medical shingles

Shingles (Herpes Zoster):

Anyone who has had chickenpox can get shingles. After the chickenpox clears, the virus (Herpes zoster) crawls up the nerves to the spinal cord, and hibernates. If the virus reactivates (wakes up), the result is shingles — a potentially painful, blistering rash. Shingles is most common in older adults. A vaccine, which can prevent shingles, is available to people 50 years and older. Dermatologists recommend this vaccine for everyone 50 and older. Shingles tends to cause more pain and less itching than chickenpox. The first sign of shingles is burning, itching, or tingling before any rash appears, on one side of the body, usually in one location. After this symptom, a rash can appear in the same area as the discomfort, and can appear as redness, groups of clear blisters, which then crust over and scab. These skin lesions can last 2-3 weeks. After the rash resolves, it can leave residual pain in the area for many months; this is called post-herpetic neuralgia.

You may be at risk for developing shingles if you:
◦ Have a history of chickenpox in the past.
◦ Are 50 years of age or older.
◦ Have an illness or injury.
◦ Are under great stress.
◦ Have a weakened immune system (cancer, AIDS, chemotherapy/radiation, organ transplantation).

If you have shingles, you are contagious to people who have not had chickenpox, or to people who have not been vaccinated to chickenpox. You should avoid children under 1 year of age, pregnant women, those who haven’t had chickenpox or the vaccine, or immunocompromised people (with cancer, on chemotherapy or radiation, with AIDS, with an organ transplant).

If you get shingles, an anti-viral medicine can make symptoms milder and shorter. The medicine may even prevent long-lasting nerve pain. Anti-viral medicine is most effective when started within 3 days of seeing the rash.

◦ To diagnose shingles, a dermatologist will get a detailed medical history, and look at the skin.
◦ If there is any doubt, the dermatologist may scrape a blister to get a sample. This sample will be examined under a microscope. The dermatologist may also send the fluid from a blister to a laboratory for testing.
◦ Without treatment, the rash clears in a few weeks. Dermatologists, however, strongly recommend treatment. Without it, many people get pain, numbness, itching, and tingling that can last for months — or years.
◦ Treatment options include pain relievers, oral anti-viral medications which can decrease the duration of the rash and the pain, oral steroids to lower swelling and improve the long-term pain.
◦ Treatments for pain after the rash clears (post-herpetic neuralgia) include specific anti-depressant medications, pain relievers, and anesthetic creams and patches
◦ If the virus is near or in your eye, it will be suggested that you go to the hospital for intravenous treatment to prevent long term complications of this eye infection.