How to Identify Shingles Rash Under the Breast

Shingles, or herpes zoster, is a viral infection that causes a painful rash with blisters that often appears as a band in one area of the body, usually one side of the torso. It is caused by the varicella-zoster virus, the same virus that causes chicken pox.

If a person becomes infected with chicken pox as a child, the rash will clear up, but the virus will remain in the body. The virus can reactivate later in life as shingles.

Shingles affects one out of every three people in the United States. The risk of shingles increases as you age, with about half of the cases occurring in men and women 50 years old and older. Most people who get shingles will have it only once, but you can get the disease more than once.

Shingles can cause a rash in the breast area. It can lead to health complications, and should be examined and treated as soon as possible.

Shingles Risk Factors

Verywell / Jessica Olah

What Does Shingles Under the Breast Look Like?

A shingles rash under the breast appears as a long, broad strip around the torso. In the early stages, the rash may look flat or like raised blotches on the skin that are pink and red. When it is fully developed, the rash will:    

  • Be red but could be darker or the same color as the skin on people with dark skin tones
  • Has fluid-filled blisters that form scabs
  • Be painful, with pain often starting before the rash appears
  • Have itchiness or tingling in the area before the rash develops

Why Does Shingles Appear on Only One Side of the Body?

The varicella-zoster virus is active in specific nerves, so shingles often appears where these nerves are located, mainly in a band along one side of the body. This band corresponds to the area where the nerves transmit signals. The shingles rash stays somewhat localized to an area, and it does not spread over your whole body.

Causes and Risk Factors 

The varicella-zoster virus causes shingles. If you are exposed to the virus later in life and have never had chicken pox, then you will develop chicken pox. The virus will stay in your body, and you risk getting shingles at another time. However, most people who have had chicken pox never develop shingles. Risk factors associated with shingles include:

  • Age: The older a person is, the more susceptible they are to developing shingles.
  • Compromised immune system: Because the immune system typically suppresses the development of shingles, those with weakened immune systems tend to be at higher risk for shingles.
  • HIV/AIDS: People with human immunodeficiency virus (HIV) or AIDS are at high risk for getting shingles.
  • Sex: Women are more likely than men to develop shingles.
  • Ethnicity: Whites are more likely to have shingles than people of other races.
  • Nerve injury: People who have damaged dermatomes are more likely to develop shingles. Dermatomes are areas of skin that have a sensory nerve that’s connected to a single spinal nerve root.
  • Genetics: If a person has a family history of shingles, they are more likely to develop it as they age. 
  • Stress: Stressful life events or ongoing stress can contribute to shingles flare-ups. The reactivation of the virus has also been linked to abuse. Other types of stress, including experiencing financial stress, being out of work, losing personal independence, or not having social support, have also been linked to shingles.

Shingles Doctor Discussion Guide

Doctor Discussion Guide Old Man

Other Possible Causes 

Shingles under the breast can sometimes mimic other types of rashes. However, there are important differences between shingles and skin conditions that cause a similar rash.

What Conditions Can Shingles Be Mistaken For?
Condition Appearance Other Symptoms
Psoriasis  Red patches on the skin, silver-white scales, and thick skin that is dry and cracked Pain, itching, soreness, swollen joints, burning in the area
Eczema Red patches that may look like hives in single or multiple clusters, and dry and flaky skin Intense itching
Poison Ivy/Poison Oak Red, swollen, and blistery skin Pain and itching
Dermatomyositis Rash around the neck or under the breast that can be purple or dark red Joint pain, fever, muscle weakness
Shingles Red ribbon-like rash with fluid-filled blisters on one side of the body Pain, itching, fatigue, flu-like symptoms

Treatment 

There is no cure for the shingles rash, but treatments can help you cope with and manage the symptoms. Treatment depends on your:

  • Age
  • Medical history
  • Overall health
  • How long you’ve had shingles
  • Severity of the flare-up

Some medications can help relieve the discomfort of your symptoms, including:

  • Antivirals: Some antiviral medications such as Zovirax (acyclovir) or Famvir (famciclovir) can help decrease the duration of symptoms, especially if these drugs are started within 72 hours of the first sign of shingles.
  • Pain medications: Shingles can be painful, and you can take pain medications for relief, such as Tylenol (acetaminophen) or Advil or Motrin (ibuprofen).

You can also use anti-itch creams and lotions to cope with the symptoms. Cool compresses may help relieve the pain and itching. Other natural remedies include taking an oatmeal bath, applying a baking soda paste, or using topical witch hazel.

When to See a Doctor

If you think you have shingles under your breast, you should see your doctor. Prompt treatment can reduce the duration of symptoms and prevent infection or further complications.

