal discharge)
  • Breathing in sneeze droplets from an infected cat
  • Sharing food bowls or litter boxes
  • Living in an environment that has been contaminated (grooming tools, bedding, etc.)
  • Transmission from mother to kittens during their first few weeks of life

The cat herpes virus is very contagious. It’s often transmitted in environments where many cats live together (such as shelters or multi-cat households).

Which Cats Are Prone to the Herpes Virus?

All cats, regardless of age, size, or breed, are at risk of getting the herpes virus. However, certain risk factors increase the likelihood that your cat will get cat herpes:

  • Living in a crowded environment with many other cats
  • Stressful living conditions
  • A weakened or compromised immune system

Can Human Beings or Dogs Catch Herpes from Cats?

No, people and dogs cannot catch herpes from cats. However, cats can catch herpes from other cats.

How Is Cat Herpes Treated?

Cat herpes can be treated with a few different antiviral drugs. Some of the most common options include:

  • Systemic antiviral therapy: This uses a human anti-herpes antiviral drug, also known as Famciclovir, that has been proven to be safe in cats. It is given by mouth and helps manage severe infections.
  • Topical ocular antiviral therapy: These anti-herpes drugs, known as idoxuridine, trifluridine, and cidofovir, can be used as eye drops in treating cat herpes. Eye drops are usually given daily and sometimes combined with other treatment options.
  • Nursing care or hospitalization: In severe cases, your veterinarian may recommend that your cat is hospitalized so they can receive nutritional support or intravenous fluid therapy (a medical treatment that delivers fluid directly into the cat’s veins).

Bacterial infections often complicate cat herpes. Combined with antibiotics, supportive treatment for your cat is essential for their recovery. With the right medication and care, your cat can live a long and healthy life.

How Can Cat Herpes Be Prevented?

Get your cat vaccinated. Starting at about six to eight weeks of age, veterinarians recommend vaccinating your kitten. At one year old, your cat should receive a booster shot and additional booster shots every year after.

Although the vaccine doesn’t prevent cat herpes, it can significantly reduce the disease’s severity.В

What Should I Do If I Think My Cat Has Herpes?

If your cat is experiencing some symptoms of cat herpes, talk to your veterinarian right away. They can help identify what medical treatment options will work best. They’ll also let you know if your cat will need nursing care or hospitalization.

How Can I Reduce Flare-Ups?

Flare-ups of the cat herpes virus are commonly treated with ointments or eye drops. Your veterinarian may recommend giving your cat amino acid supplements to boost their immune system.

You can also help your cat reduce flare-ups by providing them with a clean, comfortable environment. All bedding and blankets for your cat should be washed regularly. Bowls, trays, and litter boxes should be cleaned daily and kept in an area that is easy for your cat to access.

How Can I Help My Infected Cat Feel Better?

When your cat is infected with cat herpes, it can be a stressful time for them and you. Luckily there are a few things you can do to help your cat feel better:

  • Create a clean, comfortable, and quiet environment where your cat can rest peacefully.
  • Ensure your cat can access fresh water and a clean bowl every day.
  • Follow directions from your veterinarian and administer medications or eye drops as prescribed.

If you have other questions or concerns about your cat’s health, contact your veterinarian for advice and support.

Show Sources

ACVO: “Feline Herpes.”

International Cat Care: “Feline Herpes.”

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You may have heard about shingles and how common it is. One out of every three people in the United States will develop shingles in their lifetime. Shingles is a viral outbreak triggered by herpes family called herpes zoster, which causes chickenpox. If you had chickenpox as a child, that same virus remains in your system and can reactivate later as shingles, a rash of blisters on parts of your body.

A shingles outbreak typically starts with sensitivity and a tingling or burning sensation on the skin. After a few days, the burning sensation turns into small red blisters. These blisters are highly contagious: even if a shingles outbreak begins in one part of your body, it can spread to other regions such as your mouth. Mouth shingles can be pretty worrying and painful, so you should know what it is and how to spot it so you can treat it quickly.

Can You Get Shingles in Your Mouth?

Yes, you can get shingles in your mouth—it is also called oral shingles. Once infection occurs with the herpes zoster virus, it remains in your system. Blister outbreaks may be rare or happen when you’re stressed or immune-compromised. Unfortunately, these oral shingles blisters can be painful and take up to four weeks to heal. Shingles in the mouth can lead to:

  • Mouth sensitivity
  • Difficulty chewing
  • Fatigue
  • Muscle aches
  • Lack of appetite
  • Increased risk of bacterial infections

Oral Shingles Treatment

Shingles treatment can involve antiviral medications and anti-inflammatories to treat the blisters. If you’re worried you have a shingles outbreak, call your primary care physician or dentist as soon as you feel a burning or tingling sensation or notice the blisters.

They may prescribe antiviral medications to treat the active viral outbreak. These medications can promote the recovery process. But they are most effective when you begin the regimen early. That’s why you should seek immediate care if you suspect you may have shingles. Your physician or dentist may also recommend over-the-counter pain relievers to decrease inflammation.

Oral Care with Shingles

If you have developed new or have healing shingles blisters in the mouth, maintain proper oral hygiene so the ruptured blisters don’t get infected. Be careful not to irritate the blisters with your toothbrush, which may slow healing and make them more painful. However, keep brushing your teeth and flossing daily. Your dentist may recommend an antibacterial mouthwash to keep your mouth clean to promote healing.

Shingles Prevention

Unfortunately, researchers aren’t sure what exactly causes a shingles outbreak. Not every person who has had chickenpox gets shingles as an adult. Stress is also linked to blister outbreaks. Managing stress and being alert to medications that may compromise your immune system can help.

The shingles virus is common among adults, and you may not experience a shingles outbreak. But remember that if you do break out in those blisters, contact your physician or dentist, and they can diagnose shingles or another type of blister, help treat the active virus and help the blisters heal faster.

Healthcare providers or individuals over the age of 60 are at higher risk for shingles. You may choose to be vaccinated for the Herpes Zoster virus. These vaccinations are available through both pharmacies and medical offices.

The most common herpes symptom are sores on your genitals or mouth. But most of the time there are no symptoms, so lots of people don’t know they have herpes.

Want to get tested for herpes?

Herpes might not have any symptoms.

You or your partner may not have any herpes symptoms that you can see or feel, or the signs of herpes may be so mild you don’t even notice them. Sometimes people confuse herpes symptoms with other things, like pimples, ingrown hairs, and the flu.

Herpes symptoms come and go, but that doesn’t mean the infection goes away or that you can’t spread it to other people. Once you have herpes, it stays in your body for life.

Genital herpes symptoms

The most common symptoms of genital herpes is a group of itchy or painful blisters on your vagina , vulva , cervix , anus , penis , scrotum (balls), butt, or the inside of your thighs. The blisters break and turn into sores.

You might have these other symptoms too:

burning when you pee if your urine touches the herpes sores

having trouble peeing because the sores and swelling are blocking your urethra

pain around your genitals

If your genital herpes is caused by HSV-2, you might also have flu-like symptoms, such as:

swollen glands in your pelvic area, throat, and under your arms

feeling achy and tired

When blisters and other genital herpes symptoms show up, it’s called an outbreak. The first outbreak (also called the “first episode” or “initial herpes”) usually starts about 2 to 20 days after you get infected with herpes. But sometimes it takes years for the first outbreak to happen.

The first herpes outbreak lasts about 2 to 4 weeks. Even though the blisters go away, the virus stays in your body and can cause sores again. It’s really common to get repeat outbreaks, especially during the first year you have herpes. You might notice some warning signs a few hours or days before outbreaks flare up, like itching, burning, or a tingly feeling on your genitals.

Herpes outbreaks are no fun, but the first one is the worst. Repeat outbreaks are usually shorter and less painful. Most people with herpes get fewer outbreaks as time goes on, and some stop having them altogether.

Herpes symptoms may be more painful and last longer in people with illnesses that damage your immune system — like leukemia and HIV.

