Summary about Disease
Shingles (herpes zoster) is a painful skin rash caused by the varicella-zoster virus (VZV), the same virus that causes chickenpox. After a person recovers from chickenpox, the virus can remain inactive in the body's nerve tissue for years. Shingles occurs when the virus reactivates. It typically presents as a single stripe of blisters that wrap around one side of the body. It is much less contagious than chickenpox.
Symptoms
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.
Fever.
Headache.
Fatigue.
Causes
Shingles is caused by the reactivation of the varicella-zoster virus (VZV), which also causes chickenpox. The exact reason for reactivation is unknown, but it is thought to be related to a weakened immune system due to age, stress, certain medications, or underlying medical conditions.
Medicine Used
Antiviral medications: Acyclovir, valacyclovir, and famciclovir help to shorten the duration and severity of the illness and reduce the risk of complications. These are most effective if started within 72 hours of the rash appearing.
Pain relievers: Over-the-counter pain relievers such as ibuprofen or acetaminophen can help manage pain. Stronger pain medications, like opioids, may be prescribed for severe pain.
Topical treatments: Calamine lotion or creams containing capsaicin can help relieve itching and pain.
Steroids: Corticosteroids (like prednisone) are sometimes prescribed to reduce inflammation, but are not always recommended.
Is Communicable
Shingles is not directly contagious. However, a person with shingles can spread VZV to someone who has never had chickenpox or the chickenpox vaccine. In such cases, the exposed person will develop chickenpox, not shingles. The virus is spread through direct contact with the fluid from the shingles blisters. The disease can not be spread once the blisters have crusted over.
Precautions
Keep the rash covered to prevent the spread of the virus.
Avoid touching or scratching the rash.
Wash your hands frequently, especially after touching the rash.
Avoid contact with pregnant women who have never had chickenpox or the chickenpox vaccine, premature babies, and people with weakened immune systems until the blisters have crusted over.
Clean contaminated items with disinfectant.
How long does an outbreak last?
A shingles outbreak typically lasts 2 to 6 weeks.
How is it diagnosed?
Shingles is usually diagnosed based on a physical examination and the characteristic appearance of the rash. In some cases, a laboratory test, such as a viral culture or PCR test, may be performed to confirm the diagnosis.
Timeline of Symptoms
Prodromal Phase (1-5 days before rash): Pain, burning, tingling, or numbness in the area where the rash will appear. May also experience headache, fatigue, and fever.
Active Phase (Rash appears): Red rash develops, followed by fluid-filled blisters. Blisters typically last for 7-10 days.
Crusting Phase: Blisters break open and crust over, usually within a few days.
Postherpetic Neuralgia (PHN): Pain that persists for more than 3 months after the rash has healed. This is a complication that can occur in some people.
Important Considerations
Vaccination: The shingles vaccine (Shingrix) is highly effective in preventing shingles and postherpetic neuralgia in adults aged 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 lower the risk of complications.
Complications: Complications of shingles can include postherpetic neuralgia, bacterial infection of the blisters, vision loss (if shingles affects the eye), and neurological problems (rare).
Location of Rash: Shingles around the eye (herpes zoster ophthalmicus) requires immediate medical attention to prevent vision loss.
Immune Status: Individuals with weakened immune systems (e.g., due to HIV/AIDS, cancer treatment, or immunosuppressant medications) are at higher risk for severe shingles and complications.