Breastfeeding with Shingles

Shingles cannot be passed from one person to another and cannot be spread to an infant through breast milk. However, the varicella-zoster virus can spread from a person who has active shingles and cause chicken pox in someone who has never had chicken pox or has never received the chicken pox vaccine (varicella vaccine). The virus is spread through direct contact with fluid from the rash blisters caused by shingles.

If you have an active shingles infection, you can continue to breastfeed if you don't have skin lesions on your breast. If a lesion develops on or near the areola, where the infant’s mouth would touch the lesion while breastfeeding, you need to express your milk on that side to maintain your milk supply and prevent mastitis, an inflammation of the breast tissue that may be infected.

You can discard that milk until the infant can resume nursing directly at that breast. You may need access to a hospital-grade pump and additional lactation support to maintain your milk supply and reduce the possibility of developing a breast infection.

Before expressing breast milk, you should wash your hands well with soap and water and, if you're using a pump, follow recommendations for proper cleaning. Breastfeeding can continue on the unaffected breast.

All lesions should be covered with clean, dry bandages until they are healed to avoid direct contact with your baby. You need to be vigilant about handwashing until all lesions are fully crusted over.

You also can continue to breastfeed while you are taking antiviral medications to treat shingles.

Prevention 

There currently is just one vaccine that you can take to help lower your risk of developing shingles. The vaccine that is available in the United States is Shingrix.

Another shingles vaccine called Zostavax was used in the United States prior to November 2020, but it's no longer available. The Shingrix vaccine has been shown to be 90% effective at preventing shingles.

The shingles vaccine is recommended for most adults ages 50 and older regardless of whether they have already had shingles in the past or whether they have had a prior dose of Zostavax, unless a contraindication or precaution exists. Shingrix also is available to adults who:

  • Are taking low-dose immunosuppressive therapy
  • Have immunosuppression
  • Have recovered from an immunocompromising illness
  • Are getting other adult vaccines in the same doctor’s visit, including those routinely recommended for adults ages 50 years and older, such as influenza and pneumococcal vaccines.

It is not necessary to screen, either verbally or by lab tests, for evidence of prior varicella infection.

However, Shingrix should not be administered to:

  • People with a history of severe allergic reaction, such as anaphylaxis, to any component of the vaccine or after a previous dose of Shingrix
  • People who have tested negative for immunity to varicella-zoster virus and never had chicken pox or recieved the varicella vaccine (They should get the varicella vaccine instead.)
  • People who currently have shingles

Pregnant people and people who are ill can consider delaying their vaccination, but they should still get it later.

Summary

Shingles can develop under the breast due to reactivation of the chicken pox virus. When it affects the breast, it causes a blistering rash that looks like a long, broad strip around the torso from under the breast.

The condition can be treated with antivirals and pain medications to alleviate discomfort. The virus is transmitted through contact with the fluid from the blisters, so you can continue breastfeeding if you don't have lesions on or around your breasts that your child can be exposed to. The best way to prevent shingles is to get the shingles vaccine.

A Word From Verywell

Having shingles under the breast can be painful and uncomfortable. However, there are ways that you can manage your shingles to help ease symptoms while you wait for the rash to run its course.

In terms of dealing with further outbreaks, the good news is that even if you’ve had shingles in the past, you can get vaccinated. Once you do that, you will lower your chances of having flare-ups in the future.

Frequently Asked Questions 

What are the first signs of shingles?

The early signs of shingles are typically pain, itching, and tingling in an area of the body where the rash will develop. It could occur days before the rash appears. When the rash does appear, it will start out as pink or red blotches that could be flat or raised.

Why does shingles develop under the breast?

Shingles can develop under the breast because of reactivation of the chicken pox virus from nerves around this area. Typically, the rash will appear on the torso and wrap around the body in a ribbon-like way. In some cases, the rash can be on the breasts and affect the areola, the area around the nipples.

What makes shingles go away?

The shingles rash usually goes away on its own. Several antiviral medicines, including Zovirax (acyclovir), Valtrex (valacyclovir), and Famvir (famciclovir), can be used to treat shingles and shorten the length and severity of the illness. In the meantime, people with the rash can treat the symptoms to ease the discomfort. The life cycle of a shingles rash is about a month.   

Is shingles contagious?

You cannot give shingles to someone else. However, if you have an active shingles flare-up and skin-to-skin contact with someone who has never had chicken pox or has never been vaccinated for chicken pox, they can catch the varicella-zoster virus. The virus will develop into chicken pox, not shingles.

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9 Sources
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