Oral herpes symptoms

Usually, oral herpes is less painful than genital herpes and doesn’t make you feel as sick. Oral herpes causes sores on your lips or around your mouth — called cold sores or fever blisters. You can also get sores inside your mouth, but that usually only happens the first few times you have symptoms.

Cold sores last a few weeks and then go away on their own. They can pop up again in weeks, months, or years. Cold sores are annoying, but usually harmless in kids and adults — they can be really dangerous to newborn babies, though.

More questions from patients:

The most common symptom of genital herpes in men is a cluster of blistery sores — usually on your penis or anus. Symptoms may last up to a few weeks and go away. They may return in weeks, months, or years.

Many people with genital herpes have no symptoms, or have very mild symptoms that go unnoticed.

The first time genital herpes symptoms appear is called the “first episode” or “initial herpes.” Initial herpes symptoms are usually more noticeable than later outbreaks.

Symptoms of genital herpes in men may include

burning when you pee if you have sores

trouble peeing if you have sores covering your urethra

itching or pain around your genitals

During initial herpes, symptoms may also include

swollen, tender glands in the pelvic area, throat, or under the arms

general run-down feelings

achy, flu-like feelings

Initial herpes symptoms usually show up 2 to 20 days after you’re infected. But it may be years before the first symptoms appear.

Herpes sores usually heal in a few weeks. But the virus stays in your body – and it can flare up and cause sores again.

The only way to find out for sure if you have genital herpes is to get checked out by a doctor or nurse. If you have symptoms, they can tell you if it’s herpes by looking at or testing the sores. If you don’t have symptoms, they can do a blood test.

Planned Parenthood health centers, many other clinics, private health care providers, and health departments offer herpes tests and herpes treatments.

The only way to know for sure if you have genital herpes is to get checked out by a doctor or nurse.

The most common genital herpes symptoms in women is a cluster of blistery sores that show up on your vulva, cervix, or anus. Symptoms may last several weeks and go away. They may return in weeks, months, or years. A doctor or nurse can tell you if the sores are caused by herpes by looking at them or by testing fluid from the sores.

The thing is, many people with genital herpes have no symptoms, or have very mild symptoms that go unnoticed. Blood tests for herpes are also available, and may be useful if you’ve recently had unprotected sex with someone who has it.

Not sure if you should visit a health center for testing? Here’s a little more info on symptoms of genital herpes.

Symptoms of genital herpes in women may include:

burning when you pee if you have sores

trouble peeing if you have sores covering your urethra

itching or pain around your genitals

During your first outbreak, symptoms may also include:

swollen, tender glands in the pelvic area, throat, or under the arms

general run-down feelings

achy, flu-like feelings

Your first outbreak can happen anywhere from 2 to 20 days after you’re infected. After that, you may never have another outbreak again. Or you may find that you get one several weeks or months later. There’s no way to know for sure how often you’ll get outbreaks — it’s different for every person with herpes. Medicine can make them happen less often, and ointments can make sores heal faster and be less of a bother.

Your nearest Planned Parenthood health center can help you figure out if you have herpes, give you other STD tests, and help you get treatment.

If your baby is born with herpes it can be very serious and can even cause death. Symptoms in newborns include high fever, seizures, and being extremely tired. Symptoms can start anywhere from 5-9 days after getting exposed during birth.

If any of these symptoms show up in your newborn, let your nurse or doctor know immediately.

Help us improve – how could this information be more helpful?

In this Article

  • What Is Cat Herpes?
  • What Are the Symptoms of Cat Herpes?
  • How Do Cats Get Herpes?
  • Which Cats Are Prone to the Herpes Virus?
  • Can Human Beings or Dogs Catch Herpes from Cats?
  • How Is Cat Herpes Treated?
  • How Can Cat Herpes Be Prevented?
  • What Should I Do If I Think My Cat Has Herpes?
  • How Can I Reduce Flare-Ups?
  • How Can I Help My Infected Cat Feel Better?

What Is Cat Herpes?

Cat herpes is a contagious virus. It can cause cat flu and other respiratory infections in both wild and domestic cats.

What Are the Symptoms of Cat Herpes?

There are many different symptoms of feline (cat) herpes. Most symptoms can last two to three weeks but the virus may lay dormant inside the cat’s body for years.

In many cats, this causes no problems. But sometimes feline herpes returns occasionally throughout the cat’s life, especially in times of illness or stress.

Some of the signs of feline herpes include the following.

Upper Respiratory Infection

Upper respiratory infections may include symptoms like:

  • Eye discharge
  • Pink eye
  • Sneezing
  • Nasal discharge
  • Drooling
  • Pain or irritation in the throat
  • Exhaustion
  • Loss of appetite
  • Fever
  • Coughing

Keratitis

Keratitis is uncommon, but long-term feline herpes may cause infection and inflammation in the front of the eyes of a cat.

FHV-Associated Dermatitis

FHV-associated dermatitis is a rare infection of the feline herpes virus that affects the skin. This infection can cause inflammation and ulcers around the cat’s nose and mouth and sometimes in other areas like the front of the legs.

How Do Cats Get Herpes?

Cats can get herpes in several different ways. Some of the most common ways the virus is transmitted include:

  • Direct contact (when cats make contact with saliva, eye, or nasal discharge)
  • Breathing in sneeze droplets from an infected cat
  • Sharing food bowls or litter boxes
  • Living in an environment that has been contaminated (grooming tools, bedding, etc.)
  • Transmission from mother to kittens during their first few weeks of life

The cat herpes virus is very contagious. It’s often transmitted in environments where many cats live together (such as shelters or multi-cat households).

Which Cats Are Prone to the Herpes Virus?

All cats, regardless of age, size, or breed, are at risk of getting the herpes virus. However, certain risk factors increase the likelihood that your cat will get cat herpes:

  • Living in a crowded environment with many other cats
  • Stressful living conditions
  • A weakened or compromised immune system

Can Human Beings or Dogs Catch Herpes from Cats?

No, people and dogs cannot catch herpes from cats. However, cats can catch herpes from other cats.

How Is Cat Herpes Treated?

Cat herpes can be treated with a few different antiviral drugs. Some of the most common options include:

  • Systemic antiviral therapy: This uses a human anti-herpes antiviral drug, also known as Famciclovir, that has been proven to be safe in cats. It is given by mouth and helps manage severe infections.
  • Topical ocular antiviral therapy: These anti-herpes drugs, known as idoxuridine, trifluridine, and cidofovir, can be used as eye drops in treating cat herpes. Eye drops are usually given daily and sometimes combined with other treatment options.
  • Nursing care or hospitalization: In severe cases, your veterinarian may recommend that your cat is hospitalized so they can receive nutritional support or intravenous fluid therapy (a medical treatment that delivers fluid directly into the cat’s veins).

Bacterial infections often complicate cat herpes. Combined with antibiotics, supportive treatment for your cat is essential for their recovery. With the right medication and care, your cat can live a long and healthy life.

How Can Cat Herpes Be Prevented?

Get your cat vaccinated. Starting at about six to eight weeks of age, veterinarians recommend vaccinating your kitten. At one year old, your cat should receive a booster shot and additional booster shots every year after.

Although the vaccine doesn’t prevent cat herpes, it can significantly reduce the disease’s severity.В

What Should I Do If I Think My Cat Has Herpes?

If your cat is experiencing some symptoms of cat herpes, talk to your veterinarian right away. They can help identify what medical treatment options will work best. They’ll also let you know if your cat will need nursing care or hospitalization.

How Can I Reduce Flare-Ups?

Flare-ups of the cat herpes virus are commonly treated with ointments or eye drops. Your veterinarian may recommend giving your cat amino acid supplements to boost their immune system.

You can also help your cat reduce flare-ups by providing them with a clean, comfortable environment. All bedding and blankets for your cat should be washed regularly. Bowls, trays, and litter boxes should be cleaned daily and kept in an area that is easy for your cat to access.

How Can I Help My Infected Cat Feel Better?

