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Shingles Signs and Symptoms Shingles is caused when the varicella zoster virus attacks the nervous system. The virus is the same virus that causes chicken pox. The virus doesn’t leave the body after a person has had chicken pox, but lies dormant in the spinal cord until something like a lowered immune system, illness or other stress triggers it. It affects the nerves on only one side of the body. Usually the victim is an older adult over age 50, though shingles can occur in children whose mothers were exposed to the virus shortly before their birth. Only people who have had chickenpox can have shingles. Unlike chicken pox, shingles is hard to catch because it’s not transmitted through the air. An uninfected person has to come in contact with the blisters, and then they’ll develop chicken pox, but not shingles. Signs and Symptoms Shingles appears as red, fluid filled blisters anywhere on the body. The pain of the blisters is sometimes described as burning, shooting or excruciating. The blisters can also tingle and itch. They appear four to five days after the early symptoms begin, and appear along the nerve routes of the body, most often on the chest or in a band near the waistline. The blisters last from one day to two weeks, and may effect vision or hearing if they’re on the face.
Some cases of shingles happen without blisters. This is called zoster sine herpete. Most people recover from an attack of shingles, save some mild scarring. A person should then be immune from further episodes of shingles, though some people have more than one attack. Complications A complication of shingles is that they suffer a second episode, or chronic pain that persists for months or years in the nerves where the blisters had appeared. This is known as post herpetic neuralgia. This condition can be treated with anticonvulsant drugs, since these drugs help to quiet nerves that are firing, which is what’s happening in post herpetic neuralgia. Another treatment is with a lidocaine skin patch. Since the drug stays in the skin, it doesn’t cause drowsiness. Over the counter medicines like acetaminophen and ibuprofen can help, but for some patients the pain is such that they need stronger medicines like oxycodone. Antidepressants might sometimes be helpful as well.
Postherpetic itch can be another complication of shingles and can also be very painful. Topical anesthetics help in these cases. Treatment The VZV vaccine is available for people who are over 60 and who’ve already had chicken pox. The vaccine is quite effective, and even people who get shingles after being vaccinated have much milder symptoms. However, the vaccine doesn’t work for people who already have shingles or who have post herpetic neuralgia.
People who have shingles should avoid drafts, wash the blisters gently while bathing, and shouldn't put bandages over the sores. Hot, moist compresses might ease the pain of the blisters. The doctor might prescribe pain relievers, tranquilizers, antiviral drugs like acyclovir or even cortisone drugs like prednisone if the pain is very severe. |
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