Shingles is a painful infection of the nerves and skin.
It is caused by the
varicella zoster virus. This is the same virus that causes
Shingles occurs in people who already had chickenpox. After causing the first chickenpox infection, the virus does not leave the body. It settles in nerve roots near the spinal cord. Once reactivated, the virus travels along nerve paths to the skin. There it causes pain and a rash.
Shingles can occur in those with no known risk factor other than age.
Shingles cannot be transmitted from one person to another. But a person who has never had chickenpox and never received the
, could get chickenpox if he came in contact with a person who has shingles.
If you have any of these symptoms do not assume it is due to shingles. These symptoms may be caused by other conditions. Tell your doctor if you have any of these:
Red, slightly raised band or patch often overlain with multiple small fluid-filled blisters
Develops on one side of the body or the other, but typically does not cross the midline
Spread to multiple parts of the body—the so-called “disseminated” zoster (in severe cases)
Blisters dry out and crust (within several days)
Affects mostly the torso and face
Affected eyes (in severe cases), which can seriously threaten vision
Pain on the skin at the site of the rash (usually severe)
Tingling or itchiness on the skin, which may start a few days before the rash
Skin in the affected area is unusually sensitive to touch
The rash disappears within three weeks. The pain may continue months or years after the rash has healed. This is called
postherpetic neuralgia (PHN). PHN pain is difficult to treat. It can also be very severe.
The doctor will ask about your symptoms and medical history, and perform a physical exam. He can diagnose the rash by its appearance. He may draw fluids from the blisters for testing. But this is rare.
Shingles cannot be cured. Treatment is focused on:
Antiviral therapy may shorten a shingles episode. But you must start it within 48-72 hours after symptoms first develop. These medications can reduce the severity and duration of PHN. They are for patients with the highest risk for this condition (ie, over 55).
Your doctor may also prescribe a short course of oral steroid medication (eg,
) if your immune system is functioning normally.
Taking antiviral medications before PHN develops is the most effective way to reduce its severity.
A variety of other treatments are available:
Tricyclic antidepressants (may also treat shingles)
An SSRI (selective serotonin reuptake inhibitor) may also be prescribed.
Lidoderm patch—a transdermal form of
Transcutaneous electrical nerve stimulation (TENS)—a device that generates low-level pulses of electrical current on the skin's surface
Nerve blocks—injections near nerves to provide temporary pain relief (used as a last resort)
There is no proven way to prevent shingles. Stress and fatigue may contribute to an outbreak. Future cases of shingles should decrease as more children are vaccinated.
The US Food and Drug Administration approved a vaccine (Zostavax) for people over 60 who have had chickenpox. The vaccine decreases the likelihood of getting shingles and the severity if shingles does occur.
Please be aware that this information is provided to supplement the care
provided by your physician. It is neither intended nor implied to be a
substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER
IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the
advice of your physician or other qualified health provider prior to
starting any new treatment or with any questions you may have regarding a