by Kimberly Allen R.N.
Shingles is a viral infection that causes a skin rash that is very painful. It is caused by the same virus that causes chicken pox, the varicella zoster virus. Though it is a herpes virus, it is not related to the herpes virus that causes sexually transmitted or oral herpes. Once a person has had chicken pox the virus remains dormant in the nervous system of the body and sometimes remains that way. However, it can become active again later in the form of shingles. If the virus becomes active again it can only develop into shingles not chicken pox.
The symptoms of shingles usually appear in stages. In the beginning you may feel like you have the flu. Sometimes there’s a sensitivity to light. Then as the infection progresses, even if there’s no rash visible, you can experience the pain and burning of shingles. The shingles rash begins as small blisters surround by red tissue. All blisters continue to develop over a period of 3-5 days. The blisters appear in narrow “bands” that follow the path of nerves leaving the spinal cord. These nerves and therefore the rash form a specific “ray-like” pattern across the skin. The rash can affect the entire path of the nerve or only parts of the path. If only portions of the nerve path are affected you will see the blisters form a more cluster like appearance rather than the typical stripe. The rash and blisters can also occur around the eye. Usually the rash only affects one side of the body so typically only one eye would be affected. The blisters will eventually burst and begin to weep before crusting over. The blisters will heal in approximately 2-4 weeks though it is possible they will leave scars.
If you have had chicken pox you can get shingles. The risk of getting shingles increases when you reach the age of 50 years and after, or if your immune system is impaired. If you think you may have shingles you should contact your doctor immediately. Though shingles is rarely life threatening, if left untreated it can cause damage especially if it occurs around the eye. If the characteristic rash and pain are present, your doctor will be able to make a diagnosis upon exam. However, if the rash is not present, the doctor can order tests to verify a shingles diagnosis.
Treatment for shingles focuses on managing the symptoms, decreasing the duration of the acute illness and preventing complications as there is no cure for the disease. Currently there are antiviral medications like Zovirax, Famvir or Valtrex that are used primarily to reduce the duration and pain of shingles. The pain of shingles can be severe so many doctors treat the pain separately with NSAID’s or other medications like nuerontin or elavil and occasionally narcotic’s will be ordered if the pain doesn’t respond to other treatments.
Prevention is always better than treating after the fact. The most effective way to avoid shingles is through vaccination. There is currently a chicken pox vaccine available and though it doesn’t guarantee that you won’t get chicken pox or shingles is does significantly reduce your risk. Not only does the vaccine reduce your risk of getting chicken pox or shingles is also lowers the severity of the disease and the risk of complications. There is also a shingles vaccine for people 50 years and over that is similar to the chicken pox vaccine in that it doesn’t guarantee you get the disease but it will make it shorter and the symptoms less severe.
Fluid from the blisters can cause chicken pox, not shingles so if you have not had chicken pox or the vaccine avoid contact with anyone that has shingles or the chicken pox until the rash is healed and the blisters are dry. It is very important to avoid scratching or picking the blisters as it can lead to infection and complications. Cool compresses or baths can help alleviate the itching.
Kimberly Allen is a registered nurse with an AND in nursing. She has worked in ACF, LCF and psychiatric facilities, although she spent most of her career as a home health expert. She is now a regular contributor to HealthAndFitnessTalk.com, dispensing advice and knowledge about medical issues and questions. You can reach her with any comments or questions at firstname.lastname@example.org.