First signs of shingles
There are some early symptoms associated with the shingles virus. These early warning signs can occur many days before the more apparent symptoms arise. These tend to occur where the shingles rash will eventually develop. Acute neuralgia is frequently the initial and earliest symptom of shingles, occurring in 70 – 80% of patients. Acute neuralgia manifests as burning, tingling, or itching. The way acute neuralgia is experienced, and the intensity of discomfort, tends to vary throughout the course of the shingles outbreak, yet usually persists until the shingles rash is healed. Other early symptoms of shingles include:
- Sharp pains
- Sensitivity to touch
Symptoms of shingles
Once the first signs of shingles arise (which are often missed or ignored), it generally takes somewhere between 2 to 5 days for the more obvious symptom of shingles to manifest – the rash. A shingles rash typically appears on one side of the torso or face, often in a band-like, unilateral. The pigment of the rash varies between a pinkish color all the way to a deep red. Although noticeable to most, some people miss this shingles symptom as well. Usually within two weeks of its development, the rash will turn into small blisters (vesicles) filled with clear fluid. The blisters will scab over, and eventually begin to fade. If rubbed by clothing, or scratched, the blisters can burst, causing the internal fluid to be exposed (one common way shingles is easily transmitted to others). In most cases, the rash and blisters will heal within 2 to 4 weeks (once healed, the individual is no longer considered contagious). It is common for people to experience many of the same symptoms when the shingles rash is active, as they did prior to the rash developing (i.e. – pain, itching, headache, nausea, etc.)
Those with compromised immune systems may experience a rash that is atypical in appearance, spreading throughout the body, rather than being concentrated in one area.
Pain virtually always accompanies a shingles rash, and is considered the chief symptom of the shingles virus. This pain is typically described in one of the following ways:
- Constant aching, throbbing, and/or burning pain
- Intermittent shooting pains
- Spasms comparable to small electric shocks
Characteristically, the pain is more severe at night. Temperature changes may also affect pain intensity. Fortunately, the pain associated with shingles generally does not have huge impacts on daily life. But in rare cases, the pain of the shingles virus can be more extreme, impacting work, sleep, mood, and ultimately, daily functioning. Some report the significant impact on daily functioning has led to lethargy, decreased appetite, social withdrawal, and even depression. Also in rare cases, the rash is painless (more common in children with shingles).
The experience of increased levels of pain (compared to what is considered “normal” with the shingles virus) is defined in one of two ways:
- Allodynia – this pain occurs from minimal stimulation, such as the light touch of fabric from clothing on the skin or a cold wind grazing the body.
- Hyperalgesia – this is a more intense pain response to what might be considered a normally painful experience. Also hyperalgesia can cause the pain to diffuse throughout the body, rather than being concentrated to the area where the shingles rash develops.
Although pain is considered the primary symptoms of the shingles virus, many individuals report itching (postherpetic itch) as an equally significant symptom rather than pain. Although uncommon, in some cases the itching can be disabling.