Dr. Heck describes shingles and explains how this condition is diagnosed and commonly treated.
Shingles is the reoccurrence of chickenpox in the skin. You cannot get shingles if you’ve never had chickenpox or the chickenpox vaccine. So shingles, once you’ve had chickenpox you have the virus your entire life and when you get stressed, when your immune system weans from aging or infectious disease the shingles will come out.
Shingles is clinically diagnosed by visual inspection and the diagnosis can also be aided by a culture or a scraping if need be. Shingles is unilateral, sometimes it crosses the midline but that’s fairly infrequently. So it’s on one side and it pops up as little blisters and the pain can be very intense. Shingles has been misdiagnosed as kidney stones and heart attacks because the pain can be so severe. It can come anywhere in the body and the pain precedes the eruption of the skin outbreak. So the pain is first, and then some redness and swelling, and then the blisters.
Treatments that are available for shingles is a systemic anti-viral pill so timing is everything with this pill. It’s very important to take it at the beginning of the eruption to minimize possible complications with the shingles. The pills given are usually Valtrex or Acyclovir, those are anti-viral pills, and we give them as soon as the eruption starts and Valtrex is a 7-day course.
Some side effects from the shingle virus or some complications include scarring and a lingering pain called posturepedic neuralgia. That pain happens because shingles uses the skin nerves to travel in, and the virus inflames the nerves and that inflammation can take up to a year to go away.
Shingles is contagious and most people have either had chickenpox the real way, the old fashioned way, or had the vaccine, but if you have shingles you need to stay away from unvaccinated individuals and infants less than one year of age because they haven’t been vaccinated yet. You can transmit shingles through direct contact with the blister fluid, but it’s a respiratory virus so you do secrete very small amounts of the virus through breathing and coughing.
About Dr. Shannon Heck, M.D.:
Shannon Heck, M.D., F.A.A.D., is a board certified dermatologist and a partner in a large, thriving dermatologic practice in Phoenix and Scottsdale, Arizona. She specializes in general and cosmetic dermatology.