Shingles During Pregnancy
If you had chickenpox as a child, you will never contract it as an adult. But that doesn't mean you won't have to deal with shingles, which is caused by the highly contagious varicella-zoster virus, the same one responsible for chickenpox. Shingles, which affects an estimated one in five people, is a painful, blistering condition. It can show up at any time, but is especially alarming if it strikes during pregnancy. Fortunately, shingles in pregnancy is rare. And, for most women who develop shingles during pregnancy, the outlook is good.
Symptoms and Diagnosis of Shingles
After an outbreak of chickenpox, usually in childhood, the virus that causes it stays in your body, lying dormant in certain nerve cells. Although your immune system usually keeps the virus in check, anything that affects the immune system's ability to hold back the virus -- illnesses, immunosuppressive drugs, severe stress, or aging-related changes, for example -- can allow the virus to return with a vengeance.
Early symptoms of shingles include burning or shooting pain and tingling or itching, generally on one side of the body or face. For some people, the pain is severe. It may be accompanied by fever, chills, nausea, diarrhea, and difficulty urinating. The pain and tingling are followed by a rash, which begins with reddish bumps, most often on the trunk. In a few days the bumps become fluid-filled blisters, which usually crust over and fall off after seven to 10 days.
Even when the rash goes away, the skin color at the rash site may be different. Also, nerve pain may persist at the site of the rash (a condition called postherpetic neuralgia). About one-fifth of people who get shingles develop postherpetic neuralgia. In most people, the pain goes away within four months from the first sign of the rash.
Shingles is typically easy to diagnose. Your health care provider will suspect shingles if you have a rash on one side of the body, along with sharp, burning pain and a history of chickenpox.
Shingles Treatment During Pregnancy
Treatments can lessen the severity of shingles and reduce the risk of postherpetic neuralgia. These include the antiviral drugs acyclovir (Zovirax), famciclovir (Famvir), and valacyclovir (Valtrex).
If you believe you have shingles, it's important to see your doctor right away, because you must begin one of these medications within a few days of a shingles outbreak for best results. If your doctor prescribes an antiviral medication, it's important to take it exactly as directed. Most are taken once daily for several days. When taken as directed, these drugs should be safe during pregnancy.
In addition to the medications your doctor prescribes, there are over-the-counter (OTC) medications and self-help measures for relieving shingles pain and itching and preventing infection. These include:
- Cold compresses and cool baths to relieve blisters
- Loose clothing and clean gauze coverings over affected areas to hasten healing of blisters and prevent infection
- Antihistamines (particularly Benadryl), oatmeal baths, and calamine lotion to reduce itching
- The OTC painkiller acetaminophen. Before taking any OTC medication, it's important to speak with your doctor. Pregnant women should not take NSAIDs late in pregnancy.