What is going on?
One day, you start having this pain on one of your sides, just below your rib cage, starting in your back and wrapping around to the front. It’s very painful, but you don’t notice anything wrong in the area, so you put up with the pain and go about your day. It’s still painful a few days later, but now you notice a red-colored rash in the area. What is it? Do you need to go to the doctor?
Shingles is a viral infection caused by the herpes zoster virus. It isn’t the same virus that causes cold sores or genital herpes. It belongs to a group of viruses called herpes viruses because they are similar in structure and how they affect the body’s nervous system. Herpes zoster is directly related to the varicella-zoster virus, which causes chickenpox. After you have chickenpox, the virus lies dormant in your nerve tissue near your spinal cord and brain. Years later, it can reactivate and presents as shingles. It can occur in anyone who has had chickenpox, but it usually doesn’t appear until most people are over 50. Other things can trigger an earlier occurrence, such as cancer, HIV/AIDS, radiation treatment, chemotherapy, or certain medications (like those to prevent rejection of transplanted organs or prolonged use of steroids). The infection usually lasts 2-6 weeks, and most people only get shingles once, but some individuals may get it two or more times.
Symptoms usually include pain/burning/numbness/tingling/itching to the affected area, the area is sensitive to touch, a red rash that begins a few days after the pain, and fluid-filled blisters that break open and crust over. Usually, the rash is a single stripe of blisters that wraps on one side of the torso, but it can occur anywhere. Some other areas that it presents are on one side of the neck/face or around one eye. It’s essential to seek treatment for shingles to reduce the risk of complications, shorten the duration of infection, and decrease the chances of spreading it to others since it’s highly contagious. Complications can be significant and life-changing depending on where the infection is. Postherpetic neuralgia is when the pain continues after the blisters have cleared. This is due to damage to the nerve endings, causing them to send incorrect pain messages from the skin to the brain. Permanent vision loss can occur when a shingles infection around the eye isn’t treated soon enough. Neurological problems can ensue depending on which nerves the condition affects. You could have inflammation of the brain (encephalitis), facial paralysis, or hearing/balance problems. Some people also get a secondary bacterial infection of their skin because bacteria gets into the open blisters (usually from itching the area). Shingles can be passed to anyone who isn’t immune to chickenpox, either through having it as a child or having the vaccine. Transmission usually occurs through direct contact with the open sores, and you are contagious until the blisters scab over. The newly infected person will not get shingles but chickenpox instead. So, if you have shingles, avoid contact with pregnant women, newborns, people with weakened immune systems, and those who have never had chickenpox.
There is not currently a cure for shingles. Getting prompt treatment is vital. Two anti-viral medications, acyclovir and valacyclovir, are extremely helpful in decreasing the severity of the symptoms and the length of time you experience them. For pain, a topical capsaicin patch or numbing agents, like lidocaine (which comes in creams, gels, sprays, or skin patches), are good at providing some relief. Sometimes, your doctor will prescribe oral pain medication if the pain is severe. Another helpful thing to try is taking a cool bath or using cool, wet compresses on the blisters. Reducing the amount of stress you have is essential. It has been reported that the symptoms are worse when stressed.
The best prevention against chickenpox and shingles is to get the vaccines. The chickenpox vaccine is typically given as part of the regular childhood vaccine schedule. It’s also given to adults who never had chickenpox as a child. The shingles virus is available to those 50 and older but highly recommended for those 60 and older due to the risk of complications increasing as you age. It contains a live virus, so pregnant women or those with a weakened immune system shouldn’t receive it. Usually, one vaccination will last about five years. While either vaccine is not a guarantee that you won’t get either virus, it can help lessen the chances significantly. Also, if you get chickenpox or shingles and you’ve had the vaccine, the chances of complications and severity of the disease are reduced considerably. Good handwashing is critical after touching any blisters or the affected area to prevent spreading the infection.
Shingles are definitely not something you want to experience. Now you have the information you need to know what to look for and when to seek treatment. If you have any questions or concerns that you might have shingles, please speak with your doctor. If you would like more information, please visit the American Academy of Dermatology’s shingles page at https://www.aad.org/public/diseases/contagious-skin-diseases/shingles