What to know about a shingles rash on your ankle

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Overview

Shingles is caused by the varicella-zoster virus (VZV), the same virus that causes chickenpox. If you’ve ever had chickenpox, you have a chance of developing shingles later in life. However, you can still contract shingles if you haven’t had chickenpox.

You will most likely notice a shingles rash as a stripe on your waist and back, and only on one side of your body. But it can develop anywhere on your body, including one of your feet or ankles.

Wherever shingles develops, it can be quite painful, and it is transmissible. It’s important to avoid contact with others while you recover to prevent transmitting the virus. You can still pass on the virus until the last blister dries and scabs over.

Symptoms of a shingles rash on your ankle

Shingles is very common. According to the American Academy of Dermatology (AAD), more than 1 million people a year receive a shingles diagnosis.

The most striking symptom of shingles is the rash it causes. At first, you may notice discoloration in patches, also known as macules. These will then develop into a blistering rash, usually on your chest or torso.

The rash normally develops on only one side of your body and will be:

• discolored
• painful
• fluid-filled
• itchy

While rare, it’s possible to develop a shingles rash on your ankle. This is because a shingles infection affects your nerves, which are also present in your feet. Developing a shingles rash on your feet may lead to complications such as drop foot, so it’s important to speak with a healthcare professional if you suspect you have shingles.

A key feature of shingles rashes is that it only affects one side of your body. This means it would only appear on one ankle.

Before the rash appears, you may notice tingling and itching on your skin. Some people report that this first stage feels like a tingling or burning sensation in specific areas. This can happen anywhere from several days to 48 hours before any visible symptoms develop.

The visible rash typically only develops in the areas where you notice the pain and itching days before. According to the AAD, this can be anywhere on your body, including your ankle.

Other conditions may resemble an itchy shingles rash on your ankle. These can include:

• Contact dermatitis: This condition commonly results from something irritating the skin, which causes an itchy, blistering rash. For example, you may notice itchy rashes on your ankles after changing your laundry detergent or body lotion.
• Psoriasis: There are several types of psoriasis, but this condition can display as red scaly plaques. It’s a chronic condition that causes itchy and sore skin.
• Athlete’s foot: This is a fungal infection that most often appears as an itchy and blistering rash on your feet and toes but can also develop on your ankles. It’s the result of a ringworm infection.

Causes of a shingles rash

Shingles is the result of the same virus that causes chickenpox. If you’ve had chickenpox previously, you’re at risk of reactivating VZV and causing shingles.

VZV targets the nerve cells along the nerve network across your body. This is why it most often appears as a straight band on your torso, as most of your nerves extend outward from your spine. However, this means wherever there are nerves in your body, a shingles rash can develop. This includes your ankles and feet.

Treatments

Antiviral medications are the only medications available to treat a viral shingles infection and are the first-line treatment option. These are only available from a healthcare professional and require a prescription.

If you suspect you have shingles, speak with a healthcare professional as soon as possible. You’ll get the most benefit from these medications if you take them within 3 days of first noticing your symptoms.

These medications can help shorten your recovery and include:

• acyclovir (Zovirax, Sitavig), which is available as a tablet, capsule, or liquid
• valacyclovir (Valtrex), which comes as a tablet
• famciclovir (Famvir), which comes as a tablet

Need a refill for valacyclovir (Valtrex)? You may be able to get an online prescription through Optum Perks in as little as 15 minutes. Learn more here.

Over-the-counter medications can help provide temporary relief from pain and itching. These include:

• pain relief oral medications, such as acetaminophen (Tylenol) or ibuprofen (Advil)
• topical pain relievers to rub on the ankle, like diclofenac (Voltaren)
• topical creams containing lidocaine
• topical creams containing the natural substance capsaicin

Note that capsaicin should only be applied after your lesions have healed. It should never be applied to open wounds.

Prevention

Vaccination against chickenpox can prevent VZV from reactivating into shingles later in life. If you’ve had chickenpox before, there is a vaccination available to prevent shingles. It’s called Shingrix.

According to the Centers for Disease Control and Prevention (CDC), healthcare professionals recommend that anyone over the age of 50 years should receive Shingrix. In people between the ages of 50 and 69 years, the Shingrix vaccine is up to 97% effective at preventing shingles from developing.

If you’re an adult and have a weakened immune system, it’s also a good idea to receive the vaccination.

The vaccine can prevent shingles complications like drop foot if you do develop an infection.

By covering your shingles rash, you can prevent transmitting it to others.

If you have shingles, it’s also important to avoid contact with anyone who hasn’t had chickenpox before or who hasn’t received the shingles vaccination, as well as pregnant people and young children.

Online care for shingles

According to the AAD, it’s important to start shingles treatment within 3 days of noticing symptoms to reduce the length and severity of your infection and prevent complications.

Online care services, including Optum Perks Online Care, may make getting treatment easier. With these services, you can submit an online form answering a few questions about your symptoms, and a US-licensed healthcare professional will respond soon after to prescribe a treatment plan.

Summary

Shingles can cause an itchy, red, and painful rash anywhere along the body where there are nerve cells, including your ankle. However, it’s more common to notice it develop on one side of your torso in a straight line, typically on your waistline.

Treatment for shingles typically involves prescription antiviral medications and pain relief. Consider getting vaccinated if you’re over 50 years old or if you’re an adult with a weakened immune system.

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