When your cat is infected with cat herpes, it can be a stressful time for them and you. Luckily there are a few things you can do to help your cat feel better:

  • Create a clean, comfortable, and quiet environment where your cat can rest peacefully.
  • Ensure your cat can access fresh water and a clean bowl every day.
  • Follow directions from your veterinarian and administer medications or eye drops as prescribed.

If you have other questions or concerns about your cat’s health, contact your veterinarian for advice and support.

Show Sources

ACVO: “Feline Herpes.”

International Cat Care: “Feline Herpes.”

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Summary

What is shingles?

Shingles is an outbreak of rash or blisters on the skin. It is caused by the varicella-zoster virus – the same virus that causes chickenpox. After you have chickenpox, the virus stays in your body. It may not cause problems for many years. But as you get older, the virus may reappear as shingles.

Is shingles contagious?

Shingles is not contagious. But you can catch chickenpox from someone with shingles. If you’ve never had chickenpox or the chickenpox vaccine, try to stay away from anyone who has shingles.

If you have shingles, try to stay away from anyone who has not had chickenpox or the chickenpox vaccine, or anyone who might have a weak immune system.

Who is at risk for shingles?

Anyone who has had chickenpox is at risk for getting shingles. But this risk goes up as you get older; shingles is most common in people over age 50.

People with weakened immune systems are at higher risk of getting shingles. This includes those who:

  • Have immune system diseases such as HIV/AIDS
  • Have certain cancers
  • Take immunosuppressive drugs after an organ transplant

Your immune system may be weaker when you have an infection or are stressed. This can raise your risk of shingles.

It is rare, but possible, to get shingles more than once.

What are the symptoms of shingles?

Early signs of shingles include burning or shooting pain and tingling or itching. It is usually on one side of the body or face. The pain can be mild to severe.

One to 14 days later, you will get a rash. It consists of blisters that typically scab over in 7 to 10 days. The rash is usually a single stripe around either the left or the right side of the body. In other cases, the rash occurs on one side of the face. In rare cases (usually among people with weakened immune systems), the rash may be more widespread and look similar to a chickenpox rash.

Some people may also have other symptoms:

  • Fever
  • Headache
  • Chills
  • Upset stomach

What other problems can shingles cause?

Shingles can cause complications:

  • Postherpetic neuralgia (PHN) is most common complication of shingles. It causes severe pain in the areas where you had the shingles rash. It usually gets better in a few weeks or months. But some people can have pain from PHN for many years, and it can interfere with daily life.
  • Vision loss can happen if shingles affects your eye. It may be temporary or permanent.
  • Hearing or balance problems are possible if you have shingles within or near your ear. You may also have weakness of the muscles on that side of your face. These problems can be temporary or permanent.

Very rarely, shingles can also lead to pneumonia, brain inflammation (encephalitis), or death.

How is shingles diagnosed?

Usually your health care provider can diagnose shingles by taking your medical history and looking at your rash. In some cases, your provider may scrap off tissue from the rash or swab some fluid from the blisters and send the sample to a lab for testing.

What are the treatments for shingles?

There is no cure for shingles. Antiviral medicines may help to make the attack shorter and less severe. They may also help prevent PHN. The medicines are most effective if you can take them within 3 days after the rash appears. So if you think you might have shingles, contact your health care provider as soon as possible.

Pain relievers may also help with the pain. A cool washcloth, calamine lotion, and oatmeal baths may help relieve some of the itching.

Can shingles be prevented?

There are vaccines to prevent shingles or lessen its effects. The Centers for Disease Control and Prevention recommends that healthy adults 50 years and older get the Shingrix vaccine. You need two doses of the vaccine, given 2 to 6 months apart. Another vaccine, Zostavax, may be used in certain cases.

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Chickenpox versus shingles—What’s the difference?

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Did you know? The same virus that causes chickenpox also causes shingles. Although shingles and chickenpox are caused by the same virus, they are not the same illness. Chickenpox is usually a milder illness that affects children. Shingles results from a reactivation of the virus long after the chickenpox illness has disappeared.

The chickenpox virus stays in the body even after recovery. Later in life, the virus can reactivate and cause shingles. If you have shingles, you can spread the varicella virus to people who have never had chickenpox or never received the chickenpox vaccine. These people will develop chickenpox, not shingles. It takes from 10 to 21 days after exposure to chickenpox or shingles for someone to develop chickenpox.

What are the symptoms?

Chickenpox (Varicella)

  • Initial symptoms include sudden onset of fever, headache, and feeling tired.
  • An itchy blister-like rash, usually starting on the face, chest or back, follows 1-2 days later.
  • The rash then spreads to the rest of the body, and new blisters continue to appear for about 3-4 days.
  • Generally, within 1 week, the blisters dry out and scabs form and fall off.

Shingles (Herpes Zoster)

  • The first sign is often a tingling feeling on the skin, itchiness, or a stabbing pain.
  • After several days, a rash appears, beginning as a band or patch of raised dots on the side of the trunk or face or other areas of the body.
  • It then develops into small, fluid-filled blisters which begin to dry out and crust over within a few days.
  • When the rash is at its peak, symptoms can range from mild itching to extreme and intense pain.
  • The rash and pain usually disappear within 3-5 weeks.

How contagious is it?

Chickenpox (Varicella)
Chickenpox is very contagious. The virus can spread by breathing in the viral particles that come from the blisters. It can also be spread by direct contact with the fluid of skin lesions. A person with chickenpox can spread the disease from 1 to 2 days before they get the rash, until all their chickenpox blisters have formed scabs.

Shingles (Herpes Zoster)
Shingles cannot be passed from one person to another. Someone with an infectious shingles rash can spread chickenpox if the other person has never had chickenpox. However, someone with shingles will not cause another person to develop shingles.

Is there a vaccine?

Chickenpox (Varicella)
There are two vaccine options:

  • Two doses of the varicella vaccine.
  • A combination vaccine called MMRV (measles, mumps, rubella, and varicella).

Shingles (Herpes Zoster)
The Centers for Disease Control and Prevention (CDC) recommends that healthy adults 50 years and older get the shingles vaccine.

How can these diseases be prevented?

The best way to prevent chickenpox and shingles is to get vaccinated.

  • Avoid direct contact with a person infected with chickenpox or shingles.
  • Cover the rash.
  • Avoid touching or scratching the rash.
  • Clean your hands often.

Pain in one area of the body and a rash with blisters are very common in shingles.

How to recognize shingles symptoms herpes zoster symptoms

While 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.

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.

What Are the Symptoms of Shingles?

  • Pain, itching, or tingling in the area where the rash will later develop
  • A rash that may begin a few days after this pain, itching, or tingling occurs
  • Fever
  • Headache
  • Chills
  • Upset 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.

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.

  • Severe pain
  • Severe rash
  • Older age
  • Involvement of the eye
  • Lymphoma, leukemia, and other diseases that suppress the immune system
  • Autoimmune conditions, such as inflammatory bowel disease and rheumatoid arthritis
  • HIV
  • Diabetes
  • Recent trauma
  • Personality disorder

Can You Get Shingles in the Eye?

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.”

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.

What You Need to Know

Whether you call it a cold sore or a fever blister, oral herpes is a common infection of the mouth area that is caused by herpes simplex virus type 1 (HSV-1). Fifty percent to 80 percent of U.S. adults have oral herpes. According to the National Institutes of Health, about 90 percent of adults have been exposed to the virus by age 50.

Once infected, a person will have herpes simplex virus for the rest of his or her life. When inactive, the virus lies dormant in a group of nerve cells. While some people never develop any symptoms from the virus, others will have periodic outbreaks of infections.

Causes of Oral Herpes

Oral herpesis spread most commonly from individuals with an active outbreak or sore. You can catch oral herpes by engaging in intimate or personal contact (e.g., kissing or oral sex) with someone who is infected.

Prevention of Oral Herpes

Since oral herpes is spread through direct, physical contact, the best method of prevention is to avoid physical contact with a person’s herpes sores when they are having an outbreak.

