When Lisa Mangini had some mild itching on her chest and right shoulder, she didn’t think much of it. But the next day, raised pink welts cropped up, along with pain that she said felt like glass in her skin. Though she suspected shingles based on how people she knew described their experience with the infection, she talked herself out of going to urgent care. “I was under the impression that only older adults got shingles,” says Mangini, who was 37 at the time.
The rash spread, yet only appeared on one side of her back and chest—a telltale sign of shingles—so she went to the doctor two days later. They diagnosed her with the infection and prescribed an antiviral.
The first few days weren’t bad, but then the pain ramped up. “It was agonizing,” she says. “People describe shingles as a rash, but it’s so much more than that. Showering hurt. Wearing clothes hurt. I hadn’t used any of the prescription-strength ibuprofen they sent me home with after having my nine-month-old, and I went through all of it [when I had] shingles. It was the only thing that helped. I know you’re not supposed to use medications other than how they’re prescribed, but I was so desperate.”
Though Mangini was surprised she’d gotten the infection, she found out that both her physician and her son’s pediatrician had shingles in their late 30s or early 40s. They’re in the minority, but people of any age can be impacted—even kids. Here’s what you need to know about the infection so you can recognize the symptoms and navigate treatment if it ever affects you or a loved one.
If you’ve ever had chickenpox, you can get shingles—so don’t write off potential symptoms.
Shingles, also called herpes zoster, is an infection that causes a painful rash. It can crop up anywhere on the body and looks like a stripe of pinpoint, clustered, red blisters. It’s caused by the varicella-zoster virus, the same virus that causes chickenpox. To that end, anyone who’s had chickenpox can get shingles. Although chickenpox blisters fade, the virus that causes them stays dormant in your spinal cord indefinitely, explains Neha Vyas, MD, a family medicine physician at Cleveland Clinic. Generally, this is harmless. But if your immunity is compromised at one point or another, the virus can reactivate and cause shingles. Unfortunately, this can happen more than once. About 10% of people with shingles go on to develop another shingles infection.
Getting shingles—and a subsequent reoccurrence—is more likely to happen as we age because our immune response isn’t as strong as we get older, explains Richard Wender, MD, chair of the Department of Family Medicine and Community Health at the Perelman School of Medicine at the University of Pennsylvania. “If the chickenpox virus re-emerges, our bodies are less effective at winning the fight against the virus,” he says. This is one of the biggest reasons that the herpes zoster virus is three to four times more common in people over 65 than in younger adults.
Still, people of all ages—even children—can get shingles. For younger folks, risk factors for the infection include anything that weakens your immune system, like having an autoimmune or chronic condition or taking steroids or other immune-suppressing medications. Emotional stress may also affect immunity, making you more susceptible to viruses in general, including varicella-zoster.
Shingles symptoms tend to be mild in the beginning but worsen over time.
Although many people associate shingles with a painful rash, other symptoms can crop up before the bumps. For about two days before blisters develop, you may experience:
- Pain, burning, itching, or tingling sensations on your skin
- Headache
- Sensitivity to light
- Malaise, which is a general feeling of discomfort
During the second phase of symptoms, a blistery rash forms, often on one side of the face or body. “Since the virus lives in the nerve root, the rash roughly tracks the route that single nerve will travel,” Dr. Wender explains. Over time, the blisters burst, ooze, and scab over. This phase lasts about two to four weeks and is incredibly painful.
The American Academy of Dermatology Association says shingles rashes should be washed with a fragrance-free cleanser, coated with pure petroleum jelly, and covered with a clean, nonstick bandage daily until the blisters are completely healed. After touching your rash, wash your hands to lessen the chance of it spreading to others. During this time, it’s also vital to keep your rash covered with loose-fitting clothing and not pop the blisters, Dr. Vyas says. The fluid inside the blister can spread the herpes zoster virus, which could trigger chickenpox in individuals who haven’t been vaccinated or had it.
Shingles complications are rare but quite serious.
Although it can be scary to hear, it’s important to know that in some cases, shingles pain doesn’t go away for months or even years. However, this is quite rare. Only 10% to 18% of people who get shingles develop chronic nerve pain, called postherpetic neuralgia, in the area where they had a rash. The pain is believed to be triggered by the damage that the herpes zoster virus inflicts on the nerves. This causes them to send erratic impulses, which the brain interprets as pain.
Shingles can also affect your eyes. An estimated 8% to 20% of people diagnosed with shingles have herpes zoster ophthalmicus, which means the virus affects a nerve involved with vision. This can lead to pink eye, inflammation of different parts of the eye, or even vision loss. This complication is most common among older people and those with weakened immune systems.
Getting an official diagnosis and starting treatment early may help you recover more quickly.
If you think you have shingles, see a doctor, stat. Mangini said the physician’s assistant at her local urgent care immediately knew she had singles based on her symptoms and rash pattern. But some providers may want to swab the blisters or take a tissue sample so a lab test can confirm the diagnosis.
Although there isn’t a cure for shingles, taking an antiviral like acyclovir, valacyclovir, or famciclovir may help shorten how long you have symptoms and make them less intense. The catch? You must take the antiviral within three days of the rash developing, so act quickly.
Depending on how severe your pain is, you can use over-the-counter painkillers, or your medical provider may give you a prescription for stronger medication. And for itching, try a cool, damp cloth, oatmeal baths, or calamine lotion.
There are proven ways to reduce the risk of shingles.
The shingles vaccine (Shingrix) may help prevent shingles and its complications or at least make things more bearable if you get infected. This vaccine is two doses. The Centers for Disease Control and Prevention (CDC) recommends everyone 50 and older get vaccinated, even if they’ve had shingles before. It’s also recommended for younger people with compromised immune systems. If you’ve never had chickenpox, the risk of getting shingles is “very, very unlikely,” Dr. Wender says. But you may have had a mild case of chickenpox and not realized—and are subsequently at risk of shingles. That said, your healthcare provider can confirm if you may be a good candidate for the shingles vaccine.
You may also read that “boosting” your immune system could help prevent shingles. Following a lifestyle that supports your immune system is smart for many reasons, but you can’t pop a supplement peddled on social media to avoid getting infected. “I can give you 20 strong reasons to be exercising, sleeping well, and choosing healthier foods. I don’t think avoiding shingles would make the top 10,” Dr. Wender says. “Anything that may help overall immune function may have some benefit against shingles—but don’t lose track of the fact that the vaccine is a powerful, proven way to reduce the risk.”
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