Generally, shingles heal well and problems are few. However, on occasion, the blisters can become infected with bacteria, causing cellulitis, a bacterial infection of the skin. If this occurs, the area will become reddened, warm, firm, and tender. You might notice red streaks forming around the wound. If you notice any of these symptoms, contact your health-care professional. Antibiotics can be used to treat these complications.
Shingles isn’t infectious in the same way as chickenpox, where the virus can be passed on to other people by coughs and sneezes. However, the virus can be passed on by direct contact with fluid from shingles blisters, until they dry up and crust over. This can cause chickenpox in people who aren’t already immune to it. People with shingles should avoid contact with people who have a lowered immunity, babies or pregnant women (see Who is most likely to get shingles?). If the rash is covered, the virus is less likely to be spread.
Shingles symptoms generally disappear within three to five weeks. However, treatment is recommended to help encourage shingles pain relief. Your health care provider can offer you oral antiviral medications, including acyclovir, valacyclovir, and famciclovir, in order to speed up the course of the shingles disease. You may also be prescribed pain relieving medications, such as ibuprofen and acetaminophen.
Shingles symptoms happen in stages. At first you may have a headache or be sensitive to light. You may also feel like you have the flu but not have a fever. Later, you may feel itching, tingling, or pain in a certain area. That’s where a band, strip, or small area of rash may occur a few days later. The rash turns into clusters of blisters. The blisters fill with fluid and then crust over. It takes 2 to 4 weeks for the blisters to heal, and they may leave scars. Some people only get a mild rash, and some do not get a rash at all.
Doctors can distinguish shingles from chickenpox (or dermatitis or poison ivy) by the way the spots are distributed. Since shingles occurs in an area of the skin that is supplied by sensory fibers of a single nerve–called a dermatome–the rash usually appears in a well-defined band on one side of the body, typically the torso; or on one side of the face, around the nose and eyes. (Shingles’ peculiar name derives from the Latin cingulum, which means girdle or belt.) If a diagnosis is in doubt, lab tests can confirm the presence of the virus.
The severity and duration of an attack of shingles can be significantly reduced by immediate treatment with antiviral drugs, which include acyclovir, valacyclovir, or famcyclovir. Antiviral drugs may also help stave off the painful aftereffects of shingles known as postherpetic neuralgia (see section entitled “What are the Complications of Shingles?). Doctors now recommend starting antiviral drugs within 72 hours of the first sign of the shingles rash. Early treatment is believed to reduce the risk of postherpetic neuralgia and may speed up the healing process.