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Stages of Shingles

A shingles rash occurs due to the reactivated varicella-zoster virus. This virus is also responsible for chickenpox. Shingles occurs only in those people who have had chickenpox in the past. Painful pus-filled blisters are formed in patches, or clusters, and may take weeks, months, or even years to heal. This HealthHearty article explains the stages in which these rashes develop, and more.
Batul Nafisa Baxamusa
Last Updated: Jan 27, 2018
Shingles rash occurs only in those who have had chickenpox in the past. The causal virus―varicella-zoster―remains in a dormant stage within the body, near the nerve cells. For several years, it remains inactive, causing no trouble whatsoever. However, due to certain factors including age, stress, medications, poor nutrition, diseases, surgery, or anything that weakens the immune system of a person, this virus gets reactivated and causes shingles.
Once the virus is activated, it begins to multiply, thereby traveling up to the surface of the skin, along the nerves. Usually, the rash appears on one side of the body―either left or right. It may occur on the face (concentrated around the eye), from the middle of the back towards the chest, belly, neck, one arm or leg, like a band or a strip, and may also affect more than one area of the body, at the same time. Symptoms include pain, burning sensation, tingling, redness, fluid-filled blisters, severe itching, flu-like symptoms, chills, headache, and general fatigue.
Most people believe that like chickenpox, shingles too, is contagious. However, the fact is that being infected by the virus would not cause shingles, but chickenpox. Also, only those who have never had chickenpox, or have never been vaccinated for either chickenpox or shingles, will be affected. Therefore, we can say that a person cannot infect another with shingles, but with the virus. After the virus is active again, shingles develops in three stages; these are explained in the following sections.
Prodromal Stage

The stage that occurs before the appearance of a rash is the prodromal stage. It is the first stage of shingles that may lead to flu-like symptoms in some people. People who are about to develop shingles rash complain of nausea, headache, and chills. Some suffer from stomach pain and diarrhea. The lymph nodes may swell and become tender. People also complain of burning and tingling sensation, with or without numbness in the area where the rash will develop. These sensations are felt around the belly, head, face, neck, or either of the limbs.
Active Stage

This is when the redness and swelling develops at the site of infection. Gradually, a small band or strip of rash will appear on the body; this happens around 2 to 3 days after the virus reactivates. The rash may develop anywhere in the body, but generally occurs on either side of the trunk. Blisters that are filled with a clear fluid are formed. After about 3 to 4 days, the fluid turns cloudy. These blisters continue to appear for about 5 days and may cause a lot of pain, irritation, and discomfort. Doctors describe the pain to be similar to what it feels like being pierced by needles. After about 5 days, the blisters may break open, ooze, and crust over. Within 2 to 4 weeks the rash begins to heal.
Postherpetic Neuralgia

The infection is referred to as Postherpetic Neuralgia (PHN) when it stays for at least 30 days, or more, varying from a few months to a few years. Symptoms include aches, stabbing pain, sensitivity, and burning sensation in the affected area. This pain may be lingering in nature, and may last for many years. This stage is considered to be a complication of shingles, and is therefore, severe in nature. PHN may also have adverse effects on a person, hampering his or her ability to eat, sleep, perform everyday activities, and the like. This phase may also affect a person mentally, causing depression.
The treatment for shingles just involves pain management and prevention of postherpetic neuralgia stage. This implies, that there is no cure for this condition. Treatment methods only help deal with the bothersome symptoms in a better way. The person is asked to wear loose cotton clothes. A cool bath or application of ice packs on the blisters would help reduce the burning sensation, itching, and pain. The doctor may prescribe antiviral drugs including acyclovir, valacyclovir, and famciclovir, to prevent complications and boost faster healing. Other medications may include antidepressants, anticonvulsants, and numbing agents, depending upon the condition.
Although there is no cure for this infection, certain preventive measures can be taken to safeguard oneself from the adversities. Irrespective of the fact if you have had chickenpox or not, it is advisable to get yourself vaccinated. A chickenpox vaccine―varicella vaccine (Varivax)―is given to children, but can be taken by adults who have not had chickenpox. A vaccine for shingles called varicella-zoster vaccine (Zostavax) is given to adults over 50 years of age. Although these vaccines do not guarantee prevention from the emergence of chickenpox or shingles, they would definitely make the experience less troublesome, if these infections are to occur.
The minute one experiences the initial prodromal stage, they should speak to a doctor. Note that in some cases, it may cause potential risk to one's well-being. For instance, occurrence of shingles on the face, especially the area surrounding the eye, may pose potential threat to the eyesight. Therefore, early medical intervention would help in minimizing possible complications. Also, as a precautionary measure, a special caution should be taken by the elderly, pregnant women, children, infants, diabetics, and those with an illness. This is because people who have never had chickenpox, or have a weak immune system, may get infected by the virus. As mentioned earlier, shingles will not infect a person with shingles, but with the virus causing chickenpox.
Disclaimer: This HealthHearty article is meant for informational purposes only and should not be considered as a replacement for expert medical advice.