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All About Shingles

Shingles, also known as herpes zoster, is a viral disease in which the patient experiences a painful rash with blisters. The rash often occurs in stripes on one side of the body. The rash itself may heal within four weeks, but it can leave behind nerve pain known as postherpetic neuralgia. The virus initially enters the system as chickenpox, which usually occurs in childhood. Although the rash from chickenpox clears up, the virus doesn’t completely leave the body. This virus, known as varicella zoster, comes back later in life, perhaps even decades after the initial diagnosis of chickenpox. At this time, the virus is known as shingles. It usually appears in people over the age of 50, perhaps because their immune systems have been compromised due to age, stress, or other diseases.

The initial symptoms of shingles – headache, fever, and malaise - can mimic other illnesses and diseases. This causes the virus to often be misdiagnosed. Laboratory tests to detect VZV-specific IgM antibodies in the blood are available. Shingles may also be diagnosed by having the fluid of the blister analyzed under a microscope.

Later symptoms of shingles are itching, burning pain, feelings of tingling and prickling, numbness, and oversensitivity of the senses. Quick stabs of excruciating pain and throbbing may also affect the affected areas. After a day or two of suffering these symptoms, the hive-like rash often appears. While the rash is often restricted to the torso, it can appear on the face or other body parts. In some cases, the virus may appear in the eye area. This can result in conjunctivitis, known as pink eye, keratitis, an inflammation of the eye, and optic nerve palsies in which the eye feels shaky. These symptoms can lead to loss of vision as well as excruciating pain. The vestibulocochlear nerve can be affected if the virus spreads there from the facial nerve, which can lead to hearing loss and dizziness.

The rash will eventually turn into small blisters which at first contain fluid that later becomes cloudy or bloody. The blisters eventually crust over after about a week. As the crust falls off, the skin heals, but the area where the rash occurred may be permanently discolored or scarred if the blistering was severe.

While the virus cannot spread shingles to another person, if someone who has never had chickenpox comes in contact with the rash, they can develop the disease. People with shingles should avoid those that have never had chickenpox until the blisters crust over.

Treatment for shingles includes over-the-counter analgesics,such as calamine lotion, topical lidocaine, capsaicin cream after the blisters have crusted over, antiviral drugs, such as valaciclovir and famciclovir, and orally administered cortisteroids.

Zostavax has developed a live vaccine for shingles. Studies of the vaccine have shown it may prevent shingles in more than fifty percent of people over the age of 60 and for those that do get it; the vaccine can reduce the possibility of postherpetic neuralgia by two-thirds.

Shingles is a painful virus that can happen later in life to adults that suffered from chickenpox as a child, but a new vaccine offers hope of avoiding the return of the virus.

Additional resources on shingles:

Mayo Clinic offering the definition, symptoms, causes, risk factors, complications, treatment, and prevention of shingles

New York State Department of Health shingles fact sheet

Centers for Disease Control “What You Need to Know about Shingles” information sheet, including information about the vaccine

WebMD overview of shingles as well as prevention and treatment information

Zostavax pharmaceutical site information about the shingles vaccine

National Institutes of Health shingles information page

Medline Plus includes an interactive tutorial for shingles

Wisconsin Department of Health shingles fact sheet

University of Michigan - Shingles and Postherpetic Neuralgia information about shingles, including herbal remedy options

Harvard Medical School – Should You Get the Shingles Vaccine? information about the shingles vaccine

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