Identifying, Treating, And Preventing Shingles Under The Breast

A shingle is a viral infection characterized by a band or cluster of blisters appearing on parts of the body, usually the face or torso. One in three Americans¹ will develop shingles at some point in their lives. 

Like all cases of the infection, a shingles rash under the breasts is uncomfortable and may lead to complications if untreated. This post outlines the process of identifying, treating, and avoiding complications from shingles under the breast.

Signs you have shingles

In the early stage, shingles are often characterized by fatigue and skin sensitivity. You may also experience flu-like symptoms and skin sensations during this period, such as:

• Pain (which may be mild to intense)

• Itching

• Burning

• Tingling

• Sensitivity to touch

Once the infection takes root, you will notice a rash with fluid-filled blisters. These usually appear in clusters but may also form a strip or swath-like pattern on your skin.

The color of the rash depends on skin tone. If you have pale skin, shingles on the nipple or under your breast might appear bright red. But your rash may be red or darker if you have highly pigmented or dark skin.

A shingles rash typically appears on one side of the body, following a specific dermatome (an area of skin supplied by the same nerve root). However, a person may experience shingles affecting three or more dermatomes, and the rash may be more widespread (disseminated shingles). If you have a rash and you’re not sure what’s causing it, consult your doctor. 

Causes of shingles

The varicella-zoster virus causes shingles. It's the same virus responsible for chickenpox. The varicella-zoster virus doesn't leave your body after you have chickenpox. Instead, it becomes dormant. In some cases, the virus is reactivated many years later, and a person develops shingles. 

Risk factors for shingles

First, if you've never had chickenpox or the chickenpox vaccine, you will not develop shingles, even if you come into contact with an infected person. Instead, you will develop chickenpox first and may get shingles later if the virus becomes active again in your body.

Not all people who’ve had chickenpox get shingles, though. Your risk of developing shingles is higher if you:

• Are older (50 or older)

• Have a weakened immune system through illness or treatment

• Have too much stress

It's also possible to get shingles more than once as the virus is always present in your body.

Transmission of shingles

Shingles cannot be passed from one person to another. However, the virus that causes shingles may trigger a chickenpox outbreak in someone who has never had chickenpox (or the chickenpox vaccine) if the person comes into direct contact with fluid from shingles blisters.

Shingles infection is not particularly common in the postpartum period, but the condition can develop at any time. If you’re breastfeeding and you have shingles somewhere else on your body, it may be safe to continue breastfeeding, but speak with your doctor to confirm.

However, if you have shingles on or near your breast, you may need to pump instead, as your child could develop chickenpox from direct contact with the rash. 

The shingles virus does not spread through breast milk, even when it’s active.

Complications associated with shingles

Several complications during an active shingles infection and after recovering. These include:

• Post-herpetic neuralgia (PHN):² This is pain felt around the region where the lesions were after the rashes disappear. The pain usually resolves within a year, but it may last longer. Some people have PHN forever. PHN is most common in people who develop shingles when older and those for whom the shingles infection was exceptionally painful.

• Skin infection: Rarely, shingles can lead to a skin infection. A skin infection associated with shingles usually results from scratching shingles blisters.

• Vision loss: If shingles affect the nerves leading to the eyes, it can trigger an eye infection that may cause vision loss or blindness. Urgent medical treatment is essential to improve outcomes.

If you suspect you have a complication linked to shingles, see your doctor. Some complications are time-sensitive and require medical treatment. 

Treatment options for shingles

Shingles are typically treated with antivirals and pain medications. Your shingles treatment plan will likely include:

• Antiviral medications to reduce the duration and severity of symptoms

• Pain medications to reduce discomfort (over-the-counter or prescription)

• Topical treatments to ease itching (wash your hands immediately after applying topical treatments to reduce the risk of spreading)

• Natural home remedies, such as warm oatmeal baths and wet compresses, to improve discomfort

If you're a mother, you can still breastfeed while taking antiviral medications.

Preventing shingles

The best way to prevent shingles is to get the shingles vaccine. The CDC³ recommends vaccination for all people 50 and older and adults 19 and older who are immunocompromised. 

The Shingrix vaccine is administered in two doses over two to six months and is more effective than the previous Zostavax vaccine, which is no longer offered. 

Reducing stress and taking steps to boost your immunity may also reduce your risk of a shingles outbreak. 

Other conditions that may cause a rash under the breast

Rashes under the breast do not always indicate shingles. Various other conditions look and feel similar to shingles, but specific symptoms distinguish each condition. These include:

• Eczema (red patches in single and multiple clusters that look like hives)

• Psoriasis (red patches in thick silver-white scales)

• Dermatomyositis (dark red or purple rash around the neck)

• Poison ivy (itchy, swollen red skin with blisters)

The lowdown

The varicella-zoster virus causes shingles, which may cause a rash under the breast. Symptoms can range from burning and tingling to itching and pain. You're more at risk of developing shingles under your breast if you have poor immunity or are of advanced age.

Shingles are not transmitted through breast milk, but mothers can pass the virus to a child through direct contact with the rash, resulting in chickenpox in the infant. Speak with your doctor if you have shingles on the breast before breastfeeding your baby.

The best treatment options are antiviral drugs, but combining treatments can help speed up the healing process and improve comfort. Vaccination, stress management, and boosting your immunity can reduce your risk of getting shingles.