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Shingles

by Ron Kurtus (14 November 2004)

Shingles is an outbreak of a painful rash or blisters on the skin. Its medical name is herpes zoster. It is caused by the same virus that causes chicken pox (varicella-zoster virus).

The early signs of shingles include burning pain, tingling or itching on one side of the body or face. Then after several days small blisters or a reddish rash appears on the skin. The pain associated with shingles can be continual and piercing, even from the slightest touch.

Antiviral drugs can provide relief. Immediate medical care is important to avoid possible complications.

Questions you may have include:

What causes shingles?
What is the treatment for the disease ?
Is there any risk from the disease ?

This lesson will answer those questions. Health Disclaimer

Cause

Exposure to the chicken pox virus can result in shingles, even years later. People who have had chicken pox in the past are at a greater risk for developing shingles later because the virus remains inactive, or dormant, in certain nerve cells of the body. About 20 percent of the people who have had chicken pox will get shingles.

In many cases a weakened immune system allows the virus to break out of its dormant state and move along nerve fibers to the skin. People who are ill, experiencing trauma, or are under stress—especially if they are over the age of 50—can have their immune system weakened. Also, those with cancer or HIV are at risk of getting shingles, especially if they have previously had chicken pox.

Treatment

Doctors often treat shingles with antiviral drugs, such as acyclovir, valacyclovir, or famcyclovir. These drugs can reduce the severity and duration of a shingles attack, especially if treatment is immediately.

These drugs may also prevent a painful complication of shingles called postherpetic neuralgia, a condition in which the pain from shingles persists long after the rash has healed. Only a small number of people will develop postherpetic neuralgia and may require treatment with antidepressants, steroids, lidocaine patches (to numb the skin), and applications of topical pain relievers, such as capsaicin ointment.

Possible complications

The rash and pain of shingles usually go away within 3 to 5 weeks, but there can be complications such as the persistent pain of postherpetic neuralgia, and problems with hearing and vision.

If the virus invades an ophthalmic nerve, it can cause inflammation, impaired vision and blindness. Infection of facial nerves can cause intense ear pain, hearing loss and facial paralysis.

Shingles can be life-threatening to immuno-suppressed people, such as those who are receiving organ transplants (whose immune systems have been temporarily suppressed to avoid tissue rejection), people with HIV infection, and cancer patients receiving chemotherapy or radiation treatments. Most people will have only one bout with shingles, but those with impaired immune systems may suffer repeated episodes.

Summary

Shingles is disease related to chicken pox resulting in a painful rash or blisters on the skin. People who have had chicken pox and have a weakened immune system are more susceptible to the disease. Antiviral drugs can provide relief. Complications can be serious, including vision or hearing problems. Immediate medical care is important to avoid possible complications.

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