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Will shingles scars go away by themselves or are they permanent?

Will the scars from shingles go away by themselves or are they permanent? Is there anything that can be done to help them fade?

18 October 2018

Shingles is a viral infection known as herpes zoster and is part of the virus family that causes chicken pox.

Shingles presents with flu like symptoms and nerve pain and then pustules form that gradually crust over, usually over a 5 to 7 day period. The virus can persist for a couple of weeks and is limited to specific areas of the body.

You can find more information about the symptoms and treatment of shingles, who you should avoid while you’re infected and more in this NHS Shingles factsheet.

As the pustules scab over it’s important that the scabs are not removed, scratched or knocked off as this can cause bacterial infection to occur, the herpes simplex virus to spread and can also cause the area affected to scar more. The rash can take up to four weeks to heal.

The marks left on the skin once the sore has healed are usually an angry red or purple colour but this will gradually fade over a number of weeks and months. Usually these marks have faded completely a year after the initial infection and there are some steps you can take to help the process along.

Tips to reduce the marking from shingle lesions

  1. Ensure good hygiene and no disruption to the skin surface as it heals

  2. Protect the area from sunlight, which can darken the pigmentation, by applying  high SPF sun creams when exposed to sunlight

  3. Keep the skin well moisturised by using emollients, oils and creams containing ingredients such as Aloe Vera, Vitamin E, Vitamin C and other natural products.

Unfortunately however dilligent you are in following these steps, some scars may still be left. If the scars are very unsightly you may wish to talk to your GP about whether further treatment could help and what options are available. Depending on your circumstances they may refer you to a skin specialist (dermatologist) or plastic surgeon for certain types of treatment or surgery. Be aware that some treatments such as laser therapy may only be available privately. Below is a round-up of the different types of treatment for scarring.

Treatments for scarring

Scars can’t be removed completely but it’s usually possible to make them less noticeable. So if you feel self-conscious about a scar or scarring, or if it’s itchy, painful or restricts your movement in some way it’s worth seeking help. Here are some of the scar treatments available:

Skin camouflage (make-up)

You can buy make-up specially designed to cover scars from some pharmacies. Or for larger areas, the Changing Faces Skin Camouflage Service can help you choose the right colour make-up and teach you how to apply it. Depending on the type and extent of scarring you may be able to get camouflage make-up on the NHS.

Silicone gels or sheets

Prescribable on the NHS, these can help during the healing process to help reduce elevation and pigmentation of the area. They can also help relieve itching caused by the scar.

Steroids

Corticosteroid injections or steroid-impregnated tape can also be used to flatten and reduce the appearance of scarring. Injections are usually administerd in hospital by a specialist (NHS or private) and repeated a number of times.  The tape can be prescribed by a GP or dermatologist for you to apply yourself for up to 12 hours a day. Find out more in steroids factsheet.

Cryotherapy

This where liquid nitrogen is used to freeze the affected area. Used in the early stages it can help flatten certain scars and prevent them from growing, however this method may also cause the surrounding skin to lighten.

Laser therapy

Laser therapy may reduce redness by targeting the blood cells in the scar site. For raised or bumpy scars laser surgery/resurfacing may be used to try to flatten the scar. These treatments are usually only available privately and can be expensive. Before you commit yourself, be sure to check the credentials of the practitioner and their experience of treating scars successfully.

Dermal fillers/skin needling

These relatively common cosmetic procedures can help the appearance of scars by plumping up pitted scars/smoothing the surface of the skin. However they can be costly and treatment needs to be repeated to maintain any effect

Surgery

In more extreme cases, plastic surgery can help to make scarring look more natural and less noticeable. This usually involves a skin graft, whereby healthy skin is taken from an unaffected area of the body and used to cover the damaged tissue. 

You can find out more about scarring and scar treatments in our Ask the Expert response Cream for post operative scarring or in this NHS Scars factsheet.

Finally, if a referral to a specialist is required then it would be wise for you to check your health policy cover if applicable before any appointment or treatment is commenced, as cosmetic surgery is often not covered by healthcare policies.

Answered by the Health at Hand team

Sources and further reading

Cream for post operative scarring – AXA PPP healthcare
Scars – NHS factsheet
Plastic surgery – NHS factsheet

Resources

Changing Faces Skin Camouflage Service

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