Oral Herpes Symptoms

The initial (primary) infection of oral herpes is usually the worst. It may cause severe, flu-like symptoms, including swollen lymph nodes and headache. However, some people have no symptoms at all. During the initial infection, sores can occur on and around the lips and throughout the mouth.

Recurring infections tend to be much milder, and the sores usually erupt on the edges of the lips. Some people never have any additional outbreaks beyond the initial infection. The following are the most common signs and symptoms of a recurring oral herpes simplex virus infection.

Initial redness, swelling, heat/pain or itching may develop in the area where the infection will erupt.

Painful, fluid-filled blisters may appear on the lips or under the nose. The blisters and fluid are highly contagious.

The blisters will leak fluid and become sores.

After about four to six days, the sores will start to crust over and heal.

The signs and symptoms of an oral herpes outbreak may look like other conditions or medical problems. Always consult your health care provider for an accurate diagnosis.

Diagnosing Oral Herpes

Since oral herpes can be confused with many other infections, including allergic reactions, a virus culture (PCR), blood test or biopsy are the only ways to confirm your diagnosis. However, your health care provider may also diagnose your condition based on the location and appearance of the blisters.

Recurrence of Oral Herpes

Although the specific triggers that cause oral herpes to recur are unclear, several factors may play a role. These include:

Prolonged or intense exposure to sunlight

While recurrent outbreaks are more common in the first year after the initial episode, they tend to lessen as the body builds antibodies to the virus.

Oral Herpes Treatment Options

Your health care provider will recommend treatment options based on your:

Overall health and medical history

Tolerance for specific medicines, procedures or therapies

Your specific treatment plan may involve:

Keeping the infected area clean and dry

Taking antiviral oral medications, such as acyclovir, famciclovir and valacyclovir (these medications are traditionally the most effective)

Applying antiviral topical ointments, such as acyclovir and penciclovir

Using over-the-counter topical anesthetics or anti-inflammatory agents to alleviate symptoms

Last Updated February 2021 | This article was created by familydoctor.org editorial staff and reviewed by Beth Oller, MD

Table of Contents

How to recognize shingles symptoms herpes zoster symptoms

What is shingles?

Shingles is a painful skin rash. It is also called zoster or herpes zoster. It is caused by the varicella zoster virus. This is the same virus that causes chickenpox. Nearly one-third of people in the United States will get shingles in their lifetime. Most people will only get it once. But some people can have more than one episode.

The virus that causes shingles is not the same virus that causes oral or genital herpes. That virus is called the herpes simplex virus. The two are in the same family of viruses.

Symptoms of shingles

Shingles usually causes a painful, blistering rash. Sometimes pain, itching, or tingling start a few days before the rash appears. The rash begins with reddish bumps. In a few days, these bumps turn into fluid-filled blisters. You might feel a stinging or burning pain. The rash might also itch. Other symptoms include:

  • Fever
  • Chills
  • Nausea
  • Diarrhea
  • Headache

Shingles occurs most often on the trunk of the body. It also occurs on only one side of the body. This could be a band of blisters around your back or chest. The blisters usually scab over in about a week. The rash usually clears up in 2 to 4 weeks. You may see changes in the color of your skin when the scabs fall off. In more severe cases of shingles, these color changes could be permanent.

Even though the rash from shingles gets better or goes away in a few weeks, the pain may last longer. This condition is known as post-herpetic neuralgia (PHN). In most people, however, the pain of shingles goes away in 1 to 2 months.

What causes shingles?

Shingles is caused by the varicella zoster virus, the same virus that causes chickenpox. After you’ve had chickenpox, the virus goes dormant (inactive) in your body. It stays inside certain nerve cells. Your immune system keeps the virus in these cells. As you get older, your immune system may get weaker. If this happens, the virus may reactivate, causing shingles. Many times this happens years after you’ve had chickenpox. If you have had the chickenpox vaccine, you are less likely to get chickenpox. Therefore, you’re less likely to later develop shingles.

Most people who get shingles are over 50 years of age or have a weak immune system. For example, you might get shingles if you:

  • Have cancer
  • Take medicines that weaken your immune system
  • Have HIV or AIDS

Can I give shingles to others?

No one can catch shingles from you. But the virus can be spread to a person who has never had chickenpox. The virus lives in the blisters that shingles causes. It can be spread until the blisters are completely healed. If you have blisters that have not crusted over yet, you should stay away from:

  • Anyone who has never had chickenpox
  • Babies under 12 months old
  • Pregnant women
  • Very sick people (such as those with cancer or AIDS)

Tell your doctor if you live with children who have not had chickenpox. They may need to be vaccinated.

How is shingles diagnosed?

Your doctor will ask you about your medical history, including if you’ve ever had chickenpox. He or she will also ask about your symptoms. They will do a physical exam and inspect your rash. There is a test that can confirm shingles, but it is not normally needed.

Can shingles be prevented or avoided?

The best way to prevent shingles is through vaccination. Vaccinate your children for chickenpox. This vaccine reduces their risk for getting chickenpox. You can’t get shingles unless you’ve had chickenpox first.

When you are older, get the shingles vaccine. It is recommended for adults 50 years of age and older. It can prevent shingles. People who have had shingles should get the vaccine to help stop the disease from reoccurring. Common side effects of the vaccine are headache, plus redness, swelling, itching, and soreness at the injection site.

The shingles vaccine is not recommended for anyone who:

  • Has had an allergic reaction to gelatin or the antibiotic neomycin
  • Has an allergy to any component of the shingles vaccine
  • Has a weakened immune system due to conditions such as leukemia, HIV, or AIDS
  • Is receiving treatment for cancer
  • Is being treated with drugs that suppress their immune system, including high-dose steroids
  • Is pregnant or might become pregnant within 4 weeks of getting the vaccine

Shingles treatment

Shingles is often treated with an antiviral medicine. These medicines can reduce the severity and duration of your symptoms. Acyclovir, famciclovir, or valacyclovir are commonly prescribed. Your doctor will decide whether one of these medicines is right for you. These medicines work better if you start taking them in the first 3 days after you get the rash.

Your doctor might also have you take a steroid medicine to reduce your pain and swelling. This medicine along with the antiviral medicines may reduce your risk of developing postherpetic neuralgia.

What can I do for the pain?

To help with the pain of shingles, your doctor might have you take an over-the-counter pain medicine. This could include acetaminophen (one brand: Tylenol) or ibuprofen (two brands: Motrin, Advil).

Applying a medicated anti-itch lotion (two brands: Benadryl, Caladryl) to the blisters might reduce the pain and itching. Placing cool compresses soaked in water mixed with white vinegar on the blisters and sores might also help.

If shingles causes severe pain, your doctor might prescribe a stronger pain medicine.

Living with shingles

Most people will only get shingles once in their life. The pain and the rash resolve in 3 to 5 weeks, and the blisters don’t leave scars. There are a few complications that can occur.

The most common complication of shingles is post-herpetic neuralgia (PHN). This is when the pain of shingles lasts for a long time after the rash is gone. About 10% of people who have shingles will develop PHN. It is caused by damaged nerve fibers that send exaggerated pain messages from your skin to your brain. The older you are, the more likely you are to develop PHN. It is also likely to be more severe when you are older.

Shingles can also lead to an eye condition called herpes zoster ophthalmicus (HZO). HZO can cause a rash with small blisters to break out on the forehead and around the eye. Usually this happens only on one side of your face. Sometimes you will have pain in the same area of your face a few days before the outbreak. Infection of the eye causes extreme pain, swelling of the eyelid, light sensitivity and redness. In severe cases, the cornea can be damaged. This can affect your vision.

People who have HZO should see an eye doctor right away.

How to recognize shingles symptoms herpes zoster symptoms

An estimated one million Americans develop shingles annually. In fact, one-third of the population will suffer from shingles at some point during their lifetime. Shingles is a painful rash caused by a virus called varicella-zoster (herpes zoster) — the same virus that causes chickenpox. If you have had chickenpox, the virus will “hide” inside the body making you at risk for getting shingles. The shingles virus can be transmitted from person to person if direct contact is made with the fluid from the rash. It is important to note that the virus that causes chickenpox and shingles is not the same herpes virus that causes cold sores and genital herpes.

