SHINGLES

What is shingles? Shingles or herpes zoster is an infection caused by the same virus that causes chickenpox. The virus is called varicella zoster. After a person has had chickenpox, the virus is not destroyed but moves to the roots of spinal nerves and becomes inactive. Later, the chickenpox virus can be re-activated. When this occurs, the symptoms are called shingles. You cannot develop shingles unless you have had a previous infection of chickenpox (usually as a child).

Factors, such as age, illness, medications, or stress, can make the virus active again. Older adults and people with weakened immune systems are more likely to get shingles.

Shingles can transmit chickenpox to a person who has never had chickenpox. Virus particles reside in the blister fluid. The virus can be transmitted by direct contact with the blisters, or by indirect contact such as a washcloth with blister fluid. People who have shingles, should avoid contact with infants, children, pregnant women, and adults who have never had chickenpox until the blisters are completely dry. People who have shingles are contagious 1 to 2 days before the rash appears. But the at risk people may develop chickenpox, not shingles.

Early symptoms may include sensations of burning, tingling, or itching. When the virus reaches the skin, pain, a rash, and blisters occur. The rash and blisters may appear on the chest, back, face, inside the mouth, down an arm or leg, or anywhere in a localized area or band. Shingles can occur in the eye. Usually only one side of the body is affected. The rash from shingles will heal completely within 2 to 3 weeks and the pain or irritation will usually disappear in 3 to 5 weeks. However, if the virus damages a nerve, there may be pain, numbness, or tingling long after the rash is healed.

It is best to start treatment within 24 to 48 hours after symptoms start. Home care includes applying cool compresses to the affected areas and taking acetaminophen or other mild pain relievers. Aspirin or medicines that have aspirin in them should not be given to anyone younger than 18 years of age. Taking aspirin is a risk for a serious illness called Reye's syndrome. Non-steroidal anti-inflammatory drugs (NSAIDs) should be taken with food or milk to prevent stomach upset. NSAIDs should not be taken by anyone who has been diagnosed with asthma, ulcer disease, or a bleeding disorder. Taking NSAIDs increases the risk of bleeding with trauma, dental work, surgery, or if taking blood thinners (anticoagulants). Acetaminophen should not be taken by anyone with known liver or kidney disease. Do not drink alcohol when taking more than 1 dose of acetaminophen.

Medical treatment for shingles includes:

antiviral drugs to shorten the course of painful symptoms, minimize blister formation, and speed healing
antibacterial salves or lotions to control skin infection
topical cream for pain
anti-inflammatory drugs to ease inflammation for people over 50 years of age and
stronger pain medicine for more serious discomfort

A healthcare provider should be seen for the initial diagnosis and for age-appropriate treatment. After the initial visit, contact the provider if:

worsening pain or fever develops
the blistered areas have increasing pain, redness, or milky-yellow drainage
the blisters are close to the eyes
eye pain (shingles can occur in the eye)
face pain or inability to move muscles in the face or
symptoms (such as headache, stiff neck, weakness, hearing loss, or changes in thinking and reasoning)

Disclaimer: This content is reviewed periodically and is subject to change as new health information becomes available. The information provided is intended to be informative and educational and is not a replacement for professional medical evaluation, advice, diagnosis or treatment by a healthcare professional.

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