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Home Publications Columns Ask Your Doctor

SHINGLES (HERPES ZOSTER)

May 18, 2012
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Shingles, also called herpes zoster, gets its name from both the Latin and French words for belt or girdle and refers to girdle-like skin eruptions that may occur on the trunk of the body.Although shingles is not a life-threatening condition, it can be a very painful disorder. Early treatment can help shorten a shingles infection and lessen the chance of complications.

 

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What is Shingles?

 

Many of us had chickenpox as a child, and there is a good chance the virus is still at large in our bodies. The varicella-zoster virus,the virus that causes chickenpox can lie dormant for decades without causing any symptoms. In some people, the virus wakes up and travels along nerve fibres to the skin. The result is a distinctive, painful rash called shingles. Although shingles can occur anywhere on your body, it most often appears as a single strip of blisters that wraps around either the left or right side of your torso.

 

Symptoms: Before the Rash

 

The first symptoms of shingles appear one to five days before the rash. These early warning signs are usually felt in the location where the rash will develop:

•   Itching

•   Tingling

•   Burning

•   PainBurning

 

Other symptoms of shingles

 

A painful rash is the main symptom of shingles. Fluid-filled blisters that break open and crust over are common in shingles.

 

When to see your doctor?

Adults should contact their doctor promptly if they suspect shingles, but especially in the following situations:

•   The pain and rash occur near an eye. If left untreated, this infection can lead to permanent eye damage.

•   You are 65 or older, which increases your risk of complications.

•   You or someone in your family has a weakened immune system (due to cancer, medications or chronic illness).

•   The rash is widespread and painful.

 

Why do you get shingles?

 

Shingles is caused by the varicella-zoster virus — the same virus that causes chickenpox. Anyone who has had chickenpox may develop shingles. After you recover from chickenpox, the virus can enter your nervous system and lie dormant for years. Eventually, it may reactivate and travel along nerve pathways to your skin — producing shingles.

The reason for the encore is unclear, but it may be due to lowered immunity to infections as you grow older. Shingles is more common in older adults and in people who have weak immune systems.

Varicella-zoster is part of a group of viruses called herpes viruses, which includes the viruses that cause cold sores and genital herpes, because of this, shingles is also known as herpes zoster.  The virus that causes chickenpox and shingles is not the same virus responsible for cold sores or genital herpes, a sexually transmitted infection. Shingles is not a sexually transmitted infection.

 

Are you contagious?

 

A person with shingles can pass the varicella-zoster virus to anyone who is not immune to chickenpox. This usually occurs through direct contact with the open sores of the shingles rash. Once infected, the person will develop chickenpox, however, not shingles.

Chickenpox can be dangerous for some groups of people. Until your shingles blisters scab over, you are contagious and should avoid physical contact with:

•   Anyone who has a weak immune system

•   Newborns

•   Pregnant women

 

Diagnosis

 

If you have symptoms suggestive of shingles and is seen be an experienced doctor, the diagnosis is often made from the clinical history and examination.

You doctor might do various tests to rule out other causes of your skin rash if he or she is not sure of the diagnosis. Your doctor may also take a tissue scraping or culture of the blisters for examination in the laboratory.

 

What is the treatment for shingles?

 

There is no cure for shingles, but prompt treatment with prescription antiviral drugs can speed healing and reduce your risk of complications.

Shingles can cause severe pain, so your doctor may prescribe various medications including analgesics , anticonvulsants, Tricyclic antidepressants,  and numbing agents, such as lidocaine, delivered via a cream, gel, spray or skin patch.

Taking a cool bath or using cool, wet compresses on your blisters may help relieve the itching and pain.

 

 

What are the complications of shingles?

 

Complications from shingles can include:

•   Postherpetic neuralgia. For some people, shingles pain continues long after the blisters have cleared. This condition is known as postherpetic neuralgia, and it occurs when damaged nerve fibres send confused and exaggerated messages of pain from your skin to your brain.

•   Vision loss. Shingles in or around an eye (ophthalmic shingles) can cause painful eye infections that may result in vision loss.

•   Neurological problems. Depending on which nerves are affected, shingles can causean inflammation of the brain (encephalitis), facial paralysis, or hearing or balance problems.

•   Skin infections. If shingles blisters are not properly treated, bacterial skin infections may develop.

Vaccines and prevention

Vaccines are available to prevent chickenpox, this is often given to children and there is a vaccine available for adults to prevent shingles.

Strengthening the immune system by making lifestyle changes is thought to help prevent the development of shingles. A lifestyle designed to strengthen the immune system and maintain good overall health includes eating a well-balanced dietrich in essential vitamins and minerals, getting enough sleep, exercisingregularly, and reducing stress.

 

Conclusion

 

Any individual who has had chickenpox can develop shingles. Overall, approximately 20% of those who had chickenpox as children develop shingles at some time in their lives. People of all ages, even children, can be affected, but the incidence increases with age. Individuals with immune systems weakened by disease or drugs are also at increased risk. However, most individuals who develop shingles do not have any underlying malignancyor other immuno suppressive condition.         Treatment of shingles can help to prevent complications from developing, but unfortunately, there is no cure for shingles at this time.

 

Ask Your Doctor is a health education column and is not a substitute for medical advice from your physician. Dr Brett Hodge is an Obstetrician/Gynaecologist and Family Doctor who has over twenty eight years in clinical practice. Dr Hodge has a medical practice in theJohnsonBuildingin The Valley.

 

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