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Different Stages of Shingles

writtenByWritten by: Tessa Chatham Registered Nurse
Tessa Chatham Registered Nurse

Tessa Chatham Registered Nurse

Tessa is a MSN prepared Registered Nurse with 10 years of critical care experience in healthcare. When not practicing clinical nursing, she enjoys academic writing and is passionate about helping those affected by medical aliments live healthy lives.

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reviewBy Reviewed by: Dr. Katalin Karolyi
Reviewer

Dr. Katalin Karolyi

Katalin Karolyi, M.D. earned her medical degree at the University of Debrecen. After completing her residency program in pathology at the Kenezy Hospital, she obtained a postdoctoral position at Sanford Burnham Prebys Medical Discovery Institute, Orlando, Florida.

March 21, 2021 Read Time - 6 minutes

What Is Shingles?

The varicella-zoster virus is responsible for chickenpox and later can develop into shingles. Shingles, also known as herpes-zoster, is not related to the herpes virus that causes genital diseases. After you contract chickenpox, the virus stays in your body, lying dormant for years. It reappears as shingles when the virus reactivates. 

According to the CDC, 1 in 3 people will contract shingles at some point in their lifetime. 

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Shingles Symptoms

Common symptoms of shingles are pain and a rash in a belt-like form that stops at the midline of the body affecting only one side. Symptoms of shingles progress from burning and itching sensations to severe pain at the location of the rash. Early shingles symptoms may include burning, tingling, or a numb sensation on the skin accompanied by headache, upset stomach, and chills. 

Later stages include painful fluid-filled blisters that cause severe pain, fever, and severe itching.

What Causes Shingles?

In the United States, more than 1 million individuals annually develop shingles. The exact cause of shingles is unknown other than it is a reactive version of the chickenpox virus. The risk factors for shingles are unique to each individual; however, 90% of shingles cases result from a weakened immune system. 

The following demographics are more likely to contract shingles:

  • Transplant patients
  • Patients receiving chemotherapy
  • HIV patients
  • Patients who take immunosuppressant treatment 

Age and gender are important risk factors for shingles. Most cases of shingles occur over the age of 50. It is estimated that 50% of people will have shingles by the age of 85, and women are more likely to develop shingles than men.

What Triggers a Shingles Outbreak?

Precise triggers for herpes zoster (shingles) are unknown. Outbreaks can come as a result of the individual’s immune status. That is, if your immune system is weakened, you are more likely to suffer a shingles outbreak. 

You must also have had chickenpox to trigger a shingles outbreak. You cannot have a shingles outbreak unless you have previously contracted chickenpox.

What Does Early Stages of Shingles Look Like?

Shingles progress through several stages as the virus replicates in your body. Shingles start as a rash with red bumps, known as papules, distributed most frequently over your back and torso. 

Within several days, grouped blisters (vesicles or bullae) are present. Within seven to ten days, the vesicles dry up and crust.

The early stage of shingles looks like small, red, raised, solid pimples or an inflamed rash. These are tiny, raised bumps on the skin. Eventually, these bumps blister and later crust. The beginning stages of shingles create tingling and localized pain. 

The early stages of shingles are also described as itching, burning, or deep pain. People who have had shingles also described the early stages as similar to the beginning of the flu.

What Does a Mild Case of Shingles Look Like?

Not everyone with shingles will develop a blistering rash. A mild case of shingles may include a red rash without blisters. The shingles rash and blisters are distinct characteristics of the illness. Mild cases of shingles do not usually cause headaches, fever, or fatigue. 

Whether mild or severe, pain is the most common symptom of shingles. Most people describe a deep burning, throbbing, or stabbing sensation. The pain usually subsides within 30 days.

How Long Does it Take for Shingles to Progress?

Shingles progresses into blisters over three to five days and begins to crust over after seven to ten days. The rash is preceded by a prodromal phase lasting 48-72 hours or longer, consisting of throbbing pain and numbness in the area affecting the nerve. Once the rash blisters, it can last another three to five days before the lesions scab over. 

After the lesions crust over, it may take two to four weeks to heal completely. At this time, pain may still be present. The most painful stage of shingles is when you have fluid-filled blisters. This usually occurs three to five days after the rash first appears. 

How Do You Know Shingles Are Healing? 

Shingles begin to heal when the blisters crust over and begin to scab. At this point, once the lesions are crusted over, they are no longer contagious and you can no longer spread the chickenpox virus.

How Do Shingles Make You Feel?

People have described shingles as making you feel as if you have the flu. You feel “run down” and tired, but you also develop severe pain and a rash.

Shingles first makes you feel a burning or tingling sensation on one side of your face, chest, back, or waist. You also may develop fever, chills, fatigue, and headache. A few days later, you will see a rash appear at the location of the burning and tingling sensation. 

Once the rash appears, you may experience sharp, stabbing, or burning pain. People also report itching and being overly sensitive to touch. If the rash is near your face, you may have increased sensitivity to light. 

The pain from shingles can be debilitating, affecting your quality of life and placing a burden on your health and wellbeing. It is essential to see your doctor at the first sign of shingles.

What Happens If You Let Shingles Go Untreated?

If left untreated, you can suffer severe complications from shingles. According to the CDC, “postherpetic neuralgia (PHN) is the most common complication of herpes-zoster,” but you may also experience vision loss, hearing loss, pneumonitis, brain inflammation (encephalitis), or death. If untreated, shingles can be especially fatal for elderly, immunosuppressed, or critically ill people. 

  • Book on our free mobile app or website.

    Our doctors operate in all 50 states and same day appointments are available every 15 minutes.

  • See a doctor, get treatment and a prescription at your local pharmacy.

  • Use your health insurance just like you normally would to see your doctor.

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Shingles Treatment

Shingles can be treated with prescription medications. There is currently no cure for shingles, but antiviral drugs prescribed by your doctor can help reduce the severity of shingles. Most antiviral medications must be taken within 3 days after the rash appears, so it is vital to make an appointment to see your doctor as soon as you notice the rash. 

Preventative treatment is also available in the form of a shingles vaccine.


Read More About Shingles Here


Sources:

PlushCare is dedicated to providing you with accurate and trustworthy health information.

Centers for Disease Control and Prevention. Shingles Burden and Trends. Accessed on March 13, 2021 at https://www.cdc.gov/shingles/surveillance.html

Centers for Disease Control and Prevention. Shingles (Herpes Zoster) Clinical Overview. Accessed on February 20, 2021 from https://www.cdc.gov/shingles/hcp/clinical-overview.html 

Mayo Clinic. Shingles. Accessed on March 13, 2021 at
https://www.mayoclinic.org/diseases-conditions/shingles/diagnosis-treatment/drc-20353060

US Department of Health and Human Services. National Institute on Aging. (2021). Shingles. Accessed on February 20, 2021 from https://www.nia.nih.gov/health/shingles

Most PlushCare articles are reviewed by M.D.s, Ph.Ds, N.P.s, nutritionists and other healthcare professionals. Click here to learn more and meet some of the professionals behind our blog. The PlushCare blog, or any linked materials are not intended and should not be construed as medical advice, nor is the information a substitute for professional medical expertise or treatment. For more information click here.

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