3. Shingles is more than a rash.
An itchy, blistering rash is what most people picture when they think of shingles. But doctors say this visible eruption, which frequently forms a stripe on one side of the torso and can last three to five weeks after symptoms start, often is just the tip of the iceberg. Shingles can also involve flulike symptoms like fever, headache, and fatigue, as well as burning, stabbing, or shooting nerve pain. Some doctors rank it among the most painful conditions of adulthood.
“Many people think shingles is only a skin problem,” says Seth Cohen, MD, the medical director of infection prevention at the University of Washington Medical Center. “In reality, the rash is only part of the story. The pain can be substantial and may outlast the visible rash. Approximately 20% of patients still report some pain at three months.” Sometimes the pain can last a year or more.
Fortunately, shingles is rarely fatal—fewer than 100 people die from the illness each year, according to the CDC. But it is possible to experience dangerous and ongoing complications. Some people with more serious cases, for example, may require hospitalization and intravenous antiviral medications, Dr. Truong says. And for people with an outbreak on their face, there is also a risk of long-term issues such as blindness, facial weakness, and hearing loss. As such, it’s vital to get prompt care and treat shingles like the serious illness it is. And on that note….
4. It’s not a “ride it out” sickness.
Given how serious the complications can be, don’t plan to ride out shingles like you might with another viral illness, like a cold.
“If you think you might have shingles, especially on the face or near the eye, do not try to tough it out at home,” Dr. Cohen says. “There is a feared complication called herpes zoster ophthalmicus that occurs when shingles affects a branch of the trigeminal nerve that runs through the forehead and upper eyelid area,” he says. When this happens, the eye could become infected, which can be sight-threatening and requires urgent attention. Anyone with shingles on the forehead, eye area, or nose, where related nerve branches reside, or symptoms like eye redness, pain, or blurred vision should be “promptly evaluated by a medical professional,” Dr. Cohen says. Doctors can prescribe an antiviral treatment, along with topical or oral steroids to protect your vision.
Even if you have a shingles outbreak elsewhere on your body, “early treatment matters,” Dr. Cohen says. Seeing a doctor right away ups your chances of a fast recovery. “Antiviral therapy is most effective when started within 72 hours of rash onset, but data suggest the benefit is greatest when treatment begins within 48 hours,” he explains. That said, if you do try to push through shingles and your symptoms take a turn for the worse, you should still see a doctor. “Even after 72 hours treatment can still be appropriate if new lesions are still appearing or if there is eye, ear, or neurologic involvement,” says Dr. Cohen.
A doctor can also help you minimize the discomfort of shingles. “Don’t suffer in silence—if your pain is significant, let your doctor know,” says Dr. Cohen. “For mild pain acetaminophen or NSAIDs [like ibuprofen or aspirin] may be sufficient, but for more severe pain people may require stronger prescription pain meds. Lidocaine patches can also help but should be applied only to intact skin, not directly on the rash.” (You can pick up these patches at a local pharmacy or on Amazon.)
