Shingles: Early Signs, Why Timing Matters and When to Be Seen

What it involves

MedlinePlus defines shingles as a painful, blistering skin rash caused by the varicella-zoster virus, the same virus that causes chickenpox. After chickenpox, the virus stays dormant in certain nerves and can become active again, often after many years. MedlinePlus says it can develop at any age, and that it is more likely if you are older than 60, had chickenpox before age 1, or have a weakened immune system.

Who this is for

• Patients with burning, tingling, or shooting pain on one side of the body, with or without a rash
• Patients with a new band of blisters on the chest, back, abdomen, or face
• Patients over 60 or with a weakened immune system who notice a painful rash
• Patients with a rash near the eye, which needs prompt medical care

What to expect

• Questions about when the pain began, where the rash is, and any fever or headache
• A look at the skin, since the pattern and location usually point to the diagnosis
• A plain explanation of what treatment is available and why starting early matters
• A plan for pain relief, skin care, and when to come back or call

How shingles usually unfolds

MedlinePlus says the first symptom is usually pain, tingling, or burning on one side of the body, often severe and present before any rash appears. Red patches follow, then small blisters. The blisters break into sores that dry and crust, and the crusts fall off in 2 to 3 weeks. The rash usually covers a narrow band from the spine around to the front of the chest or abdomen, though it can involve the face, eyes, mouth, and ears.

Other symptoms that can come with it

MedlinePlus lists symptoms that may accompany the rash:

• Fever and chills, and a general ill feeling
• Headache and joint pain
• Swollen glands
• When a facial nerve is involved: weak facial muscles, a drooping eyelid, hearing loss, taste problems, or vision problems

Why the first 72 hours matter

MedlinePlus says a provider may prescribe an antiviral medicine, which helps reduce pain, prevent complications, and shorten the course of the illness. It says these medicines work best when started within 72 hours of when you first feel pain or burning, ideally before blisters appear. That is the main reason to call the day a one-sided burning patch shows up instead of waiting to see whether a rash follows.

Easing it at home

MedlinePlus lists cool, wet compresses to reduce pain, soothing baths, and rest in bed until the fever goes down. Pain medicines, antihistamines for itching, and a capsaicin cream may be suggested, and in some people a short course of a corticosteroid such as prednisone. It also says to stay away from other people while sores are oozing, especially pregnant women and anyone who has never had chickenpox or the chickenpox vaccine, because they can catch chickenpox from the blisters.

Eye, face and emergency warning signs

MedlinePlus warns that shingles affecting the eye may lead to permanent blindness without emergency medical care. It also lists complications that include bacterial skin infections, hearing loss, and, in people with weakened immune systems, infections such as encephalitis or sepsis. A painful rash with fever, confusion, or a headache that is unusual for you should not wait. If a rash is spreading with a fever, the adult fever guide describes when a fever needs prompt care.

Pain that lingers after the rash

MedlinePlus says shingles usually clears in 2 to 3 weeks and rarely returns, but pain in the area can last for months or years, a condition called postherpetic neuralgia. It is more likely in people age 60 or over. If burning or tingling continues after the skin has healed, the numbness and tingling guide describes how persistent nerve symptoms are sorted at a visit.

What about the shingles vaccine

MedlinePlus notes that the shingles vaccine is different from the chickenpox vaccine, and that older adults who receive it are much less likely to have complications. Whether the practice can give the shingles vaccine has not been confirmed on this site, so ask when you call.

Sources

• MedlinePlus — Shingles
• MedlinePlus — Shingles health topic