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Shingles and diabetes

Research has shown that chronic conditions such as diabetes are associated with an increased risk of acquiring shingles. Scientists suggest that shingles is more severe in people with diabetes. After the infection, you would be more likely to have worsening of blood glucose control, need for medical follow-up, additional medication, as well as risk of hospitalization may be increased for up to six months after the infection was noted. Shingles may occur at any age; however, it is much more common in older adults who are also are more likely to have a severe infection. Being an older adult with diabetes increases both the risk of getting the infection and serious infection.

Symptoms

Shingles symptoms usually start on one side of the body with feelings of burning or tingling nerve pain which can range from mild to intense. After several days, numbness or itching along with a rash of fluid-filled blisters (that look similar to chickenpox) result. A common location for shingles to appear is along the nerve path from one side of the upper body wrapping around the waistline. Headache, fever, chills, nausea and body aches may also be present. Shingles is commonly diagnosed by your health-care provider based on the appearance of the painful skin rash.

Facts about shingles

• Shingles and chickenpox are caused by the same virus called varicella zoster virus.
• An estimated 1 million people get shingles each year in the United States.
• Anyone who has had chickenpox can get shingles, and you can get shingles at any age.
• Your risk of getting shingles and having more severe pain increases as you get older.
• The shingles vaccine, called Shingrix, is recommended for people age 50 and older to protect against shingles and the long-term pain that it can cause.
***

Treatment

Treatment with antiviral medications such as acyclovir (brand names Zovirax and Sitavig), valcyclovir (Valtrex), or famciclovir (Famvir) can help reduce the severity and duration of a shingles attack if initiated promptly (within 72 hours). These medications may also help reduce nerve pain called postherpetic neuralgia that is often experienced after an attack of shingles. Other medicines used to treat nerve pain may include steroids, antidepressants, anticonvulsants and topical creams or ointments. Analgesics, such as acetaminophen (Tylenol) may also be recommended for headache and generalized pain.

Prevention

Vaccines to prevent shingles approved by the Food and Drug Administration for adults age 50 and older are Shingrix and Zostavax. Shingrix reduces the chance of getting shingles by

90% and is given as two injections between two and six months apart. The Centers for Disease Control and Prevention (CDC) recommends that all adults aged 50 or older receive Shingrix. The Shingrix vaccine is preferred by the CDC over the one-time Zostavax vaccine that lowers risk of shingles by 50–60%. Shingrix is also recommended for adults with chronic medical conditions such as diabetes. If you had shingles in the past, Shingrix can prevent future outbreaks. Data suggest that Shingrix reduced the expected number of later cases of shingles by about 50% in older adults. If you acquire shingles following the appropriate immunization, the severity of infection and associated complications are significantly lower. Receiving the shingles vaccine is for prevention of the outbreak, not treatment.

So if you have diabetes, consider the Shingrix vaccine. Talk with your diabetes care team and/or your pharmacist about your risk for shingles and any side effects the vaccine may have. Above all, take action to prevent this painful disorder.

Disclaimer of Medical Advice: Statements and opinions expressed on this Web site are those of the authors and not necessarily those of the publishers or advertisers. The information, which comes from qualified medical writers, does not constitute medical advice or recommendation of any kind, and you should not rely on any information contained in such posts or comments to replace consultations with your qualified health care professionals to meet your individual needs.

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Shingles is a painful skin rash caused by the same virus that causes chickenpox. Learn about the disease, its symptoms, treatment, and prevention.

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Transcript

Shingles is a disease that causes a painful skin rash. About 1 in 3 people will get shingles, and your risk increases as you age. It comes from the same virus that causes chickenpox. Although there is no cure, shingles can be prevented and treated.

Here are 5 things you need to know about shingles:

  1. Anyone who has recovered from chickenpox, and even children, can get shingles.
  2. Symptoms of shingles include burning or shooting pain, tingling or itching, chills, fever, headache, upset stomach, and rashes or blisters that develop on one side of the body, usually on your face or around your waist. There are medicines that may help.
  3. Healthy adults age 50 and older should talk to their healthcare professional about getting the shingles vaccine to reduce their risk.
  4. Generally shingles is not contagious, but a person with active shingles can spread the virus when the rash is in the blister phase. It’s important to keep the rash covered.
  5. Most cases of shingles last 3-5 weeks. Most people get shingles only one time, but, it is possible to have it more than once.

If you think you might have shingles, talk to your doctor as soon as possible. Learn more about shingles.

Control measures for patients with localized rash

  • If the patient is immunocompetent and the rash is localized, follow standard precautions and cover all lesions until lesions are dry and crusted.
  • If a patient is immunocompromised and the rash is localized, follow standard precautions plus airborne and contact precautions until disseminated infection is ruled out. If dissemination is ruled out, follow standard precautions and cover all lesions until lesions are crusted.
  • Only health care workers with adequate evidence of immunity to varicella should care for patients with zoster.

Control measures for patients with disseminated or generalized rash

  • If the rash is disseminated (lesions outside the primary or adjacent dermatomes), follow standard precautions plus airborne and contact precaution until the lesions are crusted, regardless of if the patient is immunocompromised or immunocompetent.
  • Place patient in negative airflow rooms. If this is unavailable, place patients in their own room and keep the door closed. Those without immunity to varicella should not enter the room.
  • Only health care workers with adequate immunity to varicella should care for patients with zoster.

Zoster transmission

Zoster is not spread person to person. However, if someone is not immune to varicella and is exposed to zoster, they may develop varicella disease.

  • For localized zoster, transmission occurs through contact with the fluid in the blisters of the rash. A person is not infectious before the blisters appear or after the rash has crusted over.
  • Fordisseminated zoster, transmission occurs through airborne and droplet transmission, in addition to contact with fluid in the blisters of the rash. Disseminated zoster is likely as infectious as varicella.В

Management of exposed individuals

Evaluate evidence of immunity to varicella in all individuals exposed to zoster.

  • For localized zoster, exposures include those with intimate contact (i.e., changing bandages, touching, hugging). These exposures are usually limited.
  • For disseminated zoster, exposures include those in the same 2- to 4- person bed room, adjacent beds in a large area, or face-to-face contact.

Evidence of immunity to varicella includes:

  • Documentation of age-appropriate varicella vaccination:
    • Children age 12 months to 4 years: 1 dose of varicella vaccine.
      • Children age 4 years and older, adolescents, and adults: 2 doses of varicella vaccine.
  • Laboratory evidence of immunity or laboratory confirmation of disease.
  • Born in the United States before 1980.
    • For health care workers, pregnant women, and immunocompromised persons, birth before 1980 should not be considered evidence of immunity.
  • Health care provider diagnosis of varicella or zoster or verification of history of varicella or zoster disease. Health care providers should refer to CDC’s Assessing Immunity to Varicella guidance when verifying history of disease in patients.

Exposed individuals without evidence of immunity should be offered post-exposure prophylaxis in the following situations:

  • Healthy individuals age 12 months and older should be given varicella vaccine (as long as it is not contraindicated) within 5 days of exposure.
  • The following individuals should receive VariZIG within 10 days of exposure:
      • Immunocompromised individuals.
      • Pregnant woman.
      • Hospitalized preterm infants (28 weeks or more) whose mother lacks evidence of immunity against varicella.
      • Hospitalized preterm infants less than 28 weeks of gestation or birthweight of 1000g or less, regardless of maternal immunity.
      • It is not indicated for newborn infants whose mother had onset of zoster around delivery to receive VariZIG. This differs from the varicella recommendations.

