Managing Shingles During Pregnancy: Concerns and Treatment Options

Developed shingles at 37 weeks of pregnancy?

Hello, Doctor.
I am currently 37 weeks and 3 days pregnant and was diagnosed with shingles two days ago.
The blisters are primarily located on the right side of my forehead and above my right eyelid.
During my visit, the doctor prescribed Acylovir to be taken for 7 days (four times a day) along with a topical ointment.
I would like to ask the following questions:
1.
Since I am scheduled to be induced on the day of 38 weeks and 4 days, if I take the medication as prescribed, will I be able to recover quickly? If I am not fully healed by the time of induction, will it have any impact on the baby's birth?
2.
Today, I have started to feel some swelling and pain in the lymph nodes under my right ear.
Is this related to the shingles?
Thank you.

Miss Du, 30~39 year old female. Ask Date: 2022/11/26

Dr. Wu Yuxin reply Dermatology

1.
It takes about a week to heal, and the fetus will have the mother's antibodies for the first few months, which has a minimal impact.
2.
Related.

Reply Date: 2022/11/26

More Info

Managing shingles during pregnancy can be a complex issue, particularly as you approach your due date. Shingles, or herpes zoster, is caused by the reactivation of the varicella-zoster virus, which also causes chickenpox. During pregnancy, the immune system is altered, which can affect how the body responds to infections, including shingles.

1. Treatment and Recovery Timeline: You mentioned that your doctor has prescribed Acyclovir (Acylete) to be taken four times a day for seven days. Acyclovir is an antiviral medication that is considered safe for use during pregnancy, particularly in the second and third trimesters. It can help reduce the severity and duration of shingles outbreaks. If you adhere to the prescribed regimen, you should see improvement in your symptoms within a few days. However, the complete resolution of the rash and associated pain may take longer, sometimes up to two to four weeks.
Regarding your concern about the timing of labor, if you are still experiencing symptoms of shingles at the time of induction, it is essential to communicate this with your healthcare provider. While shingles itself does not typically pose a direct risk to the baby during delivery, the presence of active lesions can complicate matters, especially if they are located in areas that could come into contact with the baby during birth. If you have not fully healed, your healthcare team may take precautions to minimize any potential risks, such as considering a cesarean delivery if there are lesions in the genital area or if there is a risk of transmission.

2. Lymph Node Swelling and Pain: The swelling and pain you are experiencing in the lymph nodes near your ear could indeed be related to your shingles outbreak. Shingles can cause lymphadenopathy (swelling of the lymph nodes) in the affected area due to the immune response to the virus. The lymph nodes act as filters for the lymphatic system, and when there is an infection, they can become swollen as they work to fight off the virus. This is a common response and is usually not a cause for alarm. However, if the swelling worsens, or if you develop additional symptoms such as fever, increased pain, or any signs of systemic infection, you should contact your healthcare provider immediately.

Additional Considerations: It is crucial to monitor your symptoms closely and maintain open communication with your healthcare provider throughout this process. They may recommend additional supportive care, such as pain management strategies, to help alleviate discomfort associated with shingles.
In summary, while shingles during pregnancy can be concerning, with appropriate antiviral treatment and monitoring, you can manage the condition effectively. Ensure that you follow your doctor's instructions regarding medication and report any new or worsening symptoms promptly. Your healthcare team is there to support you and ensure the best possible outcome for both you and your baby.

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