Disseminated Shingles: All You Need To Know About Its Symptoms, Causes, And Treatment

If you've been feeling pain, itching, and burning sensations accompanied by a rash on your skin, you may have shingles. Shingles are a stripe of blisters that appear in localized areas around the upper body. 

Research shows about 1.2 million Americans suffer from shingles yearly. If untreated, shingles can spread to other parts of the body, becoming disseminated shingles.¹

This article outlines what disseminated shingles look like, the causes, treatment, and prevention.

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What has disseminated shingles?

Shingles, or herpes zoster, is a condition that triggers a painful, blistering rash on your skin. Usually, the rash appears in one or two dermatomes (areas of skin attached to spinal nerves) around the face, throat, chest, and nearby regions.

Disseminated shingles are when more than 20 shingles blisters deviate outside the central cluster and spread over three or more dermatomes. 

Examples of areas where disseminated shingles may appear include:

  • Face: Shingles can appear in multiple areas, including your ears, mouth, and scalp

  • Back and chest: A stripe of blisters may appear on your lower back and chest regions

  • Buttocks: Disseminated shingles may appear on both buttocks or one buttock

  • Eyes: Rashes appear on the eyelids, forehead, and nose (ophthalmic herpes zoster)

Causes of disseminated herpes zoster

The primary cause of disseminated shingles is the varicella-zoster virus (VZV). It's the same virus that causes chickenpox and normal shingles. Even after you recover from chickenpox, the virus deactivates and stays in your body for years. 

Various factors can increase the risk of the virus reactivating and traveling across the nervous system again. These include:

  • Low immunity

  • Cancer treatments

  • Excess exposure to sunlight

  • Some organ transplant drugs

Stress or illnesses like the flu that lower body immunity can also cause reactivation of the varicella virus.

Symptoms of disseminated shingles

Disseminated herpes zoster has similar characteristics as chickenpox but with more severe effects. According to the Centers for Disease Control and Prevention (CDC), common symptoms include:²

  • Burning or shooting pain

  • Fluid-filled blisters

  • Itchiness or tingling

  • Painful rash (the color depends on your skin tone)

Additional symptoms you may experience include:

  • Headache

  • Fever

  • Sensitivity to light

  • Fatigue

  • Muscle tightness

If you have any disseminated shingles symptoms around the eye, seek immediate medical attention to prevent permanent eye damage. Also, red and swollen skin regions may have a bacterial infection that requires treatment.

Are disseminated shingles contagious?

You can contact the varicella-zoster virus upon contact with an open blister or rash if you’ve never had chickenpox. When the virus infects you for the first time, it causes chickenpox, not shingles. 

If you’ve had chickenpox before, you cannot catch shingles or chickenpox from an infected person. Shingles occur when the varicella-zoster virus reactivates in your body. 

To reduce the risk of spreading VZV to uninfected people, you should cover up the shingles blisters or wait until they become scabbed over.

Who is more at risk of disseminated shingles?

Anyone who's had chickenpox can develop shingles at any point in their lifetime since the varicella virus remains inactive in the body. While research is still ongoing on what reactivates the virus, researchers have found some risk factors for shingles. These include:

  • Older age: According to research, about 50% of people with shingles are over 60, with the risk of contracting the virus increasing as they approach 70.³

  • Compromised immunity: Studies show 15–30% of shingles affect those with a lowered immune system due to disease and treatment processes.⁴

Although shingles occur once in a lifetime for most people, you can develop them more than once.

Diagnosis, treatment, and prevention for disseminated shingles

If you suspect disseminated shingles, seek medical attention immediately. A doctor can diagnose the condition and determine its extent by examining your blisters and rashes. They may also need to collect a sample from the blisters or rashes to confirm the virus is present.

Once the tests detect the presence of VZV, your doctor may administer a series of treatments. The first treatment for disseminated shingles is typically intravenous antiviral medication like acyclovir, especially if you’re immunocompromised.

Your doctor may also administer pain relief medication such as morphine. If your symptoms improve, your doctor may prescribe oral acyclovir to take at home.

Disseminated shingles prevention and coping tips

The recommended shingles prevention method is the Shingrix vaccine. It has been the go-to vaccine for disseminated shingles since its approval in 2017.

Shingrix is given in two doses, with two to six months between doses. The vaccine offers protection for five years, after which you may require another. Shingrix is safe and effective in preventing shingles, although it doesn't guarantee you will never get it. Minor side effects after the vaccine include fatigue and headaches. 

However, talk to your healthcare provider before taking the vaccine if you:

  • Had an allergic reaction to any vaccine

  • Had a stem cell transplant recently

  • Are pregnant

  • Have a weak immune system due to a health condition or treatments

The lowdown

A shingle is a painful rash that causes blisters on one side of the face. When more than 20  blisters extend beyond one area, it becomes disseminated shingles. Disseminated herpes zoster can affect various body areas, including the lower midline of the body.

Shingles often impact older adults and those with weak immune systems. Treatment involves antiviral medications, while prevention requires vaccination. Talk to your doctor about getting the vaccine if you’re worried about your shingles risk.

FAQs on disseminated shingles

Are shingles contagious through the air?

The varicella virus can't be transmitted via air when someone sneezes or coughs. Instead, the virus spreads when you come into contact with an open blister or rash from an infected person.

Who should take the vaccine?

You need to get the Shingrix vaccine if you have already had chickenpox or the chickenpox vaccine. As a safety precaution, you should get vaccinated if you don't remember having chickenpox or receiving the Zostavax vaccine.

How do I cope with disseminated shingles?

If you have disseminated shingles, you can manage symptoms by taking medication and keeping the blisters and rashes clean, soothing your skin, and applying a cool washcloth.

  1. Shingles (Herpes zoster) | Centers for Disease Control and Prevention

  2. Signs & symptoms | Centers for Disease Control and Prevention

  3. Shingles | National Institute on Aging

  4. A case of disseminated zoster in an immunocompetent patient (2019)

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