What is Shingles?

Shingles, also known as herpes zoster, is a painful skin rash. It is caused by the Varicella Zoster virus that is a parasite of our organism after an initial infection and is reactivated.

Shingles usually appears in a band, or strip, or a small area on one side of the face or body along an afferent nerve – sensory nerve.

Shingles is most common in older adults (>65 years old), and people who have weakened immune systems because of stress, injury, certain medicines, or other reasons. Usually most people who get shingles will only have it once in their life, although in rare cases the virus may manifest more than once.

Shingles occurs when the virus that causes chickenpox “wakes up” again in your body. After having chickenpox, type 3 Herpes virus goes dormant in the nerve roots. In some people, it stays dormant forever. In other cases, the virus “wakes up” when disease, stress, some medications (e.g. corticosteroids, antineoplastic agents)or ageing weaken the immune system. It is not clear why this happens, but after the virus becomes active again, it can only cause shingles, not chickenpox.

Shingles cannot spread to a person from someone else who has shingles; however, there is a small chance that a person with a shingles rash can spread the virus to another person who has not had chickenpox and who has not been vaccinated.

Shingles symptoms happen in stages. Initially you may have a headache or be sensitive to light. You may also feel like you have the flu, without fever.

Later, you may feel itching, tingling, or pain in a certain area. This is the area where a band, strip, or small area of rash may occur after a few days. The rash turns into clusters of blisters. The blisters fill with fluid and then crust is formed over them. It takes 2 to 4 weeks for the blisters to heal, and they may leave scars. Some people only get a mild rash, while others do not get a rash at all.

Treatment

Shingles is treated with medicines. These medicines include antiviral medicines and medicines for pain.

See your doctor right away if you think you may have shingles. Starting antiviral medicine right away can help your rash heal faster and be less painful. And you may need prescription pain medicine if your case of shingles is very painful.

Some doctors treat only the symptoms of shingles, such as pain, when the disease is diagnosed more than 72 hours after the rash. Analgesics and creams are administered to reduce itching.

  • Antiviral antibiotics, such as acyclovir, valacyclovir and famciclovir, can reduce the duration of skin rashes and pain, including postherpetic neuralgia. For any benefit to be achieved, treatment should be initiated early, approximately 24-72 hours after the rash appears. Nevertheless, treatment administration even at a later stage is considered beneficial, although it is not included in the indications.
  • Prescription painkillers are often essential as the pain level is very high in many people. The pain is often so intense that people do not tolerate any clothing touching the skin area with a rash.
  • Postherpetic neuralgia may require further medicines, such as opioids, to control pain. Postherpetic neuralgia is pain or allodynia that persists in some persons, even after the disappearance of the rash. Certain people do not respond to common pain treatments and may need to be referred to a pain specialist.

Sometimes, topical or systemic corticosteroids are used to reduce inflammation and pain; however, they should only be used under the medical supervision, since in some patients the infection may get worst due to the use of corticosteroids. Topical medications can be used to soften the area or to prevent any possible infections.