Summary about Disease
Zona, commonly known as shingles, is a painful skin rash caused by the reactivation of the varicella-zoster virus (VZV), the same virus that causes chickenpox. After a person recovers from chickenpox, the virus remains dormant in nerve cells. Years later, the virus can reactivate and travel along nerve pathways to the skin, causing shingles. Shingles typically appears as a single stripe of blisters that wraps around either the left or right side of the torso.
Symptoms
Symptoms of shingles usually affect a small section on one side of the body. They may 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
Headache
Fever
Sensitivity to light
Fatigue
Causes
Shingles is caused by the reactivation of the varicella-zoster virus (VZV) in people who have previously had chickenpox. The virus remains dormant in nerve tissue near the spinal cord and brain. The reason for reactivation is not always clear, but it is often linked to a weakened immune system due to factors such as:
Aging
Stress
Certain medications (like immunosuppressants)
Illness (like HIV/AIDS, cancer)
Medicine Used
Antiviral medications are the primary treatment for shingles. These medications can help shorten the duration of the illness and reduce the severity of symptoms. Common antiviral drugs include:
Acyclovir (Zovirax)
Valacyclovir (Valtrex)
Famciclovir (Famvir) Pain relievers, such as acetaminophen, ibuprofen, or prescription pain medications, may also be used to manage pain. In some cases, topical creams or ointments may be prescribed to soothe the skin and reduce itching.
Is Communicable
Shingles itself is not contagious. However, a person with shingles can spread the varicella-zoster virus to someone who has never had chickenpox or hasn't been vaccinated against it. If this happens, the person will develop chickenpox, not shingles. The virus is spread through direct contact with the fluid from the shingles blisters. A person is contagious until all the blisters have crusted over.
Precautions
To prevent the spread of VZV to others:
Keep the rash covered.
Avoid touching or scratching the rash.
Wash your 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.
Avoid sharing towels, clothing, or other items that may have come into contact with the rash.
How long does an outbreak last?
A shingles outbreak typically lasts between 2 to 6 weeks.
How is it diagnosed?
Shingles is usually diagnosed based on a physical examination and a review of the patient's medical history. The characteristic rash and pain pattern are often sufficient for diagnosis. In some cases, a laboratory test may be performed to confirm the diagnosis. This can involve taking a skin scraping or fluid sample from a blister and testing it for the varicella-zoster virus.
Timeline of Symptoms
Prodrome (1-5 days before rash): Pain, burning, itching, tingling, or numbness in the affected area. May also include headache, fever, fatigue, and general malaise.
Active Rash (3-5 days after prodrome): Red rash appears, followed by fluid-filled blisters. The blisters typically form in a band or stripe on one side of the body.
Blistering and Crusting (7-10 days after rash onset): Blisters break open and begin to crust over.
Healing (2-4 weeks): Crusts fall off, and the skin begins to heal. Pain may persist even after the rash has cleared (postherpetic neuralgia).
Important Considerations
Postherpetic Neuralgia (PHN): This is the most common complication of shingles, characterized by persistent nerve pain that can last for months or even years after the rash has healed. Early treatment with antiviral medications can help reduce the risk of PHN.
Ophthalmic Shingles: Shingles involving the ophthalmic branch of the trigeminal nerve can affect the eye and lead to serious complications, including vision loss. Prompt medical attention is crucial.
Vaccination: The shingles vaccine (Shingrix) is recommended for adults aged 50 years and older, even if they have had shingles before. The vaccine can help prevent shingles and reduce the risk of PHN.
Immunocompromised Individuals: Shingles can be more severe and prolonged in people with weakened immune systems.
Prompt Treatment: Seeking medical attention as soon as possible after the onset of symptoms is crucial for effective treatment and reducing the risk of complications.