What is Shingles?
Shingles are caused by the varicella-zoster virüs.This virus is also the cause of chickenpox. In a person who has had chickenpox (in most cases during childhood), the virus remains hidden quietly in the nerve roots. One day , they can become active again and cause a new painful rash. This is called shingles or herpes zoster.
All the people who had chickenpox do not develop shingles. About one person of 3 in North America will develop shingles at one time or another time in their own life. Most people with shingles have between 50 and 70 years of age, but it can occur at any age.
What Are The Causes Of Shingles ?
The latent or asymptomatic infection which is caused by the varicella zoster virus can become active again. This new infection can occur during a period when the immune system is a little less efficient. Several reasons may explain this decrease of immunity :
- Taking medications that suppress immune function (e.g. corticosteroids)
- HIV infection or some forms of cancer
- Radiation therapy
Most of the time, it is difficult to know exactly what triggers reactivation of the virus. The herpes zoster rarely occurs in children under the age of 10 years. By contrast, the risk of herpes zoster in a child of this age significantly increases if the child has been infected with this virus during the first year of life or if mother has suffered from chickenpox during pregnancy.
A person who suffers from a rash due to shingles can pass the chickenpox virus-shingles to another person who has never been infected by this virus, usually a child. However, this newly infected individual has the chicken pox and not shingles. Shingles is a reactivation of the latent virüs.It is not a first infection that is passed by a person who has shingles.
What are the Symptoms of Shingles?
When it is reactivated, virus may cause symptoms such as a rash, stomach aches, headaches, fever and chills. These symptoms are often preceded by warning signs (prodrome) such as soreness, itching, numbness or pain in the days before the rash. The rash produces blisters filled with fluid hat hurt and this cause a burning sensation and tingling.
When the virus varicella-zoster enters its latent phase after chicken pox, it stays inactively in certain nerves. The characteristic skin rash of herpes zoster appear on the areas of skin that are innervated by the nerve cells where it hides the virus. It is why only a portion or one side of the body is affected by the rash. The rash most often appears on the chest, abdomen, back, buttocks, back of the neck and sometimes in the face or scalp.
The rash produces very small red vesicles filled with fluid. The rash usually occurs on one side of the trunk of the person, in the form of a band of blisters from the middle of the back down to the sternum, passing through one side of the chest. The blisters rupture, dry out and then are covered with a crust.
The rash and the blisters usually last 7 to 10 days and they completely disappear after a month. The pain may persist for up to 3 months or can be longer in a very small percentage of people. In most cases, a single episode of herpes zoster can occur, but some people experience repeated infections.
When the immune system is weakened, the symptoms are more marked, rash is more severe and lesions take longer to heal and sometimes leave scars. The virus can also invade other organs, but it is rare in people whose immune system is healthy.
Post-herpetic neuralgia (PHN) is a complication of shingles. It is characterized by intense pain on the path of the affected nerves, where the virus of herpes zoster is located. The neuralgia may last for several weeks, months, or years and may remain for life. We do not know the cause of post-herpetic neuralgia.
Other complications may occur if the virus infects the optic nerve(nerve of the eye). The virus can cause an infection or eye pain which is triggered by exposure to light. If shingles are in the region of the eye, it is necessary to consult an eye care professional immediately. If this infection is not treated, the virus can cause blindness. If the virus attacks two specific nerves of the face, it causes Ramsay Hunt syndrome. This syndrome leads to ear pain, paralysis of the face and loss of hearing.
The rash of shingles is very characteristic and it is easy to diagnose. If necessary, the doctor may take a sample of the fluid in the blisters and ask for a scan to find the virus varicella-zoster. To reduce the risk of complications, a person who has a characteristic rash of shingles should consult with their physician immediately.
Treatment and Prevention of Shingles
Antiviral drugs (e.g. acyclovir, valacyclovir and famciclovir) offer the best possible efficiency, if they are started during the first 72 hours of the rash which is caused by shingles. These medicines help to reduce to the minimum the extent of the rash and minimize the pain that accompanies it. The vesicles form more quickly crusts and heal faster. Antiviral medications can also contribute to the decrease the risk of onset of chronic pain due to shingles.
Talk to your pharmacist about the use of nonprescription drugs such as ibuprofen or naproxen to relieve the pain associated with shingles. If the pain is very intense, the doctor may prescribe other types of medication (e.g. pregabalin, or narcotic medication for pain such as oxycodone) to relieve pain. Your doctor may also recommend an ointment called capsaicin which helps to decrease the pain associated with shingles.
Here are some ways to relieve the itching and pain associated with the herpes zoster:
- Applying a lotion-based oxide scale on the blisters
- Apply cool compresses and wet
- Make sure that the vesicles are dry and clean and avoid using wound dressings and adhesive bandages.
For the prevention of herpes zoster, it is necessary to avoid getting the chicken pox. A person who has never been reached chickenpox should be careful not to touch the blisters on the skin of a person with chickenpox or shingles. There is now a vaccine against varicella-zoster for children and adults. As the number of vaccinated children increases, the incidence of chickenpox will decrease and less people will suffer from shingles later. There is also a vaccine against the virus herpes zoster, which is aimed at people of 50 years or more and that can help to reduce the intensity and duration of the pain caused by shingles.
If you had already chickenpox, you can avoid the reactivation of the virus and the onset of herpes zoster. It is enough to have a healthy diet, exercise regularly, and be well rested to give you the maximum chance to be in good shape.