Shingles is a painful, blistering skin rash caused by the varicella-zoster virus, which is the same virus that causes chickenpox. After you get chickenpox, usually as a child, the virus remains dormant in certain nerves in the body.
If the virus becomes active again in these nerves, shingles occurs, even years later after you’ve had chickenpox.
Scientists don’t have an answer as to why the virus suddenly becomes active. Often, only one attack occurs and then it’s dormant the rest of your life.
Shingles can happen in any age group, but it’s more likely to happen if:
Older than 60
Had chickenpox before age 1
Your immune system is weakened by medications or disease
If either an adult or child has direct contact with a shingles rash on someone, and has not already had chickenpox as a child or a chickenpox vaccine, they can develop chickenpox from this contact. They will not get shingles, but rather chickenpox.
The first symptom is usually one-sided pain, tingling, or burning. The pain and burning can be severe and is usually shows up before any rash appears.
For most people, red patches on the skin, followed by small blisters, are the symptoms.
Then the blisters break, forming small ulcers that begin to dry and form crusts. The crusts fall off in 2 to 3 weeks, but fortunately, scarring is rare.
The rash is usually spotted in a narrow area from the spine, around to the front of the belly area or chest.
The face, eyes, mouth, and ears may be affected by the rash.
Other symptoms of shingles may include:
Fever and chills
Difficulty moving some of the muscles in the face
Loss of eye motion
Swollen glands (lymph nodes)
Sometimes pain, muscle weakness, and a rash can show around different parts of your face, if shingles affects a nerve in your face.
Signs and tests
Doctor can make the diagnosis by looking at your skin and asking about your medical history.
Tests are rarely needed, but your doctor may take a skin sample to see if the skin is infected with the virus that causes shingles.
Blood tests may show an increase in white blood cells and antibodies to the chickenpox virus, but can’t prove the rash is caused from shingles.
Treatment For Shingles:
Your doctor may prescribe an antiviral like Acyclovir, Famciclovir, or Valacyclovir. The drug helps reduce pain and shortens the course of the disease.
The medications ideally should be started within 24 hours of feeling pain or burning, and preferably before the blisters appear.
The drugs are in pill form, and given in doses many times greater than those recommended for HSV-1 and HSV-2.
Some people may need the medicine through a vein (by IV), instead of pill form.
Anti-inflammatory medicines, (corticosteroids, like Prednisone), may be used to reduce swelling and slow continued pain.
Unfortunately, these drugs don’t work for all patients.
Other medicines to relieve symptoms may include:
Antihistamines to reduce itching
Zostrix, a cream that may reduce the risk of postherpetic neuralgia
Cool wet compresses can be used to reduce pain.
Colloidal oatmeal bath, starch baths, or calamine lotion, may help relieve itching and discomfort.
Resting in bed until the fever goes down is recommended.
Skin should be kept clean, and contaminated items should not be reused.
Nondisposable items should be washed in boiling water. Isolate the infected person while lesions are oozing, to prevent infecting other people, who have never had chickenpox.
Pregnant women are especially at risk when exposed to an infected person.
Fortunately, herpes zoster (shingles) usually clears in 2 to 3 weeks and rarely recurs.
If the virus affects nerves that control movement, (the motor nerves), you may experience a temporary or permanent weakness or paralysis.
Sometimes, the pain where the shingles occurred may last from months to years in that same area.
This is called postherpetic neuralgia and it’s caused by the nerves being damaged after an outbreak of shingles. Pain ranges from mild to very severe.
Usually, in people over 60 years of age.
Complications of Shingles may include:
Another attack of shingles
Blindness (if shingles occurs in the eye)
Infection, including “encephalitis or sepsis” in persons with weakened immune systems
Bacterial skin infections
Ramsay Hunt syndrome (a painful rash around the ear that occurs when the varicella zoster virus infects a nerve in the head)
Call your health care provider if you have symptoms of shingles, and if you have a weakened immune system and your symptoms persist or worsen.
Shingles that affect the eye is most serious, since if you don’t get emergency medical care, it could lead to permanent blindness.
Is there anything that can be done to prevent shingles?
Avoid touching the rash and blisters on people with shingles or chickenpox, especially, if you’ve never had chickenpox or chickenpox vaccine.
A herpes zoster vaccine is available and it’s not the same as the chickenpox vaccine.
Older adults who receive the herpes zoster vaccine are less likely to have complications from shingles.
Doctors recommend that adults older than 60 should receive the vaccine as part of routine medical care..