What is shingles?
Shingles, also known as herpes zoster, is a painful blistering rash that is caused by the varicella-zoster virus. This is the same virus that causes chickenpox, and should not be confused with the herpes simplex virus that leads to cold sores and genital herpes.
Once a person has had chickenpox, the virus that triggers it becomes dormant, but remains in certain nerve roots linked to the spinal cord. This virus can be reactivated when a person’s immunity drops, and can then multiply and cause the painful rash to appear.
This usually occurs many years after the initial chickenpox episode.
Unlike chickenpox, these blisters are usually confined to one or two nerve roots and appear only on one part of the body. It is accompanied by pain, which is often the first symptom and may precede the appearance of the rash by one or two days. The pain can feel like a burn or a bad muscle ache. It can be severe enough to affect sleep.
A person’s immunity may be compromised for various reasons: stress, use of medications that may weaken the immune system, or an underlying condition such as cancer. The body’s immunity also tends to decline with age, thus elderly patients run a higher risk of developing shingles.
Patients can develop post-herpetic neuralgia, where they experience pain in the affected area even after the blisters dry up and disappear. It can be very persistent and last for several weeks to months, causing significant distress to the patient. This complication is more likely to occur in older patients, especially those aged 50 or older. In some cases, the area affected can be very sensitive. A simple act of putting on clothes can trigger discomfort and pain.
Occasionally, the blisters can become infected with bacteria, and will require treatment with antibiotics. Scarring can also occur. If shingles affects the forehead, there is also a potential for eye complications. It is important to seek medical attention as soon as possible.
4 ways to treat shingles
- Oral antiviral medications such as acyclovir or valaciclovir, which stop viral reproduction and shorten healing time. Topical antibiotics can be used to treat the areas of broken skin, and painkillers should be given
- Saline compresses to help dry up blisters
- Medications such as gabapentin can help ease nerve pain for patients with post-herpetic neuralgia
- Vaccines are commonly prescribed for those aged 60 years or older, even if they do not recall having chickenpox before. Vaccines have been proven to reduce the occurrence of shingles by more than half, even the incidence of post-herpetic neuralgia