Shingles is a viral infection that causes a painful rash known as Herpes Zoster.
Shingles is not a life-threatening condition; however it can be very painful.
Early treatment can help shorten the duration of shingles infection and minimize the chance of complications.
Shingles is caused by the Varicella Zoster virus which also causes chickenpox.
Following chickenpox infection, the virus lies inactive (dormant) in the nerves which may be reactivated many years later as shingles.
Typically, the shingles rash occurs on one side of the body that may appear as a band of blisters following the path of the nerve where the virus had been inactive.
Risk factors
- Older persons aged >60 years
- People with weakened immune systems from:
- HIV/AIDS
- medical treatments such as steroids, radiation and chemotherapy
- history of bone or lymphatic cancer
Symptoms
The symptoms of shingles may include:
- Pain, burning, tingling or extreme sensitivity in a certain part of the body
- A red rash with or without itching that begins a few days after the pain
- Fluid-filled blisters that break open and crust over
- Fever with chills and headaches
- Upset stomach or abdominal pain
Pain is usually the first symptom of shingles.
It can be intense with just the slightest touch causing severe pain while some patients may have the pain without the rash.
Diagnosis
Shingles is usually diagnosed based on:
- history of pain with the typical rash or blisters
- clinical examination
- tissue scraping or culture of the blisters if in doubt
Seek professional help promptly if you have any of these symptoms:
- The pain and rash occur near the eyes which can lead to permanent eye damage if left untreated.
- The rash is extensive and painful.
Complications of shingles
- Post herpetic neuralgia is a condition which is excruciatingly painful.
- Inflammation of the brain (encephalitis)
- Hearing problems
- Temporary or permanent blindness
- Loss of facial movement (paralysis)
- Secondary bacterial skin infections if the blisters are not treated adequately
Treatment
An episode of shingles usually heals on its own within a few weeks, but prompt treatment can ease pain, promote healing and reduce the risk of complications.
Treatment options include:
- High doses of oral antiviral medications acyclovir, valacyclovir or famciclovir.
- Anti-inflammatory drugs such as corticosteroids (prednisone) to reduce inflammation and lower the risk of post herpetic neuralgia.
- Pain relievers such narcotics (opioids) may be needed for relief of severe pain.
- Topical ointments to soothe pain such as lidocaine.
Tips to help minimize the pain include:
- See your doctor and request for pain relief if the pain is severe.
- Apply an anti-itch cream or calamine lotion to the affected area.
- See your doctor if itching is severe. Hydrocortisone cream or oral antihistamines may be necessary to relieve itching.
- Bathe with cool water and wash the blisters twice a day with regular soap and water but do not bandage them.
- You may apply cool compresses to the blisters to relieve the pain and itch.
Prevention
These measures include:
Chickenpox vaccine
Although the chickenpox vaccine does not guarantee complete protection against chickenpox or shingles, it can reduce the severity of the disease and the risk of complications.
Avoid contact with infected persons
High risk groups such as the Elderly, those with HIV, on steroids and pregnant women should avoid contact with infected persons.