Management of exposed health care workers

To prevent transmission of varicella in health care facilities, all health care workers should have evidence of immunity to varicella. This information should be documented and readily available. See Ensuring Immunity to Varicella in Health Care Workers for more information. Health care workers exposed to zoster:

  • With adequate evidence of immunity to varicella:
    • Should be monitored daily for symptoms of varicella from days 8-21 after exposure.
  • With 1 documented dose of varicella vaccine:
      • Should receive a second dose of varicella vaccine. Monitor for symptoms of varicella from days 8-21 after exposure.
  • Without any documented varicella vaccine:
      • Should be furloughed from days 8-21 after exposure or removed from patient care settings during this time. These health care workers should be offered varicella vaccine within 3-5 days after exposure if it is not otherwise contraindicated. Health care workers who are at high risk for severe disease and cannot receive varicella vaccine are recommended to receive VariZIG.

Herpes is an infection caused by the herpes simplex virus (HSV) type 1 or 2. The part of the body affected by the virus denotes the type of infection. Herpes has cyclical episodes, with dormancy following a period of active symptoms.

The first episode is usually the most severe, and symptoms may take two to four weeks to heal. Signs of herpes may not develop immediately after an individual contracts the virus, but noting symptoms and seeking treatment is essential to ensure one does not spread the infection.

Sores

Fluid-filled blisters are the most common symptom of herpes. They appear on the skin in a localized area. Oral herpes blisters develop on the face, usually around the lips. Blisters may also appear on or around the genitals .

Though less common, some people may also develop blisters on the buttocks, anus, and inner thighs. Herpes whitlow causes blisters on the fingers, cuticles, toes, and feet.

Regardless of the site of these sores, herpes blisters tend to break open and seep, then crust over before healing. This process usually takes take seven to 21 days, though the initial breakout may take longer.

How to recognize shingles symptoms herpes zoster symptoms

Tingling Sensation

A herpes episode usually starts with a tingling sensation in the area where the sores will form. This tingling may begin up to two days before the appearance of the blisters .

In some individuals, especially those who are unaware they have the virus, the sensation may be so mild as to go unnoticed. However, individuals who have had a few episodes will likely be alerted of an impending flare-up and can take measures to lessen discomfort.

How to recognize shingles symptoms herpes zoster symptoms

Itching and Burning

The tingling sensation often accompanies burning and itching in the affected area. These symptoms may persist even after the appearance of the sores because the virus is active in the epidermal layer .

It is imperative that people resist the urge to scratch and irritate the skin, regardless of how severe the discomfort may be. Further aggravating the skin will only cause more damage, lengthening the recovery period and possibly spreading the infection.

Scratching also increases the risk of the blisters becoming secondarily infected with bacteria.

How to recognize shingles symptoms herpes zoster symptoms

Redness and Pain

Once the blisters form, the affected skin will be red and painful . Inflammation and redness increase the prominence of the blisters.

The pain can range from a dull ache to more severe discomfort. The affected area may also become tender, such that any contact causes increased pain.

These symptoms usually subside as the sores heal, but tenderness may remain afterward.

How to recognize shingles symptoms herpes zoster symptoms

Problems with Urination

Pain and burning during urination are typical signs of genital herpes. The pain may be mild or severe but will make urination uncomfortable regardless.

This symptom is more commonly experienced by women because the sores on the external genitalia become irritated when they come into contact with urine.

The pain usually lessens in intensity once the crusting stage is complete. Once the sores heal, urination pain should cease.

How to recognize shingles symptoms herpes zoster symptoms

Headaches and Muscle Pain

Other systemic symptoms that may accompany a herpes outbreak are headaches and muscle pain. Headaches tend to be severe while the muscle pain can be of low intensity, though draining nonetheless.

As with a low-grade fever, over-the-counter medications can provide relief. A severe complication, herpes meningoencephalitis , can also cause these symptoms.

How to recognize shingles symptoms herpes zoster symptoms

Enlarged Lymph Nodes

Many herpes flare-ups cause the lymph nodes near the affected area to enlarge. With genital herpes, the lymph nodes on both sides of the groin are affected.

With oral herpes, those of the neck or ear become inflamed. As the herpes flare-up subsides, the enlargement should also decrease.

Tenderness accompanying the swelling can add to discomfort or pain, especially in people with genital herpes.

How to recognize shingles symptoms herpes zoster symptoms

Fever

In many individuals, herpes episodes come with flu-like symptoms, especially fever , due to the virus’ interference with the immune system.

The fever is usually low-grade, though it may cause fatigue and a general feeling of ill health. Fever is most common during the first outbreak of herpes and is less likely to occur with subsequent flare-ups.

In a few cases, body temperature may rise even before the appearance of sores, though most experience this sign after the outbreak begins. Physicians usually recommend over-the-counter medication for relief from the fever.

In rare cases, mostly involving young children and those with impaired immunity, a high-grade fever may develop and persist longer.

How to recognize shingles symptoms herpes zoster symptoms

Eye Infection

In some cases, the herpes virus may spread and infect one or both eyes , causing herpes keratitis. This infection can result in pain, blurred vision, and light sensitivity, as well as discharge and a feeling of grittiness in the eyes.

Severe infections that do not receive proper treatment may also cause scarring that could lead to clouded or impaired vision.

The virus can be transferred to the eye by touching or scratching a herpes blister and then touching or rubbing the eye.

How to recognize shingles symptoms herpes zoster symptoms

Discomfort When Swallowing

Some oral herpes infections can spread to the esophagus, a tube that leads from the mouth to the stomach, causing herpes esophagitis .

When that happens, pain and difficulty swallowing can develop. Some people also experience nausea, chest pain, heartburn, and low-grade fever.

Typically, people with particularly low immunity experience this complication.

Affiliation

  • 1 Klinika za infektivne bolesti, Medicinski fakultet, Novi sad.
  • PMID: 10518396
  • Search in PubMed
  • Search in NLM Catalog
  • Add to Search

Authors

Affiliation

  • 1 Klinika za infektivne bolesti, Medicinski fakultet, Novi sad.
  • PMID: 10518396

Abstract

History: There has been considerable interest in varicella-zoster virus in the middle of the twentieth century. Virus isolation in 1958 had made it possible to find out the complete DNA sequence of the varicella-zoster virus. Molecular identify of the causative agents of varicella and shingles had been proved. ETIOPATHOGENESIS AND HISTOPATHOLOGY: Varicella-zoster virus is a member of the Herpesviridae family. After primary infection which results in varicella, the virus becomes latent in the cerebral or posterior root ganglia. Some of these individuals develop shingles after several decades because of virus reactivation. It is caused by decline of cellular immune response. Circumstances such as old age, hard work, using of steroids or malignancies contribute to the appearance of shingles. Histopathological findings include degenerative changes of epithelial cells such as ballooning, multinucleated giant cells and eosinophilic intranuclear inclusions.

Epidemiology: Shingles occur sporadically, mainly among the elderly who have had varicella. There is no seasonal appearance of shingles. Individuals suffering from shingles may be sometimes contagious for susceptible children because of enormous amount of virus particles in vesicle fluid.

Clinical features: Clinically, shingles is characterized at first by pain or discomfort in involved dermatome, usually without constitutional symptoms. Local edema and erythema appear before developing of rash. Maculopapular and vesicular rash evolves into crusts. The most commonly involved ganglia are: lumbar, thoracic, sacral posterior root ganglia, then geniculate ganglion of the VIIth cranial nerve and the trigeminal ganglion. The most common complication, postherpetic neuralgia, may last for as long as two or three weeks, sometimes even one year or more. Other complications that may be seen in shingles, but more rarely, are ocular (keratitis, iridocyclitis, secondary glaucoma, loss of sight), neurological (various motor neuropathies, encephalitis, Guillain-Barre syndrome), secondary bacterial infection of vesicles. Immunocompromised patients often develop more severe disease lasting up to two weeks, skin lesions are more numerous and often with hemorrhagic base and there is a high possibility for cutaneous dissemination and visceral involvement including viral pneumonia, encephalitis and hepatitis. Chronic shingles may also be found in immunocompromised hosts, particularly in those with a diagnosis of HIV infection. In patients with HIV infection, shingles is often characterised by radicular pain and itching several days before appearance of skin lesions. Those patients may have two or more dermatomes involved and recurrences of shingles cannot be quite infrequent in those patients. But visceral involvement is rarer than in other immunocompromised patients. Shingles may occur in the second half of pregnancy and usually have a mild course. However, congenital abnormalities has been described in few cases.

