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Surefire Signs You Have Shingles, According to Experts

What to know about Shingles. 
FACT CHECKED BY Emilia Paluszek

Shingles is a viral infection that causes a painful rash and blisters that can appear anywhere on the body, but most commonly found around the torso. The condition isn't life threatening, but it is very discomforting and can last anywhere from three to five weeks. The Centers for Disease Control and Prevention, states "About 1 out of every 3 people in the United States will develop shingles, also known as herpes zoster, in their lifetime. An estimated 1 million people get shingles each year in this country. If you've ever had chickenpox, you can get shingles. Even children can get shingles. Your risk of shingles increases as you get older." Eat This, Not That! Health spoke with Erica Susky, an Infection Control Practitioner (ICP) in hospital epidemiology who explained what shingles feels like for patients and signs to watch out for. Read on—and to ensure your health and the health of others, don't miss these Sure Signs You've Already Had COVID.


Signs of Shingles

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Susky shares, "The pain starts as a burning or tingling, then a rash will appear which lasts about 7-10 days. The rash is often itchy. The pain and itching can continue after the rash heals. In about 30% of zoster (or shingles) cases, complications can occur. The most common is postherpetic neuralgia, which is pain that lasts much longer after the rash heals. Postherpetic neuralgia may even persist for months and years." 


What Causes Shingles

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According to Susky, "Shingles is caused by a virus, the Varicella-Zoster Virus (VZV). This is the same virus that causes chickenpox. When one is first exposed to the virus, they get chickenpox. As chickenpox resolves, the virus remains in the nerves of the spine (dorsal root ganglia). Shingles is not a new infection, but rather the reactivation of the virus one is carrying in their spinal nerves from when they acquired chickenpox. Someone with a healthy immune system will keep the VZV in check. If the immune system is stressed; immune suppression, aging and even mental stress, the immune system may no longer be as effective at keeping the virus within the dorsal root nerves. In this case, the virus will replicate along the nerves and appear as a linear rash which is the area supplied by the nerve."


Treatment for Shingles and How it Can Help be Prevented

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Susky explains, "Shingles is often treated with antiviral drugs to reduce the severity and shorten the duration of illness (acyclovir, valacyclovir or famciclovir). As one already has VZV in their body, therefore prevention is not about avoiding exposure to another person with chickenpox or shingles, but is rather about preventing viral reactivation. This can be done by keeping one's stress levels managed. As people age, their immune systems wane. Because of this, a shingles vaccine is recommended to prevent zoster. However, some immune suppressed people are not suitable for the zoster vaccine and should always check with their doctor."

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Who is at Risk for Shingles and Why?

Woman's neck with blisters scar and rash caused by chickenpox

"People with weakened immune systems are at a higher risk of getting shingles, but shingles can happen to anyone who has had chickenpox before (10-20% of the general population)," says Susky. "However, shingles does happen more often and with greater severity in immune compromised people. These groups include the elderly, people with HIV, cancer and on immunosuppressant drugs."

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How Contagious is Shingles?

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Susky emphasizes, "Shingles is not as contagious as chickenpox; it is usually spread through contact with the rash or through objects that have come in contact with the rash. In severe cases of shingles (usually in immune compromised people), the rash can develop in 3 or more areas supplied by three separate nerves (referred to as dermatomes). This is called disseminated zoster. In other words, the rash covers a larger area on the body. This usually reflects that the immune system has had a larger breach in controlling VZV and the reactivation is greater. In this case, the infection is more contagious but is still not as contagious as chickenpox. Someone with localized zoster, or in one or two lines supplied by one or two nerves (or dermatomes) are usually fine around other people if they wash their hands regularly and can keep the rash covered (usually by their clothes). Someone with a disseminated form of zoster is more contagious and could potentially spread it in an airborne route. People with disseminated zoster should stay away from other people (unless those around them have had chickenpox before)."

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Exposure to Someone with Shingles

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Susky states, "Having managed zoster exposures before, I always get asked if being exposed to someone with shingles will be a risk of getting shingles. People cannot get shingles from another person with shingles, people can get chickenpox from someone with shingles but only if they have never had chickenpox before. Shingles is not a viral infection coming from someone else, rather the VZV already in one's body for a long-time is re-emerging as shingles."

Heather Newgen
Heather Newgen has two decades of experience reporting and writing about health, fitness, entertainment and travel. Heather currently freelances for several publications. Read more about Heather
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