Shingles: The warning signs that appear ‘several days’ before rash include pain


It’s probably been years since you battled the itchy condition common in children known as chickenpox. While this health problem might be long gone, the virus that triggers it stays in your nervous tissue. Known as the varicella-zoster virus (VZV), it can cause shingles later in life. Three key sensations could break the news of the virus resurfacing.

Dr Deborah Lee from Dr Fox Online Pharmacy said: “After the primary infection, which causes chickenpox, VZV becomes latent in the nervous tissue.

“Latency means the virus is still alive, but in a resting state, and is not actively reproducing, so does not cause symptoms.

“When an attack of shingles occurs, the virus reactivates inside the nerve cells that supply a specific dermatome.”

However, this doesn’t happen without your body ringing the alarm bells.

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The Centers for Disease Control and Prevention (CDC) explains that pain, itching, or tingling often appear “several days” before the rash in the area where the skin sign will strike down. 

Dr Lee said: “There are three stages of shingles – the pre-eruptive phase, the acute exudative phase and the chronic phase.

“The pre-eruptive phase occurs 48 hours before any skin lesions are visible but can last up to 10 days in rare cases. 

“Common symptoms include feeling unwell, headaches, photophobia, fever, and strange feelings of burning or pricking in the skin, in one specific area where in due course the rash becomes apparent.”

After the pain, itching and tingling alert of shingles, the next symptom that appears is the telltale rash. This happens during the exudative phase.

Dr Lee continued: “In the acute exudative phase, the patient continues to feel unwell, but has now developed a skin rash and has severe pain at the site. 

“The rash starts with small macules – flat collections of fluid in the skin – which quickly coalesce to form vesicles (blisters).”

Unfortunately, you might not be out of the woods just yet once this stage ends.

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The expert added: “The chronic phase is known as post-herpetic neuralgia (PHZ). 

“[Around] 20 percent of those who have shingles are said to develop PHZ. This is persisting pain at the shingles site lasting for more than four weeks after the lesions have healed. 

“The pain can be burning, tingling, and severe, can last for months or sometimes years, and can be very disabling.”

The NHS advises getting help as soon as you think you might be suffering from shingles to “avoid” longer-lasting problems.

The health body explains that taking medicine could help speed up recovery but it works best when taken within three days of your initial symptoms.

So being able to identify the warning sensations, ranging from tingling to pain, could play an important role.

The doctor added: “Your GP may prescribe an antiviral medication such as aciclovir for seven to 10 days.

“However, not everyone needs antivirals – it is usually reserved for older patients, those who are immune suppressed, or those with a severe attack.”



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