What Are the Early Symptoms of Shingles?
Shingles are characterized by painful rashes or blisters caused by the reactivation of the chickenpox virus in your body. You can only contract shingles if you have had chickenpox, usually occurring in childhood. The virus that causes shingles is the same virus that causes chickenpox. Treatment includes antivirals and pain-reducing measures, but the best form of prevention is vaccination.
What are the Symptoms of Shingles?
Shingles are a disease that lives in your nerve cells and affects your nerves. You can only contract shingles if you have had chickenpox at some point in your life, as shingles are a reactivation of the same virus within your body. Common symptoms, as outlined by the National Institute of Health (NIH), include:
- Fluid-filled blisters
- Burning, shooting pain
- Tingling, itching, or numbness of the skin
- Chills, fever, headache, or upset stomach
Early symptoms of shingles have been reported in some cases, where a person experiences them prior to having a visible rash or blisters. Some “early” symptoms listed by NHS 24, a national telehealth and telecare organization, include:
- burning, tingling, numbness, or itchiness of the skin in the affected area
- a feeling of being generally unwell
Diagnosis of Shingles & Serious Complications
Shingles must be diagnosed by a medical professional. Your doctor should ask for your medical history and the symptoms you have been experiencing recently. The giveaway for shingles includes pain and itching on one side of the body and fluid-filled blisters or rashes. The majority of the time, your doctor can diagnose you through a visual examination.
Your doctor may also take a skin sample to analyze in a laboratory and confirm shingles. When visiting your doctor with a suspected case of shingles it is helpful to know your medical history, specifically if you have ever received the chickenpox vaccine. This will be helpful for your doctor to diagnose you and begin treatment.
It is crucial to seek medical care right away if you suspect shingles. Although shingles usually clear up with treatment within 3 to 5 weeks, they can cause some more serious complications and health conditions. Specifically, if shingles symptoms develop in or around the eye it can lead to eye damage or blindness.
The most common complication associated with shingles is postherpetic neuralgia (PHN). PHN is defined by the National Health Service (NHS) as “a lasting pain in the areas of your skin where you had shingles.” Approximately 10 to 18 percent of people who have shingles will experience PHN, with a higher likelihood being those older than 40 years. The CDC lists these as rare complications sometimes associated with shingles:
- hearing problems
- brain inflammation
There is no cure for shingles, and treatment includes reducing pain and symptoms associated with infection. Early treatment with prescription antiviral drugs can speed up the healing process while reducing the risk of complications. The varicella-zoster virus causes chickenpox. This virus is a part of a group of viruses called herpes viruses, which include the same viruses that cause genital and oral herpes. Therefore, the same antivirals which are usually prescribed for herpes are also prescribed for shingles. Consider the table below regarding commonly prescribed antivirals for shingles.
Generic and Brand Name Drugs to Treat Shingles
Generic Drug Name
Brand Drug Name
*Famvir was recently discontinued by the Food and Drug Administration (FDA).
Home Remedies & Lifestyle Changes
Home remedies have also been shown to help reduce the pain associated with shingles symptoms. Your doctor may recommend you work to reduce the amount of stress in your life. Stress is thought to be linked to shingles due to the immune-weakening effect that stress has on your body. Other home remedies include:
- Cool bath
- Cool compress on blisters or rash
- Oatmeal bath
- Calamine lotion
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Primary & Urgent Care
Although one does not necessarily need to see a doctor for shingles, medical attention and antiviral treatment can both lessen the pain and shorten the duration of the rash or blisters. It is recommended that you see a doctor if you suspect you have shingles; this is especially true in the following situations cited by the Mayo Clinic:
- the pain and rash occur near an eye
- you are age 60 or older
- you or someone in your family has a weakened immune system
- the rash is widespread and painful
Shingles Vaccine & Prevention
Vaccination is one of the best forms of prevention from shingles. The current shingles vaccine, brand name Shingrix, is an effective way to prevent shingles. One study revealed a 91.3 percent efficacy rate of the Shingrix vaccine against shingles. Shingrix was approved by the FDA in 2017 and is given in two doses, with 2-6 months in between each dose. The CDC recommends adults ages 50 years and older get the vaccine. The Mayo Clinic recommends getting the shingles vaccine if you:
- Have already had chickenpox, the chickenpox vaccine, or shingles
- Received the prior shingles vaccine called Zostavax
- Do not remember having chickenpox at some point in your life
It is essential to speak with your healthcare provider about the best time for you to get vaccinated, along with the benefits and potential side effects of vaccination. You can get the shingles vaccine at your doctor’s office and some pharmacies.
