From the Guidelines
Shingles does not always present with blisters, as some individuals may experience pain without visible lesions or develop red bumps that do not progress to blisters. The presentation of shingles can vary, with the classic rash beginning as red, painful patches that develop into fluid-filled blisters within 1-2 days 1. However, some people may experience only pain without visible blisters, a condition called zoster sine herpete. In other cases, the rash might appear as red bumps without progressing to blisters.
Key Points to Consider
- Shingles is caused by the reactivation of the varicella-zoster virus, which has remained dormant in nerve tissues 1.
- The virus reactivates and travels along nerve pathways to the skin, typically causing pain, tingling, or burning sensations before any visible rash appears.
- Antiviral medications like acyclovir, valacyclovir, or famciclovir are most effective when started within 72 hours of rash onset and can reduce the severity and duration of symptoms 1.
- It is essential to seek medical attention promptly if shingles is suspected, as early treatment can significantly improve outcomes.
Treatment and Prevention
- Treatment for shingles typically involves antiviral medications, with oral acyclovir or valacyclovir recommended for uncomplicated cases 1.
- Disseminated or invasive herpes zoster requires treatment with intravenous acyclovir and a temporary reduction in immunosuppressive medication 1.
- Prevention of primary varicella zoster infection can be instituted in varicella-susceptible patients after exposure to individuals with active varicella zoster infection 1.
From the Research
Shingles and Blisters
- Shingles, also known as herpes zoster, is a viral infection that causes a painful rash, usually on one side of the body 2, 3, 4.
- The rash typically progresses to clear vesicles that become cloudy and crust over in seven to 10 days 2.
- However, not all cases of shingles have blisters, as some people may experience only pain or a mild rash 4.
- The presence of blisters is a common symptom of shingles, but it is not a universal symptom, and some people may not develop blisters at all.
Symptoms of Shingles
- The symptoms of shingles can vary from person to person, but common symptoms include:
- Pain or burning sensation on one side of the body
- Red rash that progresses to blisters
- Fever
- Headache
- Fatigue
- In some cases, people may experience symptoms such as abnormal skin sensations, malaise, or low-grade fever before the rash appears 2, 3.
Treatment of Shingles
- Antiviral medications such as acyclovir, valacyclovir, or famciclovir can help shorten the duration of the rash and reduce the risk of complications 2, 3, 5, 6.
- Treatment with these medications is most effective when started within 72 hours of the onset of symptoms 2, 6.
- In addition to antiviral medications, other treatments such as pain relievers, corticosteroids, or topical creams may be used to manage symptoms and prevent complications 3, 4, 5.