Shingles, also known as herpes zoster, is a painful, blistering skin rash due to the varicella-zoster virus, the virus that causes chickenpox. Once you are infected with chickenpox, the virus becomes dormant. This means the virus remains in your body, but in an inactive state. The reason the virus becomes active and causes shingles is uncertain. It is thought that stress can cause the outbreak, but this is simply a theory.
Shingles may develop in any age group, but you are more likely to develop the condition if:
- You are older than 60
- You had chickenpox before age 1
- Your immune system is weakened by medications or disease
If an adult or child has direct contact with the shingles rash on someone and has not had chickenpox as a child or a chickenpox vaccine, they can develop chickenpox, rather than shingles.
What Are The Symptoms of Shingles?
The first symptom is usually one-sided pain, tingling, or burning. The pain and burning may be severe and is usually present before any rash appears.
Red patches on the skin, followed by small blisters, form in most people.
- The blisters break, forming small ulcers that begin to dry and form crusts. The crusts fall off in 2 to 3 weeks. Scarring is rare.
- The rash usually involves a narrow area from the spine around to the front of the belly area or chest.
- The rash may involve face, eyes, mouth, and ears.
Additional symptoms may include:
- Abdominal pain
- Difficulty moving some of the muscles in the face
- Drooping eyelid (ptosis)
- Fever and chills
- General ill-feeling
- Genital lesions
- Hearing loss
- Joint pain
- Loss of eye motion
- Swollen glands (lymph nodes)
- Taste problems
- Vision problems
You may also have pain, muscle weakness, and a rash involving different parts of your face if shingles affects a nerve in your face.
Diagnosis of Shingles:
Shingles is usually diagnosed by the appearance of the lesions, and a medical history. Blood testing is usually not needed, except in extreme cases.
Treatment of Shingles:
Antivirals are the best form of treatment, and may decrease the length of the illness. Treatment with antivirals needs to be started in the first 24 hours to be effective. If you do not get medication within the first 24-48 hours, the antivirals are usually not helpful. Therefore, symptom management is important. Narcotics for the pain can help, as well as medications like Lyrica or Gabapentin – also help treat post-herpetic neuralgia (pain associated with shingles and after shingles are gone).
Strong anti-inflammatory medicines called corticosteroids, such as prednisone, may be used to reduce swelling and the risk of continued pain. These drugs do not work in all patients.
Other medicines may include:
- Antihistamines to reduce itching (taken by mouth or applied to the skin)
- Pain medicines
- Zostrix, a cream containing capsaicin (an extract of pepper) that may reduce the risk of post herpetic neuralgia
Cool wet compresses can be used to reduce pain. Soothing baths and lotions, such as colloidal oatmeal bath, starch baths, or calamine lotion, may help to relieve itching and discomfort.
Resting in bed until the fever goes down is recommended.
The skin should be kept clean, and contaminated items should not be reused. Nondisposable items should be washed in boiling water or otherwise disinfected before reuse. The person may need to be isolated while lesions are oozing to prevent infecting other people who have never had chickenpox — especially pregnant women.
How Long Will It Last?
Herpes zoster usually clears in 2 to 3 weeks and rarely recurs. If the virus affects the nerves that control movement (the motor nerves), you may have temporary or permanent weakness or paralysis.
Sometimes, the pain in the area where the shingles occurred may last from months to years – known as post herpetic neuralgia.
Sometimes, the pain in the area where the shingles occurred may last for months or years. This pain is called post herpetic neuralgia. It occurs when the nerves have been damaged after an outbreak of shingles. Pain ranges from mild to very severe pain. It is more likely to occur in people over 60 years.
Other complications may include:
- Another attack of shingles
- Blindness (if shingles occurs in the eye)
- Infection, including encephalitis or sepsis (blood infection) in persons with weakened immune systems
- Bacterial skin infections
- Ramsay Hunt syndrome if shingles affected the nerves in the face
The Shingles Vaccination
The vaccine for shingles (Zostavax®) is recommended for use in people 60 years old and older to prevent shingles. The older a person is, the more severe the effects of shingles typically are, so all adults 60 years old or older should get the shingles vaccine.
The shingles vaccine is specifically designed to protect people against shingles and will not protect people against other forms of herpes, such as genital herpes. The shingles vaccine is not recommended to treat active shingles or post-herpetic neuralgia (pain after the rash is gone) once it develops.
Just An FYI!
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