Diagnosis: The diagnosis of shingles is usually made by history and physical examination. Exceptionally, for example in zoster sine herpete and atypical forms of shingles, virus isolation and serological tests must be used.

Differential diagnosis: Some other diseases may cause similar skin lesions and rash (varicella, erysipelas, impetigo, enteroviral infections, herpes simplex infections). These diseases are excluded by using detailed history taking and physical examination, laboratory findings, virus isolation and commercially available serological tests.

Therapy: The vast majority of immunocompetent persons with shingles should be treated only by symptomatic therapy. Predominantly it is directed toward reduction of fever and avoiding secondary bacterial skin infection in immunocompetent hosts. Acute neuritis and post-herpetic neuralgia require administration of various analgesics, even like amitriptyline hydrochloride and fluphenazine hydrochloride. Acyclovir therapy is limited to ophthal

This sheet is about having herpes zoster (shingles) in a pregnancy or while breastfeeding. This information should not take the place of medical care and advice from your healthcare provider.

What is herpes zoster (shingles)?

Herpes zoster, commonly known as shingles, is a viral disease caused by the same virus that causes varicella (chickenpox), called varicella-zoster virus. Chickenpox happens when a person is first exposed to the varicella-zoster virus. For more information on varicella (chickenpox), please see the MotherToBaby fact sheet: https://mothertobaby.org/fact-sheets/varicella/.

When someone has recovered from chickenpox, the varicella-zoster virus can stay inactive in some of the nerves in the body. If the inactive virus later becomes active again, it causes shingles. Shingles can lead to skin infections, nerve pain, and hearing or vision problems.

How do you get the virus that causes shingles?

The varicella-zoster virus can spread through direct contact with the blisters or rash of someone who has chickenpox or shingles, or by sharing eating and drinking utensils. The virus can also be transmitted through saliva or sexual contact. Talk with your healthcare providers about testing options to see if you have ever had the varicella-zoster virus. Your healthcare providers can also discuss vaccines to help prevent chickenpox and shingles.

I have shingles. Can it make it harder for me to become pregnant?

Studies have not been done to see if shingles can make it harder to get pregnant.

Does having/getting shingles increase the chance for miscarriage?

Miscarriage can occur in any pregnancy. Studies have not been done to see if having shingles can increase the chance of miscarriage.

Does shingles increase the chance of birth defects?

Every pregnancy starts with a 3-5% chance of having a birth defect. This is called the background risk. Shingles is rare in pregnancy. There are not a lot of studies that look at the effects of shingles on a pregnancy. However, shingles has not been seen to increase the chance of birth defects. If you are pregnant and develop shingles, talk to your healthcare provider about treatment.

Does having/getting shingles increase the chance of pregnancy-related problems?

Studies have not been done to see if having shingles in pregnancy could cause other pregnancy-related problems, such as preterm delivery (birth before week 37) or low birth weight (weighing less than 5 pounds, 8 ounces at birth). However, shingles has not been seen to increase the chance pregnancy complications.

Does having shingles in pregnancy cause long-term problems?

Studies have not been done to see if having shingles in pregnancy could cause long-term problems in the child.

Breastfeeding with shingles:

The virus that causes shingles has not been found in breast milk. It is important to keep the baby from coming into direct contact with the rash or blisters to lower the chances of spreading the virus. If you suspect your baby has any symptoms that could be due to either chickenpox or shingles, contact the child’s healthcare provider. Talk with your healthcare provider about all of your breastfeeding questions.

If a male has shingles can it make it harder to get a partner pregnant or increase the chance of birth defects?

There are no studies looking at possible risks to a pregnancy when a male has shingles. A study that tested semen while the donor had chickenpox did not find any signs of the varicella-zoster virus in semen. In general, exposures that males or sperm donors have are unlikely to increase the risk to a pregnancy. However, if a person is not immune to chickenpox and their intimate partner has shingles, there is a risk of the person who is pregnant to become infected. For more information, please see the MotherToBaby fact sheet Paternal Exposures at https://mothertobaby.org/fact-sheets/paternal-exposures-pregnancy/.

Please click here for references.

OTIS/MotherToBaby recognizes that not all people identify as “men” or “women.” When using the term “mother,” we mean the source of the egg and/or uterus and by “father,” we mean the source of the sperm, regardless of the person’s gender identity.

Affiliation

  • 1 Klinika za infektivne bolesti, Medicinski fakultet, Novi sad.
  • PMID: 10518396
  • Search in PubMed
  • Search in NLM Catalog
  • Add to Search

Authors

Affiliation

  • 1 Klinika za infektivne bolesti, Medicinski fakultet, Novi sad.
  • PMID: 10518396

Abstract

History: There has been considerable interest in varicella-zoster virus in the middle of the twentieth century. Virus isolation in 1958 had made it possible to find out the complete DNA sequence of the varicella-zoster virus. Molecular identify of the causative agents of varicella and shingles had been proved. ETIOPATHOGENESIS AND HISTOPATHOLOGY: Varicella-zoster virus is a member of the Herpesviridae family. After primary infection which results in varicella, the virus becomes latent in the cerebral or posterior root ganglia. Some of these individuals develop shingles after several decades because of virus reactivation. It is caused by decline of cellular immune response. Circumstances such as old age, hard work, using of steroids or malignancies contribute to the appearance of shingles. Histopathological findings include degenerative changes of epithelial cells such as ballooning, multinucleated giant cells and eosinophilic intranuclear inclusions.

Epidemiology: Shingles occur sporadically, mainly among the elderly who have had varicella. There is no seasonal appearance of shingles. Individuals suffering from shingles may be sometimes contagious for susceptible children because of enormous amount of virus particles in vesicle fluid.

Clinical features: Clinically, shingles is characterized at first by pain or discomfort in involved dermatome, usually without constitutional symptoms. Local edema and erythema appear before developing of rash. Maculopapular and vesicular rash evolves into crusts. The most commonly involved ganglia are: lumbar, thoracic, sacral posterior root ganglia, then geniculate ganglion of the VIIth cranial nerve and the trigeminal ganglion. The most common complication, postherpetic neuralgia, may last for as long as two or three weeks, sometimes even one year or more. Other complications that may be seen in shingles, but more rarely, are ocular (keratitis, iridocyclitis, secondary glaucoma, loss of sight), neurological (various motor neuropathies, encephalitis, Guillain-Barre syndrome), secondary bacterial infection of vesicles. Immunocompromised patients often develop more severe disease lasting up to two weeks, skin lesions are more numerous and often with hemorrhagic base and there is a high possibility for cutaneous dissemination and visceral involvement including viral pneumonia, encephalitis and hepatitis. Chronic shingles may also be found in immunocompromised hosts, particularly in those with a diagnosis of HIV infection. In patients with HIV infection, shingles is often characterised by radicular pain and itching several days before appearance of skin lesions. Those patients may have two or more dermatomes involved and recurrences of shingles cannot be quite infrequent in those patients. But visceral involvement is rarer than in other immunocompromised patients. Shingles may occur in the second half of pregnancy and usually have a mild course. However, congenital abnormalities has been described in few cases.

Diagnosis: The diagnosis of shingles is usually made by history and physical examination. Exceptionally, for example in zoster sine herpete and atypical forms of shingles, virus isolation and serological tests must be used.

Differential diagnosis: Some other diseases may cause similar skin lesions and rash (varicella, erysipelas, impetigo, enteroviral infections, herpes simplex infections). These diseases are excluded by using detailed history taking and physical examination, laboratory findings, virus isolation and commercially available serological tests.

