What makes shingles flare up

National Institute of Neurological Disorders and Stroke toll-free braininfo ninds. National Shingles Foundation shingles shinglesfoundation. NIA scientists and other experts review this content to ensure it is accurate and up to date.

Breadcrumb Home Health Information Shingles. On this page: What is shingles? What are the symptoms of shingles? How is shingles diagnosed and treated? How long does shingles last? Am I at risk for shingles? When should I get the shingles vaccine? Tips for coping with shingles. Sign up for email updates about healthy aging.

As well as painkilling medication, some people with shingles may also be prescribed a course of antiviral tablets lasting 7 to 10 days. Commonly prescribed antiviral medicines include aciclovir, valaciclovir and famciclovir.

Antiviral medicines are most effective when taken within 72 hours of your rash appearing, although they may be started up to a week after your rash appears if you are at risk of severe shingles or developing complications.

If you are over 50 years of age and have symptoms of shingles , it is likely you will be prescribed an antiviral medication. If you are pregnant and have shingles, it is likely your GP will discuss your case with a specialist to decide whether the benefits of antiviral medication significantly outweigh any possible risks. Shingles will not harm your unborn baby. If you are under 50 years of age, you are at less risk of developing complications from shingles anyway, so you may not need antiviral medication.

Antiviral medication is not usually necessary for otherwise healthy children because they usually only experience mild symptoms of shingles and have a small risk of developing complications. However, if your child has a weakened immune system, they may need to be admitted to hospital to receive antiviral medication directly into a vein intravenously.

To ease the pain caused by shingles, your GP or pharmacist may recommend painkilling medication. Some of the main medications used to relieve pain associated with shingles are described below. The most commonly used painkiller is paracetamol , which is available without a prescription.

Always read the manufacturer's instructions to make sure the medicine is suitable and you are taking the correct dose. Non-steroidal anti-inflammatory drugs NSAIDs , such as ibuprofen , are an alternative type of painkilling medicine also available without a prescription.

For more severe pain, your GP may prescribe an opioid, such as codeine. This is a stronger type of painkiller sometimes prescribed alongside paracetamol. Occasionally, your GP may consider seeking specialist advice before prescribing an even stronger opioid, such as morphine. If you have severe pain as a result of shingles, you may be prescribed an antidepressant medicine. These medications are commonly used to treat depression , but they have also proven to be useful in relieving nerve pain, such as the pain associated with shingles.

The antidepressants most often used to treat shingles pain are known as tricyclic antidepressants TCAs. Examples of TCAs most commonly prescribed for people with shingles are amitriptyline, imipramine and nortriptyline.

If you have shingles, you will usually be prescribed a much lower dose of TCAs than if you were being treated for depression. This will usually be a tablet to take at night. Your dose may be increased until your pain settles down. It may take several weeks before you start to feel the antidepressants working, although this is not always the case. Anticonvulsants are most commonly used to control seizures fits caused by epilepsy , but they are also useful in relieving nerve pain.

As with antidepressants, you may need to take anticonvulsants for several weeks before you notice it working. If your pain does not improve, your dose may be gradually increased until your symptoms are effectively managed.

Complications can sometimes occur as a result of shingles. They are more likely if you have a weakened immune system the body's natural defence system or are elderly.

Postherpetic neuralgia is the most common complication of shingles. It's not clear exactly how many people are affected, but some estimates suggest that as many as one in five people over 50 could develop postherpetic neuralgia as the result of shingles.

Postherpetic neuralgia can cause severe nerve pain neuralgia and intense itching that persists after the rash and any other symptoms of shingles have gone. Postherpetic neuralgia sometimes resolves after around three to six months, although it can last for years and some cases can be permanent. It can be treated with a number of different painkilling medicines. If one of your eyes is affected by shingles ophthalmic shingles , there is a risk you could develop further problems in the affected eye, such as:.

If not treated promptly, there is a risk that ophthalmic shingles could cause a degree of permanent vision loss. Ramsay Hunt syndrome is a complication that can occur if shingles affects certain nerves in your head. In the US, Ramsay Hunt syndrome is estimated to affect 5 in , people every year and it may affect a similar number of people in the UK. Ramsay Hunt syndrome is usually treated with antiviral medication, corticosteroids and painkilling medication.

The earlier treatment is started, the better the outcome. Around three-quarters of people given antiviral medication within 72 hours of the start of their symptoms usually make a complete recovery. Those who don't make a full recovery may be left with permanent problems, such as a degree of permanent facial paralysis or hearing loss.

A number of other possible problems can also sometimes develop as a result of shingles, including:. Shingles is rarely life threatening, but complications such as those mentioned above mean that around 1 in every 1, cases in adults over the age of 70 is fatal. Home Illnesses and conditions Infections and poisoning Shingles. Shingles See all parts of this guide Hide guide parts 1. About shingles 2. Symptoms of shingles 3. Causes of shingles 4. Diagnosing shingles 5. Treating shingles 6. These signs and symptoms may include:.

Pain is usually the first symptom of shingles. For some, it can be intense. Depending on the location of the pain, it can sometimes be mistaken for a symptom of problems affecting the heart, lungs or kidneys. Some people experience shingles pain without ever developing the rash.

Most commonly, the shingles rash develops as a stripe of blisters that wraps around either the left or right side of your torso. Sometimes the shingles rash occurs around one eye or on one side of the neck or face. Contact your doctor promptly if you suspect shingles, but especially in the following situations:. The shingles rash is associated with an inflammation of nerves beneath the skin.

Anyone who's had chickenpox may develop shingles. After you recover from chickenpox, the virus enters your nervous system and lies dormant for years. Eventually, it may reactivate and travel along nerve pathways to your skin — producing shingles. But, not everyone who's had chickenpox will develop shingles.

The reason for shingles is unclear. But it may be due to lowered immunity to infections as you grow older. Shingles is more common in older adults and in people who have weakened immune systems. Varicella-zoster is part of a group of viruses called herpes viruses, which includes the viruses that cause cold sores and genital herpes.

Because of this, shingles is also known as herpes zoster. But the virus that causes chickenpox and shingles is not the same virus responsible for cold sores or genital herpes, a sexually transmitted infection.

A person with shingles can pass the varicella-zoster virus to anyone who isn't immune to chickenpox. This usually occurs through direct contact with the open sores of the shingles rash. Once infected, the person will develop chickenpox, however, not shingles. In one out of three people, the virus fires up again in adulthood as shingles.

The question that remains largely unanswered despite research is what triggers VZV to reactivate into shingles? Aging is the strongest risk factor for this decline in immunity.

Statistically, half of all shingles cases in the United States are diagnosed in people aged 50 or older, and the risk continues to rise exponentially with each additional decade of life.