However, if you have or have had shingles, you’re probably worried about how it will progress and whether it will continue to hurt for a long time.

You know that it initially presents as a peculiar pain in some part of the body that may resemble a headache or muscle discomfort. It’s also common to describe it as a burning sensation, itching, tingling, and marked skin sensitivity.

After a few days of this vague pain, shingles usually manifests as multiple bumps resembling small blisters (vesicles) that tend to cluster in a linear pattern. It can appear anywhere on the body.

Here you can see more pictures of shingles

This is the point at which a diagnosis is usually made and treatment is prescribed, which consists of:

• Oral antiviral (acyclovir, valacyclovir, brimonidine, famciclovir).
  • Note: It’s not alwaays necessary. If you’re young, your doctor might not prescribe it, and that’s perfectly fine.
  • Topical antivirals (Zovirax/acyclovir cream) are sometimes prescribed, but they aren’t effective.
• Some topical products to prevent secondary infection and dry out the blisters: antibiotic creams, compresses, sprays…
• Pain relievers to ease the pain.

And this is where you ask yourself: Now what am I supposed to do?

Scabs

Those small fluid-filled blisters dry out over the course of a few days. They then turn into black scabs, which are quite noticeable.

Little by little, they fall off, revealing an area of pink skin.

If you have dark skin, once the scabs have healed, a brown spot may remain on the affected area—a condition we call post-inflammatory hyperpigmentation.

This spot usually fades over time, but it may take several months to do so.

Intense pain

It doesn’t always happen, but the pain from shingles can be very intense. It’s normal for it to interfere with physical activity, sleep, or appetite.

This pain usually begins before the blisters appear on the skin. However, it doesn’t go away once the skin heals; rather, it’s normal for it to persist over time. We consider a duration of three months from the appearance of the blisters to be normal.

What if it lasts longer?

In that case, we call it postherpetic neuralgia, and it is a somewhat more complex condition that persists over time.

It is more common in older adults (it occurs in only 2% of those under 60) and in cases where antiviral treatment was started more than 72 hours after the appearance of the blisters.

This pain is treated with medications that are somewhat more specialized than standard pain relievers (gabapentin, amitriptyline, etc.). Treatment typically requires management by professionals specializing in pain management.

In conclusion…

If you’ve had shingles and experienced pain, the pain usually goes away within a few weeks after the blisters have healed.

If your shingles outbreak was very extensive, you started treatment late, or you’re over 60, you’re at slightly higher risk of developing postherpetic neuralgia (pain lasting longer than 3 months).

Any discoloration left by the outbreak will fade over time.

The post I’ve had shingles—what now? first appeared on Dra. LOREA BAGAZGOITIA.

What is shingles?

Shingles is a skin eruption characterized by clusters of small, fluid-filled blisters that typically appear on skin that is redder than normal. These blisters are usually located on an elongated area of ​​skin known as a “dermatome.” Dermatomes are areas of skin supplied by the same nerve. Shingles typically affects only one dermatome, which is why it has a characteristic “shingle-like” appearance. Occasionally, it can spread to two or three dermatomes, or even cause scattered pimples around the shingles.

The blisters gradually turn into black scabs over several days, taking on a rather unsightly appearance. Within a few weeks, these scabs fall off, disappear, and the skin returns to normal.

Here you can see more pictures of shingles

In 3 out of 4 cases, the appearance of pimples is accompanied by pain in the affected area, which is usually described as burning, pricking, or simply a feeling of heightened sensitivity. These symptoms can appear days (or even weeks) before the pimples appear and last for up to a month after the pimples disappear.

The pain from shingles can start before and last for a while after the skin has healed.

Why does shingles appear?

It is caused by the varicella-zoster virus, the same one that causes chickenpox. As we have mentioned before, we cannot eliminate viruses, so after recovering from chickenpox, the virus remains dormant in our bodies, causing no discomfort or problems for years.

It is caused by a reactivation of the varicella-zoster virus

It is possible that over time this virus may reactivate as shingles. It is more common in older people, but it can also occur in younger people with chronic illnesses, during periods of stress, or with weakened immune systems.

What complications can shingles cause?

Shingles usually heals without leaving any lasting effects. The most common complication (in almost 8 out of 100 cases) is pain that lasts longer than a month in the affected area, which can be very bothersome and prolonged. This is called postherpetic neuralgia. Sometimes, the skin where the spots appear can become infected with bacteria, which is easily treated.

Although infrequent, the most common complication is postherpetic neuralgia.

If it affects the periocular area, eye complications may occur that should be evaluated by an ophthalmologist. If it is in the ear, it could also cause complications that should be evaluated by an otolaryngologist. Neurological complications are rare.

Complications are more common in older people

In general, complications are more frequent the older the person suffering from it is and in immunocompromised people (such as HIV+ people or transplant recipients)

How is shingles treated?

Treatment for shingles is not mandatory. It usually clears up on its own after a few days, but since the medications used to treat it are quite safe, we typically prescribe a week of antiviral pills (such as acyclovir, valacyclovir, or others). In addition, pain relievers like paracetamol, metamizole, or anti-inflammatories are often used.

The treatment reduces the duration of pimples and the pain.

The treatment helps shorten the duration of skin lesions, reduce pain, and prevent transmission. It is also believed to reduce the risk of postherpetic neuralgia. For this reason, it is especially important for older adults and immunocompromised individuals. It is best to start treatment within the first three days.

Is shingles contagious?

There is a possibility of transmission through skin-to-skin contact with the lesions themselves, especially when they are blisters and break open. Contagiousness decreases once treatment begins. Although it is the varicella-zoster virus, which is transmitted through the air, this is not the case with shingles.

The post Shingles: the chickenpox virus years later first appeared on Dra. LOREA BAGAZGOITIA.