Shingles

Overview:

Shingles, known as herpes zoster, is a viral infection that results in a blistering skin rash appearing in a striped pattern. Typically, the rash affects only one side of the body and is preceded by general itching and headaches. The same virus responsible for chickenpox, called herpes zoster, causes shingles. After a person has had chickenpox, the virus remains dormant in the spinal nerves and can reactivate later in life, leading to shingles. The risk of developing shingles is higher in individuals with weakened immune systems, such as those with HIV or undergoing anti-cancer therapy. Shingles primarily affects older adults, with approximately five out of every thousand individuals over the age of 65 contracting the disease. The main symptom is a rash, often accompanied by intense pain lasting for about four weeks, resulting from nerve irritation caused by the virus. Depending on the location of the rash, other symptoms may occur, such as eye pain or temporary vision loss if the rash is on the face.

Diagnosis:

Shingles can usually be diagnosed through a physical examination, as the distinct rash pattern is often visible. Sometimes, a patient’s history is necessary to confirm a previous case of chickenpox. In cases where the rash is absent or atypical, biochemistry tests may be used to detect the presence of the virus in the body.

Treatment:

Shingles typically resolves on its own as the virus runs its course. Treatment focuses on alleviating pain, fever, and itching associated with the condition. Antiviral medications are commonly prescribed to reduce the spread of the virus and shorten the duration of the rash, but they do not address the residual nerve pain. Lotions can help relieve itching, while pain medications such as morphine or steroids may be used to reduce pain and inflammation. If lotions are ineffective, local anesthetics like lidocaine can help minimize rash irritation.

Management:

After receiving medication, individuals with shingles should avoid direct sunlight, as it can aggravate the rash. Sufficient rest is essential, as stress can exacerbate inflammation and trigger further outbreaks. It is important to note that shingles can be contagious to individuals who have never had chickenpox, so it is recommended that young children and adults without prior exposure to the virus avoid contact with individuals with shingles.

Prevention:

A vaccine called Zostavax has been developed to reduce the occurrence of shingles by half in infected individuals. Since 2007, adults over the age of 60 who had chickenpox as children are advised to receive the vaccine. Additionally, research suggests that adults who have had chickenpox may develop some immunity to shingles by being exposed to children with chickenpox. Maintaining a healthy immune system and reducing stress levels are crucial in minimizing the risk of shingles outbreaks.

Shingles – Resources

Chicken Pox / Shingles (Varicella – zoster)
VZV Research Foundation
36 East 72nd St
New York, NY 10021
Tel: 212-472-3181

https://www.ninds.nih.gov/health-information/disorders/shingles