What is going on?
One day, you start having this pain on one of your sides and it is just below your rib cage starting in your back and wraps around to the front. It is very painful but you don’t notice anything wrong in the area, so you put up with the pain and go about your day. A few days later, it is still painful, 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, but it belongs to a group of viruses called the herpes viruses because they are similar in structure and how they affect the body’s nervous system. Herpes zoster is actually directly related to the varicella-zoster virus, which causes chicken pox. After you have chicken pox, 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 had chicken pox, but usually doesn’t appear until most people are over the age of 50. Other things can trigger an earlier occurrence, such as cancer, HIV/AIDS, radiation treatment, chemotherapy or certain medications (like those to prevent transplanted organs from being rejected or prolonged use of steroids). An 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, 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 is important 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 as it is 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 messages of pain from the skin to the brain. Permanent vision loss can occur when a shingles infection around the eye is not treated soon enough. Neurological problems can ensue depending on which nerves the infection 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 in to the open blisters (usually from itching the area). Shingles can be passed to anyone who isn’t immune to chicken pox, 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 get chicken pox instead. So, if you have shingles, avoid contact with pregnant women, newborns, people with weakened immune systems and those who have never had chicken pox.
There is not currently a cure for shingles. Getting prompt treatment is key. Two anti-viral medications, acyclovir (Zovirax) and valacyclovir (Valtrex), are extremely helpful are decreasing the severity of the symptoms and length of time you experience them. For pain, capsaicin topical patch or numbing agents, like lidocaine (which comes in creams, gels, sprays or skin patches), are good at providing some relief. Sometimes, if the pain is severe, your doctor will prescribe oral pain medication. Another useful thing to try is taking a cool bath or using cool, wet compresses on the blisters. Reducing the amount of stress you have is important…it has been reported that when stressed, the symptoms are worse.
The best prevention against chicken pox and shingles is to get the vaccines. The chicken pox vaccine is typically given as part of the regular childhood vaccine schedule. It is also given to adults who never had chicken pox as a child. The shingles virus is available to those who are 50 and older, but highly recommended for those who are 60 and older due the risk of complications increasing as you age. It contains a live virus, so it is important that pregnant women or those with a weakened immune system do not 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, in the advent that you do get chicken pox or shingles, if you have had the vaccine, then the chances of complications and severity of the disease are greatly reduced. Good handwashing is especially important after touching any blisters or the affected area to prevent spreading it.
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