What is Shingles?
Shingles is a painful, inflamed rash caused by a viral infection in the nerves, also known as herpes zoster. It is caused by the varicella zoster virus, the same virus that causes chickenpox.
What causes Shingles?
If you were vaccinated for chickenpox in childhood, shingles is most likely not a concern, however, for those adults who were not vaccinated or who contracted chickenpox as children, the virus remains in their system for life. The virus may remain inactive and dormant forever, but the virus will reactive in up to 25% of adults, causing a painful rash.
No one knows why some people develop shingles and others don’t. Many times, adults who suffer an attack are older than 60 and had chickenpox as a child. Another risk factor is a compromised immune system which allows the virus to reactivate.
As far as whether shingles is contagious or not, if a child is exposed to someone with shingles, he or she may develop chickenpox if unvaccinated. On the other hand, adults coming into contact with someone having shingles will not likely be infected.
What are the symptoms of Shingles?
If you are an older adult reading this, you may think that every rash you experience could be shingles.
There are characteristic symptoms, though, that are unlike other types of rashes.
Most people will only experience symptoms for a few weeks and the condition will most likely not return. Others may have symptoms that may linger for a few months. Shingles attacks come in stages. The preliminary symptoms include tingling and burning before the rash appears. Other possible symptoms include headaches, fever, dizziness, and light sensitivity.
Eventually, tingling, itching, joint pain, swollen glands, and burning pain will develop. The skin rash generally will be focused on one side of the body or localized in one area of the body, often on the spine, stomach, and chest, although it may also occur on the face and mouth.
The rash typically will change to blisters, which burst and create small ulcers. Any scratching can cause the blisters to burst and may possibly scar your skin. Within two to three weeks, the ulcers heal.
Other symptoms include:
- Abdominal pain
- Chills
- Facial distortion due to muscle cramping
- Fever
- Headaches
- Joint pain
- Swollen glands
- Vision issues
When the rash appears on the face, patients will often be embarrassed or self-conscious, which is normal, but do remember that all of these symptoms are temporary and should disappear as the rash begins to clear.
You may think that shingles is just a complicated rash that will eventually resolve itself, but shingles can lead to serious complications.
Shingles that affects the eye may lead to permanent blindness if you do not receive emergency medical care, and post-herpetic neuralgia can lead to ongoing nerve pain. If the virus affects the nerves that control movement (the motor nerves), you may have temporary or permanent weakness or paralysis.
What is post-herpetic neuralgia?
Occasionally, the pain in the area where the shingles occurred may last for months or years after the initial outbreak has healed. This pain is called post herpetic neuralgia. This happens when the outbreak damages your nerves. Pain can range from mild to very severe and is more likely to occur in people over 60 years of age.
Other possible complications of shingles may include:
- Another attack of shingles
- Blindness (if it occurs in the eye)
- Deafness
- Infection, including encephalitis or sepsis (blood infection) in people with weakened immune systems
- Bacterial skin infections
- Ramsay Hunt syndrome if it affected the nerves in the face
Complications from the shingles virus are unlikely in otherwise healthy people. Complications occur most often in patients with other health conditions (e.g., compromised immune systems) or those who do not seek prompt medical care.
What are my treatment options for Shingles?
Usually, shingles will clear in two to three weeks and rarely recurs. Currently, there is no cure for shingles, but there are many treatments that can decrease the painful symptoms or shorten the duration of the virus. It is important to begin treatment for shingles at the onset of symptoms to reduce the likelihood of complications.
There are a number of different treatment options for more severe or long-lasting cases, such as:
- Antiviral medications: Your doctor may prescribe an antiviral medication to fight the virus, if needed. Antivirals help to reduce pain and complications, shortening the outbreak of shingles. Start antiviral medications within 24 hours of feeling pain or burning and preferably before the blisters appear.
- Anti-inflammatory medications: Not all people respond well to corticosteroids, and the side effects may not be worth it for more at-risk populations.
- Antihistamines: For patients who experience itching, antihistamines (taken by mouth or applied to the skin) can reduce itching.
- Over-the-counter pain medicines: Some patients find pain relief with non-steroidal anti-inflammatory drugs like ibuprofen or naproxen sodium. Zostrix, a cream containing capsaicin (an extract of pepper), may also reduce the risk of post-herpetic neuralgia. You can apply it for acute pain relief as well.
- Self care: Cool, wet compresses can reduce your pain. Soothing baths and lotions, such as colloidal oatmeal bath, starch baths, or calamine lotion, may help to relieve itching and discomfort. Keep your skin clean and make not to reuse any contaminated items. Wash non-disposable items in boiling water or otherwise disinfect them before reuse. In the stage where shingles lesions are oozing, avoid contact with unvaccinated people or people who have never had chickenpox (especially pregnant women).
If you are caring for a person with shingles, avoid touching the rash and blisters if you have never had chickenpox or the chickenpox vaccine. This occurs most often for parents caring for their children who have contracted chickenpox.
There is a shingles vaccination. Older adults who receive the herpes zoster vaccine are less likely to have complications from shingles. Adults older than 60 should receive the herpes zoster vaccine as part of routine medical care.
