By: Dr. Anthony Ng
For those who have had shingles before, it is a very painful and uncomfortable experience. There are many others who have yet to have it and may wonder what it is and what can one do about it. Herpes Zoster, or more commonly known as shingles, is essentially a reactivated viral infection caused by Varicella Zoster. This is the same virus that causes chicken pox. It usually happens to 2 in every 10 people in their lifetimes. Shingles is a painful blistering illness that while it can occur in anyone with a history of chicken pox, it is more likely to occur in individuals over 60 years old. A person, adult or child with no history of having chicken pox or having received the chicken pox vaccine, can contract chicken pox if they come into contact with the shingles rashes when there are vesicles in the skin.
Shingles often starts with one sided pain and unusual feelings such as tingling, pins and needles like, numbing and even burning. They may start in one spot and then spread to other areas that are covered by a particular nerve. The pain and numbing can be extremely painful and they usually precede the appearance of any skin rashes. The rashes usually start as reddish patches and then progress to small blisters, sometimes even looking like pimples. The blisters can break. They may have some wetness to them and forming small sores. These sores will dry and crust over, sometimes remaining for 2 to 3 weeks. Shingle rashes may affect a narrow area from the spine to the front of the belly or chest. They can also appear on the face, near the mouth, eyes and ears. Additional symptoms of shingles may include abdominal pain, fever and chills, headaches and swollen glands. If the rash affects the face, there may also be muscle weakness such as drooping eyelids, loss of eye motion and taste problems.
The diagnosis of shingles is often done from history and a physical exam by your health care provider. Blood test is rarely needed. Seeking treatment early is the best way to deal with an outbreak of shingles. If one notices possible signs of shingles, they should contact their health provider immediately. The earlier treatment is initiated, such as within 72 hours of outbreak of symptoms, the sooner the symptoms will remit with less discomfort and less risk of complications. Treatment likely would include being prescribed a course of oral antiviral medication, such as acyclovir, famciclovir and valacyclovir, lasting about a week. Sometimes low dose steroids may be prescribed to help lessen the swelling and pain. Over the counter medications in general can help with most discomfort of shingles. Cool compresses can help relieve some of the skin discomfort. An important consideration when one has shingles is to avoid contacting others with no history of chicken pox or vaccine and more importantly, when there is oozing from the blisters of a shingles rash. Someone with shingles should also avoid any contact with pregnant women.
It is important to not scratch the rashes as they may worsen the sores. Keep any open sores clean to prevent bacterial infection. If shingles rashes affect the face and eyes, an eye exam by an ophthalmologist may be needed to make sure the virus does not affect the eye. Untreated virus in the eye can potentially lead to blindness. Most shingles resolve by 2 to 3 weeks but some residue nerve discomfort may persist. Shingles can recur but for many, it usually does not. For some, a condition called postherpetic neuralgia may develop. This is when the nerve that was affected has been damaged. This postherpetic neuralgia is pain in the area where the shingles occur and can last for months and even years. This is more likely to occur in individuals over 60 years old.
It is unclear what would cause someone to have a shingles outbreak. Injuries, being older than 50 years old, recent medication, illness or stress have all been implicated as reasons for a person have an outbreak of shingles. There is a shingles vaccine which is currently approved for people over 50 years old, though CDC is recommending those over 60 years old receiving the vaccine. This is not the same as a chickenpox vaccine as it is more potent. Side effects for this vaccine may include redness and tenderness at injection site, swelling and headaches. Not all insurance would cover this vaccine so one would need to check with their insurance carrier prior to getting the vaccine. With the shingles vaccine, it lessens the risk of developing shingles or decreases its severity and chances of complications if one does develop shingles. The vaccine offers protection for about 6 years.
Shingles is a viral condition that can be very painful and uncomfortable and with potentially serious complications. However, early recognition and treatment will often lead to minimal long term effects.
http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001861/ Accessed Oct 16,2012.
Mayo Clinic: http://www.mayoclinic.com/health/shingles/DS00098
TV5 Forecast Center
Healthy Living: Shingles
By: Dr. Anthony Ng
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