Shingles

Shingles is a painful, condition that often occurs in people 50 and older who had chicken pox when they were children.

Certain conditions are risk factors for shingles; they make it more like for shingles to occur, or to occur at an earlier age, even in childhood. These conditions impair the immune system and include advanced age; Hodgkin's disease; corticosteroids; radiation therapy; having chickenpox before 1 year of age; and infection with HIV, the virus that causes AIDS.   

Shingles, or herpes zoster, is caused by the varicella-zoster virus, which also causes chicken pox. After a person has recovered from chicken pox, the virus lies dormant in the body's nerve roots for many years, resurfacing when the immune system is weakened. When it reactivates, the virus travels along a nerve, eventually causing pain, itching and a rash. People who have not had chicken pox can catch chicken pox if they are exposed to a person who has shingles. Shingles itself, however, is not contagious.

When you get shingles, the first symptoms are pain, itching or tingling in the area of the nerve. A rash may form, but only on one side of the body, along the path of the affected nerve. This could be on your chest, side, back or face. Half of the rashes occur on the mid-portion of the trunk; other areas that may be affected include the head, arms, abdomen, genitalia and inner thighs. The rash first takes the form of reddish bumps that turn into clusters of tiny blisters about the size of a pinhead. The blisters form over two days and become filled with fluid. They then form a crust that will fall off in 14 to 21 days. A low-grade fever and fatigue may accompany the rash.

In some people, shingles can cause a condition called post-herpetic neuralgia, a pain that continues for months after the blisters have healed. The older a person is, the more likely he or she is to develop this condition. It seldom occurs in someone younger than 50. About half of people over age 60 will develop it. The pain can be a burning/boring feeling, a sudden piercing or stabbing, or both.  

During the blistering stage of shingles, you can spread infection to others, but the infection you spread will be the varicella-zoster virus, which causes chicken pox in anyone who hasn't had it. While the blistering rash is present, avoid contact with anyone who has not had chicken pox, especially if they're very young, very old, ill or have a weakened immune system. Some people do not recall whether they've had chicken pox, so you should remain cautious while the rash is present.

Studies suggest that shingles is less common in healthy people who have been vaccinated against chicken pox than in people who have had chicken pox.

In May 2006, the Food and Drug Administration approved the first vaccine for adult shingles. Zostavax is for adults ages 60 and older: Studies showed it can prevent shingles roughly half the time. Up to one in 10 older adults won't be candidates for the vaccine, because of weakened immune systems caused by cancer therapy, organ transplants, HIV/AIDS, or other reasons. The vaccine contains live but weakened varicella virus that could overwhelm those immune systems. Researchers don't know how long immunity lasts after vaccination.

What to do

Shingles is a viral condition that responds best when it is treated early. Call your health care provider at the first sign that you might have shingles, especially if you get shingles on your face, or on or near your eye.

Use Medicine Effectively

Oral antiviral medications usually are prescribed. For the best results, antiviral medication should be started within 72 hours of the onset of the rash. A doctor also may prescribe a steroid or a pain-relieving cream for the rash and may advise you to take medication for fever and pain. In addition to antiviral medications used to lessen the severity and length of the illness, your health care provider might tell you to take non-steroidal inflammatory drugs (NSAIDs) or other medications to control pain.

Self-care Steps for Shingles

• Avoid contact with anyone who has not had chicken pox.

• Take showers and gently clean the rash, but avoid taking baths until the rash is gone.

• A sterile dressing should be used when the blistering rash is present.

• An over-the-counter capsaicin cream is available for relief of post-herpetic neuralgia.