Shingles: symptoms and early treatment by video

Shingles is caused by the chickenpox virus. After chickenpox, the virus stays dormant in the body and can reactivate years later as a painful rash, almost always on one side of the body or face, often in a stripe.

The most common complication is nerve pain that continues after the rash heals, called postherpetic neuralgia. According to the CDC, 10% to 18% of people with shingles get it, and the risk rises with age.

Here is how the video visit works:

A few days before the rash, many people feel pain, tingling or itching in one area of skin, sometimes with fever. Then a painful rash appears, often itchy, on one side of the face or body. If you are not sure what your rash is, see skin rash.

The blisters scab over in 7 to 10 days and the rash clears in 2 to 4 weeks.

• Pain, tingling or itching of the skin before the rash
• A painful rash on one side of the face or body
• Blisters that scab over in 7 to 10 days
• Fever
• Headache
• Chills

Antiviral medicines (acyclovir, valacyclovir and famciclovir) can shorten shingles and make it milder. The CDC says they should be started as soon as possible after the rash appears. The doctor decides whether one is right for you, based on your evaluation.

Over-the-counter or prescription pain relievers help with the pain. We do not prescribe controlled substances. For itching, the CDC mentions wet compresses, calamine lotion and lukewarm oatmeal baths. Keep the rash clean and covered.

Shingles is usually recognized by how the rash looks. If the doctor needs more information, she gives you a lab order for a lab near you. If pain continues after the skin heals, book again: the doctor helps you manage it.

You cannot catch shingles from someone. But a person who never had chickenpox or the chickenpox vaccine can catch the virus through direct contact with fluid from the blisters, or by breathing in virus particles from them, and would get chickenpox, not shingles.

The virus stops spreading once the blisters scab over. Until then, cover the rash and avoid contact with pregnant people who have not had chickenpox or the vaccine, premature or low-birth-weight babies, and people with weakened immune systems.

The CDC recommends 2 doses of the recombinant shingles vaccine for adults 50 and older, and for adults 19 and older with a weakened immune system, even if they have had shingles before. Ask about it at your pharmacy or with your doctor.

Children can get shingles, although it is not common. We see children of all ages, with a parent or legal guardian on camera for the whole visit. For their safety, a baby under 3 months old with a fever of 100.4 °F (38 °C) or higher needs emergency care right away. For other rashes, see rashes in children.

For your safety, go to the emergency room or call 911 if you have any of these signs. See also when to go to the ER.

• A rash near the eye, on the forehead or on the tip of the nose, or changes in vision: shingles can affect the eye
• Confusion, a severe headache with a stiff neck, weakness or changes in hearing
• A rash spread over much of the body, especially if your immune system is weakened
• High fever, or blisters with pus and spreading redness