Therapy: The vast majority of immunocompetent persons with shingles should be treated only by symptomatic therapy. Predominantly it is directed toward reduction of fever and avoiding secondary bacterial skin infection in immunocompetent hosts. Acute neuritis and post-herpetic neuralgia require administration of various analgesics, even like amitriptyline hydrochloride and fluphenazine hydrochloride. Acyclovir therapy is limited to ophthal

  • Symptoms
    • What Are the Symptoms of Shingles?
  • Treatment
    • What Is the Treatment for Shingles?
  • Complications
    • What Is Postherpetic Neuralgia?
  • Prevention
    • How Do You Prevent Shingles?
  • Guide
    • Shingles Treatment and Complications Topic Guide
    • Doctor’s Notes on Shingles Treatment and Complications Symptoms

What Are the Symptoms of Shingles?

Generally, shingles heals well and problems are few. However, on occasion, the blisters from the disease can develop an acute bacterial infection, causing cellulitis, a bacterial skin condition. If this occurs, the area will become reddened, warm, firm, and tender. You might notice red streaks forming around the wound. If you notice any of these symptoms, contact your health care professional. Antibiotics can be used to treat these complications and hopefully avoid scarring associated with the infection.

A more worrisome complication occurs when shingles affects the face of a patient, specifically the forehead and nose. In this situation, it is possible, although not likely, that shingles can affect the eye (known as herpes zoster ophthalmicus), leading to loss of vision. If you have shingles on your forehead or nose, your eyes should be evaluated by a healthcare professional.

A rare complication of shingles is known as Ramsay Hunt syndrome. In this case, the cranial nerves (cranial nerves V, IX, and X) are involved. Symptoms may include peripheral facial nerve weakness and deafness. The typical rash is often observed around the ear and ear canal.

What Is the Treatment for Shingles?

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There are several effective treatments for shingles, which is an adult expression of the varicella zoster or chickenpox virus. Medicine for treatment of viral disease (antivirals) can reduce the severity and duration of the rash if started early (within 72 hours of the appearance of the rash). They include:

In addition to antiviral medications, pain medications may be needed to control symptoms of the condition. Both nonsteroidal anti-inflammatory medications and any narcotic pain-control drug may be used for pain management in shingles.

The affected area should be kept clean. Bathing is permitted when you have the condition, and the area can be cleansed with soap and water. Cool compresses and anti-itching lotions, such as calamine lotion, may also provide relief. An aluminum acetate solution (Burow’s or Domeboro solution, available at your pharmacy) can be used to help dry up the blisters and oozing.

What Is Postherpetic Neuralgia?

The most common complication of shingles is postherpetic neuralgia. This occurs when the nerve pain associated with shingles persists beyond one month, even after the rash is gone. It is a result of irritation of the nerves of sensation by the virus. The pain can be severe and debilitating. Postherpetic neuralgia occurs primarily in people over the age of 50 and affects 10%-15% of people with shingles. There is evidence that treating shingles with antiviral agents can reduce the duration and occurrence of postherpetic neuralgia.

The pain of postherpetic neuralgia can be reduced with medical treatment. Tricyclic antidepressant medications (amitriptyline [Elavil] and others), as well as antiseizure medications (gabapentin [Neurontin], carbamazepine [Tegretol], and pregabalin [Lyrica]), have all been used to relieve the pain associated with postherpetic neuralgia. In 2012, the FDA approved the use of gabapentin enacarbil (Horizant), previously used for the management of restless legs syndrome, for the treatment of postherpetic neuralgia. Capsaicin cream (Zostrix), a derivative of hot chili peppers, can be used topically on the area after all the blisters have healed, to reduce the pain. Lidocaine pain patches (Lidoderm) applied directly to the skin can also be helpful in relieving nerve pains by numbing the nerves with local lidocaine anesthetic. These pain-relief options should be discussed with your health care professional.

How Do You Prevent Shingles?

Currently, there are two shingles vaccines called Zostavax and Shingrix. Recommendations from the Centers for Disease Control and Prevention (CDC) are that healthy adults 50 or older should get Shingrix, which is given as two injections separated by 2-6 months. Even adults who previously received Zostavax should now receive Shingrix in addition. A chickenpox vaccine is also available. According to information from the CDC, children should get their first dose of the varicella immunization at 12 to 15 months, and the second dose at 4 to 6 years of age. The shots will prevent chickenpox, though they will still be at risk for shingles, potential postherpetic neuralgia, and related conditions later in life.

What Is Shingles?

Shingles, also called zoster or herpes zoster, is a skin rash caused by a viral infection of the nerves right below the skin.

What Causes Shingles?

The varicella zoster virus causes shingles and chickenpox. Anyone who has had chickenpox can later develop shingles — even children. That’s because the virus stays dormant (resting) in the nervous system for the rest of a person’s life.

In many people, the virus never comes back. But in others, it flares up and causes shingles. It’s uncommon for someone to get shingles more than once.

People of all ages can get shingles, but most cases are in people over 50 years old.

What Are the Signs & Symptoms of Shingles?

Often the first shingles symptoms happen in the area where the rash will appear. A person may have tingling, itching, or pain in this area. When the rash shows up, the pain may be mild or severe.

The rash starts as groups of tiny pimples on one side of the body or the face. It’s often in the shape of a band or belt. The pimples change to pus-filled blisters that break open and scab over in about 7–10 days. The scabs usually heal and fall off about 2–4 weeks after the rash starts.

How to recognize shingles symptoms herpes zoster symptoms

Some kids with shingles also may have a fever and a headache, and might feel tired and achy. Rarely, a child has the pain of shingles without the rash. More severe symptoms can happen, but usually in people over age 50.

What Problems Can Happen?

Most cases of shingles heal on their own, with or without treatment, and won’t lead to any other problems. In rare cases, shingles can lead to complications, including:

  • Ongoing pain (post-herpetic neuralgia): Damaged nerve fibers in the skin send confused messages to the brain, leading to pain. Pain can go on for a long time after the shingles rash is gone. This is the most common shingles complication.
  • Vision problems: Shingles near or in an eye can lead to vision loss.
  • Skin infections: A shingles rash can become infected with bacteria, leading to impetigo or cellulitis.
  • Nervous system problems: Shingles on the face can involve different nerves that connect to the brain. This can lead to nerve-related problems such as facial paralysis, hearing problems, and problems with balance. In very rare cases, shingles can lead to encephalitis (inflammation of the brain).

How Is Shingles Diagnosed?

Doctor usually can diagnose shingles by looking at the rash. Rarely, a doctor may send a small sample of infected skin to be checked in a laboratory.

If you think your child might have shingles, call your doctor. If your child might have shingles on the face, it’s important to get a doctor’s help right away to keep the infection from spreading to the eyes.

How Is Shingles Treated?

Not all kids who get shingles need treatment. If a doctor decides a treatment may help, it should start right away. Treatment usually includes an antiviral medicine and pain-control medicines.

Antiviral medicines like acyclovir (Zovirax) or valcylovir (Valtrex):

  • help heal the skin rash
  • stop the virus from multiplying
  • help control pain

Pain medicines (over-the-counter or prescription creams, sprays, or skin patches):

  • help control pain
  • ease inflammation (swelling and redness)

Medicines can’t rid the body of the virus, but they can lower the chances of complications and help speed healing. Ask your doctor if treatment might help your child.

As the rash heals, keep the area clean. Wash it with water and a mild soap, and apply cool, wet compresses to the blisters several times a day to ease pain and itching. Oatmeal baths also can bring relief.

To prevent the virus from spreading to other people, keep the rash covered at all times.

Can Shingles Be Prevented?

It’s not always possible to prevent shingles. But the chickenpox vaccine can make a case of shingles less serious. If your child hasn’t had chickenpox, ask your doctor about getting the chickenpox vaccine.

There is a shingles vaccine, but it’s mostly given to older adults. The older someone is, the more severe shingles can be. Kids are unlikely to be seriously affected by shingles.

What Else Should I Know?

Children whose shingles rash that can’t be completely covered should not go to school or childcare until the blisters scab over and are dry.

Newborn babies, pregnant women, people with weakened immune systems, and anyone who is not immune to chickenpox should avoid close contact with anyone who has shingles until the rash is gone.