Shingles, also known as Herpes Zoaster, is a localized, painful rash caused by reactivation of the varicella zoster virus (VZV) which also causes chickenpox. The virus remains hidden in the body after chickenpox infection for many years and reoccurs later as shingles. Approximately 30% of all people who have been infected with chickenpox will later develop shingles.
A shingles rash usually appears on one side of the face or body and lasts from 2 to 4 weeks. Its main symptom is pain, which can be quite severe. Other symptoms of shingles can include fever, headache, chills and upset stomach. Very rarely, a shingles infection can lead to pneumonia, hearing problems, blindness, brain inflammation (encephalitis) or death.
Shingles is very common. Fifty percent of all Americans will have had shingles by the time they are 80. While shingles occurs in people of all ages, it is most common in 60- to 80-year-olds. In fact, one out of every three people 60 years or older will get shingles.
Shingles can occur at any age, but is most common in people who are over 50 years of age. Among people who are over 80 years of age, about 11 people in every 1,000 have shingles each year. Shingles is much less common in children.
Shingles is not spread from person to person. However, the blister fluid from the shingles rash is infectious and contact with the blister fluid can cause chickenpox in a person who has not previously had chickenpox. Shingles is less contagious than chickenpox and the risk of a person with shingles spreading the virus is low if the rash is covered.
Causes
The virus that causes chickenpox also causes shingles. After a person gets rid of the chickenpox, the virus stays in the body. The virus travels to the nerves where it sleeps. Shingles appears when the virus wakes up. It is not clear what reactivates or “wakes up” the virus. A short-term weakness in immunity may cause this.
Shingles is much less contagious than chickenpox. But a person with shingles can still spread the virus. Anyone who has not had chickenpox can get this virus.
If the virus spreads to someone who has not had it, the person will get chickenpox — not shingles. Newborns and those with a weak immune system have the highest risk of getting the virus from someone who has shingles.
This virus spreads when the person has uncovered, open blisters and someone touches the blisters. Once the blisters form scabs, the person is no longer contagious.
Who is at risk?
Some people who have had chickenpox have a higher risk of getting shingles. These people –
- Are 50 years of age or older.
- Have an illness or injury.
- Are under great stress.
- Have a weakened immune system.
Some illnesses and medical treatments can weaken a person’s immune system and increase the risk. These include –
- HIV/AIDS.
- Some cancer treatments, such as chemotherapy or radiation.
- Medicine taken to prevent rejection of a transplanted organ.
- Cortisone when taken for a long time.
Symptoms
Shingles tends to cause more pain and less itching than chickenpox. Common signs and symptoms are –
The warning – An area of skin may burn, itch, tingle, or feel very sensitive. This usually occurs in a small area on 1 side of the body. These symptoms can come and go or be constant. Most people experience this for 1 to 3 days. It can last longer.
Rash – A rash then appears in the same area.
Blisters – The rash soon turns into groups of clear blisters. The blisters turn yellow or bloody before they crust over (scab) and heal. The blisters tend to last 2 to 3 weeks.
Pain – It is uncommon to have blisters without pain. Often the pain is bad enough for a doctor to prescribe painkillers. Once the blisters heal, the pain tends to lessen. The pain can last for months after the blisters clear.
Flu-like symptoms – The person may get a fever or headache with the rash.
Complications
- Scarring
- Secondary bacterial skin infection
- Nerve complications such as nerve palsies
- Pneumonia
- Eye damage where the ophthalmic nerve has been affected.
- Ramsay Hunt syndrome if shingles affects the nerves of the face or ear
Treatment
It is best to get treatment immediately. Treatment can include –
Pain relievers to help ease the pain – The pain can be very bad, and prescription painkillers may be necessary.
Anti-viral medicine – This medicine may be prescribed when a doctor diagnoses shingles within 72 hours of the rash first appearing. The earlier anti-viral treatment is started, the better it works. Anti-viral medicines include famciclovir, valacyclovir, and acyclovir. These can lessen the pain and the amount of time the pain lasts.
Nerve blocks – Given for intense pain, these injections (shots) contain a numbing anesthetic and sometimes a corticosteroid.
Corticosteroids – To lower swelling and pain, some patients may get corticosteroid pills with their anti-viral medicine. This treatment is not common because it can make the rash spread.
Treatments for pain after the rash clears – Certain anti-depressants, pain relievers, anesthetic creams and patches, and anti-seizure medicines can help.
Alternative Treatment
Rhustoxicodendron (Rhustox) is useful when blisters emerge that are not only painful but very itchy, and warmth brings relief. The pain is worse at night and less noticeable when moving about.
Arsenicum album is indicated for shingles with red, burning lesions that are relieved by warmth and are worse at night, causing great restless anxiety.
Mezereum is indicated if there is severe pain, if the skin burns and itches and forms brown scabs, or if the is person middle-aged or elderly. Lasting neuralgic pains that shoot along the nerve after the skin has healed are often helped by this remedy.
Ranunculus is useful if there are nerve pains and itching, or the slightest touch, movement or eating makes the symptoms worse.
Lachesis is prescribed if the left side of the body is affected, plus some swelling, which is aggravated by wan-nth but is relieved by cold.
Apis is used when the swelling and stinging pains predominate, improve with cold and become aggravated by heat.
Adenosine monophosphate (AMP) – The study used injections of AMP, so researchers don’t know if taking AMP orally would have any effect. People who take dipyridamole (Persatine) or carbamazepine (Tegretol) should not take AMP.
Vitamins B-12 and E– A few studies suggest that vitamin E (1,200 to 1,600 mg per day) and injections of B-12 (but not oral B-12) might help reduce symptoms of postherpetic neuralgia.
Cayenne – Capsaicin cream made from cayenne pepper can relieve pain when applied to the skin. Capsaicin may help relieve the pain of post-herpetic neuralgia, and an over-the-counter ointment is approved for this treatment.
Licorice – Traditionally, licorice gel has been used topically (applied to the skin) to treat shingles and postherpetic neuralgia. In test tubes, one of the constituents of licorice, called glycyrrhizin, stops the varicella zoster virus from reproducing.
Reference –
http://www.medicinenet.com/shingles_herpes_zoster/page4.htm#what_is_the_treatment_for_shingles
https://www.nia.nih.gov/health/publication/shingles
https://www.aad.org/dermatology-a-to-z/diseases-and-treatments/q—t/shingles/who-gets-causes
http://www.nhs.uk/Conditions/Shingles/Pages/Symptoms.aspx