Shingles recovery in pregnancy

Overview

Shingles is a painful rash caused by the same virus that causes chickenpox. It can happen to anyone who had chickenpox before. In pregnancy, it requires extra care to protect both the mother and the baby.

Shingles in pregnancy is uncommon. Most pregnant women have had chickenpox and are immune, so shingles is rare during pregnancy.

It affects pregnant women who have had chickenpox in the past, especially if they have a weakened immune system or high stress.

Symptoms

Common symptoms

• Pain, burning, or tingling on one side of the body
• A red rash that turns into fluid-filled blisters
• Itching or sensitivity to touch
• Fever, headache, feeling tired

Causes

Main causes

• Shingles is caused by the reactivation of the varicella-zoster virus (the same virus that causes chickenpox).
• After chickenpox, the virus stays dormant in nerve tissue and can reactivate later in life, especially when the immune system is weak.

Risk factors

• Being pregnant (pregnancy changes the immune system)
• Having a weakened immune system (due to illness or certain medications)
• High stress or fatigue
• Being over 50 (but pregnancy can be an exception)

When to see a doctor

See a doctor urgently if:

• If the rash appears near your eye
• If you have a severe headache or stiff neck
• If you have trouble breathing
• If you have a high fever

Book a routine appointment if:

• If you suspect you have shingles, contact your midwife or GP as soon as possible
• If you have any rash and you're pregnant, it's always safest to check with a doctor

Diagnosis

Your doctor can usually diagnose shingles by looking at the rash. They may take a sample from a blister to confirm the virus.

Tests that may be done

• Physical examination of the rash
• Blister fluid test (PCR test) to identify the virus

What to expect at your appointment

If you are diagnosed with shingles during pregnancy, your healthcare team will monitor you and your baby. You may be referred to a specialist for extra checks.

Treatment

Treatment focuses on relieving pain and helping the rash heal quickly. Antiviral medication is sometimes recommended but must be discussed with your doctor. Pain relief options include paracetamol (avoid ibuprofen unless advised). Cool compresses and soothing creams can help.

Self-care at home

• Keep the rash clean and dry to avoid infection
• Apply cool, wet compresses to soothe itching
• Wear loose, soft clothing to avoid rubbing the rash
• Rest and manage stress – stress can make shingles worse

Medical treatments

Your doctor may consider antiviral medicines to shorten the illness. These are most effective if started within 72 hours of the rash. Only take medicines that your doctor or midwife approves for use in pregnancy. Always check with them before using any new treatment, including over-the-counter pain relievers.

When is surgery considered?

Not applicable.

Living with this condition

Recovery from shingles can take a few weeks. You may feel tired and have nerve pain even after the rash clears. It's important to take care of yourself and follow your healthcare provider's advice.

Lifestyle tips

• Get plenty of rest and sleep
• Avoid scratching the rash
• Keep stress low – try gentle activities like walking or listening to calming music
• Stay in touch with your healthcare provider

Diet and exercise

Eat a balanced diet with plenty of fruits, vegetables, and protein to support your immune system. Gentle exercise like short walks is fine, but listen to your body. Avoid intense activity until you feel better.

Mental health and emotional wellbeing

Having shingles while pregnant can be worrying. You may feel anxious about the baby's health. It's normal to have these feelings. Talk to your midwife or doctor about your worries. If you feel overwhelmed, distress, or loss of hope, please reach out for help. You are not alone.

Prevention

There is no sure way to prevent shingles reactivation, but a healthy lifestyle and stress reduction may lower your risk. The shingles vaccine is not recommended during pregnancy, so it's best to discuss the risks and benefits with your doctor if you are planning a pregnancy or have had shingles before.

Vaccines

Shingles vaccines are not given during pregnancy. If you have never had chickenpox, you can be vaccinated before pregnancy. Talk to your doctor about your vaccination status.

Screening programmes

There is no routine screening for shingles in pregnancy. Diagnosis is based on symptoms.

Complications

If left untreated

• Postherpetic neuralgia - long-term nerve pain after the rash heals
• Bacterial skin infection from scratching
• Spread of the virus to other parts of the body (very rare)
• If the rash affects the eye, it can lead to vision loss

Long-term outlook

Most pregnant women recover fully from shingles with no lasting problems. The baby is usually not affected, especially if the mother had chickenpox before. With good care and rest, you can expect to heal within 2 to 4 weeks. Nerve pain may last longer, but treatments are available. Remember to reach out for support if you need it.

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