We can’t talk about shingles without talking about chickenpox, as the same virus causes them. Therefore, receiving the chickenpox vaccine is also extremely important in the later prevention of shingles. Receiving the chickenpox vaccine does not make you immune to chickenpox, as you may still become infected with chickenpox. However, those vaccinated usually have much milder symptoms than those not vaccinated when infected by chickenpox.
The CDC recommends two doses of the chickenpox vaccine for children, adolescents, and adults who have never had chickenpox and were never vaccinated. The CDC infographic below outlines the role that the chickenpox vaccine plays in saving lives and preventing illness.
Costs Associated With Treatment
Cost Helper Health cites the cost of treatment for those with insurance as between $5 and $50 and between $20 and $500 for those without insurance. There are several costs associated with the treatment of shingles, which may include:
- Office Visit (Co-Pay or Out of Pocket Cost)
- Over-The-Counter (OTC) Pain Medication
- Antibiotic Ointment
The cost of antiviral medication varies based on the specific antiviral you are prescribed and choose to use. The average cost of brand-name antiviral for a 30-tablet supply is $545.45, compared to $116.72 for generic retail prices. Valacyclovir appears to be the most expensive of the three antivirals, whereas Acyclovir is the least costly.
What are Shingles?
Shingles, also known as Herpes Zoster, is caused by the same virus that causes chickenpox. It is known to be a common viral infection that causes a painful rash usually on one side of the face or body. The rash consists of blisters that typically scab over in 7 to 10 days and heal within 2 to 4 weeks.
Singles is not a life-threatening condition, but the painful rashes or blisters can be prevented by the chickenpox vaccine in childhood or the shingles vaccine in adulthood. It is estimated that 1 in 3 people will get shingles, accounting for the 1 million cases of shingles diagnosed each year.
Source: Cleveland Clinic
How do Shingles Spread?
A Center for Disease Control (CDC) analysis found that chickenpox cases were reduced when comparing pre-and post-vaccine availability. Prior to a chickenpox vaccine being readily available, 4 million people got chickenpox every year; now, approximately 350,000 people get chickenpox every year.
Shingles are spread through direct contact with the fluid from the developed rash or blisters. You are not spreading shingles specifically, but rather the virus that causes shingles. This same virus, the varicella-zoster virus (VZV) is also responsible for chickenpox. You can only get shingles if you have been infected with chickenpox at least once.
Therefore, someone with an active case of shingles can spread the VZV only to a person who has never had chickenpox or had the chickenpox vaccine. This would cause them to become infected with chickenpox. That person can develop shingles later due to this previous chickenpox viral infection. You can not infect another person with shingles directly.
Once infected and having experienced chickenpox, the varicella-zoster virus lies dormant in your body but is able to reactivate many years later. Because you have had chickenpox does not guarantee that you will develop shingles. Reactivation is not fully understood but is believed to be linked to lowered immunity that coincides with growing older. Being that more and more children have been and continue to be vaccinated for chickenpox, those most at risk are older, ages 50 and above. Other risk factors include some who:
- Is older than 50 years old
- Has certain diseases that weaken your immune system (e.g. HIV/AIDS, etc.)
- Is undergoing cancer treatments
- Is taking certain medications
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Shingles Frequently Asked Questions (FAQs)
Consider this additional information regarding shingles.
Can I Get Shingles If I Have Never Had Chickenpox?
No, you can only get shingles if you have had chickenpox first. If you are infected by someone with an active case of shingles, then you can develop chickenpox. This could then later be the cause of your shingles.
Can I Get Diagnosed With Shingles Over Telehealth?
Yes, you can get diagnosed with shingles through virtual care. However, some doctors may also ask that you come in for a physical examination. Mira has recently launched virtual care options for its members. Members can select a virtual primary care physician, get diagnosed virtually, and obtain prescriptions for $45 per month with a low copay of $25.
Can I Get Shingles More Than Once?
Yes, you can get shingles more than once in your life, but this is known to be extremely rare. However, there have been recurring cases reported where the same person experienced shingles two to three times. One study found that 85 out of 1,700 (5%) persons with a documented case of shingles experienced a second or third infection within an average of 8 years. Having shingles once does not protect you from ever having the disease again, albeit rare. The shingles vaccine can lessen your chances of initial and reinfection dramatically.
Shingles are a result of the reactivation of the chickenpox virus. Anyone who has ever had chickenpox may develop shingles. The infection manifests as a painful rash or blisters on one side of the body. One of the best forms of treatment is vaccination; the chickenpox vaccine in childhood or the shingles vaccine as an adult can significantly lessen your risk of developing shingles. Additional treatment may include antivirals, antibiotics, pain-relieving medication, and home remedies.
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Kendra Bean is from Maui, Hawaiʻi. She is currently enrolled at the University of Hawaiʻi at Mānoa, specializing in Epidemiology. She is passionate about improving health literacy and access to care, specifically in rural areas.