Shingles at a Glance

The frustrating condition known as shingles is the reactivation of the common chickenpox virus which has lay dormant for many years in a nerve root randomly located in your body. Its onset is usually triggered by some form of stress that lowers your resistance driving the immune system below a threshold that allows the dormant virus to turn on and go into an active phase. The onset of the rash can be preceded by several days of a burning pain that varies in intensity but has a reputation of being quite uncomfortable. As the virus is “trapped” in a nerve, the rash appears only in the swath of skin supplied by that nerve. The painful clusters of blisters follow a band of skin known as a dermatome. The rash is limited to this area never going above or below that band of skin and does not cross the midline in the front or back.

This is a herpes virus, distinctly different from the ones that cause cold sores or sexually transmitted lesions, it is nonetheless not curable in the usual sense. Remember the virus has been dormant ever since childhood and is activated by a weakened immune system which normally would be holding the virus in check. Treatment is limited to some antiviral drugs such as Valtrex, Famvir, or Zovirax. These can be very helpful in relieving the pain and inflammation if they are started within 48 to 72 hours of the onset of the rash. Prior to the availability of these drugs high doses of ibuprofen was and still can be helpful in reducing the intensity of the pain. In severe cases, a steroid may provide some relief. The average outbreak of shingles can last several weeks and vary in intensity considerably from one individual to the next.

Shingles is not contagious in the usual sense. If you have had chickenpox you should be protected. If you never had chickenpox then you have no immunity and may be vulnerable to developing chickenpox through direct contact with the lesions and the blister fluid. Reducing the spread of chickenpox in general by regular immunizations of infants has provided some hope for decreasing the problems with this condition. A vaccine (Zostavax) for adults over 60 years of age who are vulnerable is also available. It is not perfect but drastically reduces the risk of shingles and its complications. Complications from shingles are few but can result in serious eye problems when it involves that area of the face. Also post herpetic neuralgia is a troublesome condition where the pain persists for long periods of time after the rash has subsided.