Summary about Disease
Shingles, also known as herpes zoster, is a painful rash caused by the varicella-zoster virus (VZV), the same virus that causes chickenpox. After a person recovers from chickenpox, the virus lies dormant in nerve tissue near the spinal cord and brain. Shingles occurs when the virus reactivates. It typically presents as a single stripe of blisters around either the left or the right side of the torso.
Symptoms
Common symptoms of shingles include:
Pain, burning, numbness or tingling
Sensitivity to touch
A red rash that begins a few days after the pain
Fluid-filled blisters that break open and crust over
Itching Other possible symptoms include:
Fever
Headache
Fatigue
Sensitivity to light
Causes
Shingles is caused by the reactivation of the varicella-zoster virus (VZV), the same virus that causes chickenpox. The virus remains dormant in nerve cells after a chickenpox infection. What triggers the reactivation is not always clear, but factors like weakened immune systems (due to age, stress, certain medications, or illnesses) are thought to play a role. Shingles is not caused by exposure to someone with shingles; it's a reactivation of a previous chickenpox infection.
Medicine Used
Antiviral medications are the primary treatment for shingles. Common antiviral drugs include:
Acyclovir (Zovirax)
Valacyclovir (Valtrex)
Famciclovir (Famvir) These medications can help shorten the duration and severity of the illness. Pain relievers may also be prescribed or recommended:
Over-the-counter pain relievers (acetaminophen, ibuprofen)
Prescription pain medications (opioids, if needed for severe pain)
Topical treatments (capsaicin cream, lidocaine patches)
Is Communicable
Shingles itself is not communicable. You cannot catch shingles from someone who has shingles. However, the varicella-zoster virus (VZV) can be spread from someone with shingles to someone who has never had chickenpox or hasn't been vaccinated against it. In this case, the person exposed will develop chickenpox, not shingles. The virus is spread through direct contact with the fluid from the shingles blisters. Shingles is considered communicable until all blisters have crusted over.
Precautions
To prevent the spread of VZV from someone with shingles:
Keep the rash covered.
Avoid touching or scratching the rash.
Wash hands frequently and thoroughly.
Avoid contact with pregnant women who have never had chickenpox or the chickenpox vaccine, premature or low birth weight infants, and people with weakened immune systems.
Stay home from school or work until the blisters have crusted over. Vaccination: The Shingrix vaccine is recommended for adults 50 years and older, even if they have had chickenpox or shingles before. It significantly reduces the risk of developing shingles.
How long does an outbreak last?
A shingles outbreak typically lasts for 2 to 6 weeks. The pain can persist for longer, even after the rash has healed; this is called postherpetic neuralgia (PHN).
Pain, tingling, or burning: Usually precedes the rash by a few days.
Rash and blisters: Appear within a few days of the pain and last for 7-10 days.
Crusting: Blisters will then dry up and crust over. This takes several days.
Healing: The rash typically heals within 2 to 4 weeks.
How is it diagnosed?
Shingles is usually diagnosed based on a visual examination of the rash and a review of the patient's medical history. The distinctive appearance and location of the rash (typically on one side of the body in a band-like pattern) are often enough for diagnosis. In some cases, a doctor may take a skin sample (scraping or swab) from the blisters to confirm the diagnosis. This sample is then tested for the varicella-zoster virus (VZV) using a viral culture or PCR (polymerase chain reaction) test.
Timeline of Symptoms
The typical timeline of shingles symptoms is as follows:
Prodrome (1-5 days before rash): Pain, burning, tingling, numbness, itching, or extreme sensitivity in a specific area of skin. Headache, fever, and fatigue may occur.
Rash (2-3 days after prodrome): Small, red spots appear, which then turn into fluid-filled blisters. The rash is usually confined to one side of the body.
Blisters (3-5 days): Blisters fill with fluid, enlarge, and may break open.
Crusting (7-10 days): Blisters dry up and form crusts.
Healing (2-4 weeks): The crusts fall off, and the skin heals. Some people may experience lingering pain (postherpetic neuralgia) even after the rash has healed.
Important Considerations
Postherpetic Neuralgia (PHN): This is a common complication of shingles characterized by persistent nerve pain in the area where the rash occurred, even after the rash has healed. It can be severe and debilitating.
Ophthalmic Shingles: If the shingles rash involves the eye, it can lead to serious complications, including vision loss. Prompt medical attention is crucial.
Weakened Immune System: People with weakened immune systems (due to HIV/AIDS, cancer treatment, or organ transplantation) are at higher risk for severe shingles and complications.
Vaccination: The Shingrix vaccine is highly effective in preventing shingles and postherpetic neuralgia. It is recommended for adults 50 years and older.
Early Treatment: Starting antiviral medication within 72 hours of the rash appearing can significantly reduce the severity and duration of the illness and the risk of PHN.