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Shingles - aftercare

Herpes zoster - treatment

Shingles is a painful, blistering skin rash that is caused by the varicella-zoster virus. This is the same virus that causes chickenpox. Shingles is also called herpes zoster.

 

What to Expect

An outbreak of shingles usually follows the following course:

  • Blisters and pimples appear on your skin and cause pain.
  • A crust forms over the blisters and pimples.
  • In 2 to 4 weeks, the blisters and pimples heal. They rarely come back.
  • Pain from shingles lasts for 2 to 4 weeks. You may have tingling or a pins-and-needles feeling, itching, burning, and a deep pain. Your skin may be very painful when it is touched.
  • You may have a fever.
  • You may have short-term weakness of certain muscles. This is rarely lifelong.

To treat shingles, your health care provider may prescribe:

  • A medicine called an antiviral to fight the virus
  • A medicine called a corticosteroid, such as prednisone
  • Medicines to treat your pain

You may have postherpetic neuralgia (PHN) pain. This is pain that lasts longer than a month after symptoms of shingles start.

Skin Care and Itch Relief for Shingles

To relieve itching and discomfort, try:

  • A cool, wet compresses on the affected skin
  • Soothing baths and lotions, such as colloidal oatmeal bath, starch baths, or calamine lotion
  • Zostrix, a cream that contains capsaicin (an extract of pepper)
  • Antihistamines to reduce itching (taken by mouth or applied to the skin)

Keep your skin clean. Throw away bandages you use to cover your skin sores. Throw away or wash in hot water clothing that has contact with your skin sores. Wash your sheets and towels in hot water.

While your skin sores are still open and oozing, avoid all contact with anyone who has never had chickenpox, especially pregnant women.

Managing Pain

Rest in bed until your fever goes down.

For pain, you can take a type of medicine called NSAIDs. You do not need a prescription for NSAIDs.

  • Examples of NSAIDs are ibuprofen (such as Advil or Motrin) and naproxen (such as Aleve or Naprosyn).
  • If you have heart disease, high blood pressure, kidney disease, or have had stomach ulcers or bleeding, talk with your provider before using these medicines.

You may also take acetaminophen (such as Tylenol) for pain relief. If you have liver disease, talk with your provider before using it.

You may be given a narcotic pain reliever. Take it only as directed. These medicines can:

  • Make you sleepy and confused. When you are taking a narcotic, do not drink alcohol or use heavy machinery.
  • Make your skin feel itchy.
  • Cause constipation (not being able to have a bowel movement easily). Try to drink more fluids, eat high-fiber foods, or use stool softeners.
  • Make you feel sick to your stomach. Try taking the medicine with food.

When to Call the Doctor

Call your provider if:

  • You get a rash that looks or feels like shingles
  • Your shingles pain is not well-managed
  • Your pain symptoms do not go away after 3 to 4 weeks

References

Dinulos JGH. Warts, herpes simplex, and other viral infections. In: Dinulos JGH. Habif's Clinical Dermatology: A Color Guide in Diagnosis and Therapy. 7th ed. Philadelphia, PA: Elsevier; 2021:chap 12.

Whitley RJ. Chickenpox and herpes zoster (varicella-zoster virus). In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 9th ed. Philadelphia, PA: Elsevier; 2020:chap 136.

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    • Shingles

      Animation

    •  

      Shingles - Animation

      The same virus that made you itch and scratch from chickenpox when you were a child can come back to haunt you when you get older. You'll know it's come back by the painful, blistery rash it leaves on your skin. Shingles is caused by the varicella-zoster virus, the same virus that's responsible for chickenpox. Before there was a vaccine to prevent chickenpox, it was a very common childhood illness. After you have chickenpox, the virus can lie hidden in your body for years. Then when you get older, it can become active again. This time it's called shingles, not chickenpox. Doctors don't really know why the shingles virus reappears in some people but not others. If you're over age 60 or you have a weak immune system, your risk of getting the disease is higher. You can tell that it's shingles by the red, blistery patches on your skin, especially if you had chickenpox when you were young. Usually the rash is focused on your trunk area around your back, belly, and chest. You may also have blisters on your face. It will probably hurt, tingle, or burn, sometimes even before there is a rash. When the blisters break open, they'll dry out and form crusts. If you do have shingles, your doctor may prescribe an antiviral drug like acyclovir, famciclovir, or valacyclovir. These drugs fight the virus that causes shingles, but you need to start taking them within 24 hours after you start feeling the pain and burning of the rash for them to be effective. You may also get medicines to reduce swelling and relieve itching and pain. To ease really bothersome itching at home, soak in a soothing bath or gently rub calamine lotion on your skin. Most cases of shingles clear up within a couple of weeks. Sometimes, though, shingles can leave behind permanent nerve damage, called postherpetic neuralgia. The good news about shingles is that once it clears up, it's usually gone for good. But the pain, and nerve damage it causes, can sometimes linger. If you've had shingles and your pain isn't subsiding or your rash isn't clearing up, call your doctor. To avoid getting shingles, stay away from anyone who has either shingles or chickenpox, especially if you've never had chickenpox before. And get vaccinated against the varicella-zoster virus if you're over age 60.

    • Shingles

      Animation

    •  

      Shingles - Animation

      The same virus that made you itch and scratch from chickenpox when you were a child can come back to haunt you when you get older. You'll know it's come back by the painful, blistery rash it leaves on your skin. Shingles is caused by the varicella-zoster virus, the same virus that's responsible for chickenpox. Before there was a vaccine to prevent chickenpox, it was a very common childhood illness. After you have chickenpox, the virus can lie hidden in your body for years. Then when you get older, it can become active again. This time it's called shingles, not chickenpox. Doctors don't really know why the shingles virus reappears in some people but not others. If you're over age 60 or you have a weak immune system, your risk of getting the disease is higher. You can tell that it's shingles by the red, blistery patches on your skin, especially if you had chickenpox when you were young. Usually the rash is focused on your trunk area around your back, belly, and chest. You may also have blisters on your face. It will probably hurt, tingle, or burn, sometimes even before there is a rash. When the blisters break open, they'll dry out and form crusts. If you do have shingles, your doctor may prescribe an antiviral drug like acyclovir, famciclovir, or valacyclovir. These drugs fight the virus that causes shingles, but you need to start taking them within 24 hours after you start feeling the pain and burning of the rash for them to be effective. You may also get medicines to reduce swelling and relieve itching and pain. To ease really bothersome itching at home, soak in a soothing bath or gently rub calamine lotion on your skin. Most cases of shingles clear up within a couple of weeks. Sometimes, though, shingles can leave behind permanent nerve damage, called postherpetic neuralgia. The good news about shingles is that once it clears up, it's usually gone for good. But the pain, and nerve damage it causes, can sometimes linger. If you've had shingles and your pain isn't subsiding or your rash isn't clearing up, call your doctor. To avoid getting shingles, stay away from anyone who has either shingles or chickenpox, especially if you've never had chickenpox before. And get vaccinated against the varicella-zoster virus if you're over age 60.

      Self Care

       
       

      Review Date: 4/9/2020

      Reviewed By: Linda J. Vorvick, MD, Clinical Associate Professor, Department of Family Medicine, UW Medicine, School of Medicine, University of Washington, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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