Who Is at Risk of Shingles Virus? ( courtecy;-
medicinenet.com )
What Is Shingles? Common
Symptoms
Shingles is a virus
condition involving inflammation of sensory nerves that can result in severe
pain. It causes localized pain, numbness, and itching, followed by the
appearance of clustered blisters in a strip pattern on one side of the body.
Sometimes the pain can persist for weeks, months, or years after the rash heals
(known as postherpetic neuralgia). The term “shingles” is derived from the
Latin word cingulum, meaning girdle -- the idea being that shingles often
girdles part of the body.
Shingles Virus
Shingles
is caused by the same virus that causes chickenpox (varicella-zoster virus or
VZV), a member of the herpes family of viruses. After a person has chickenpox,
the virus can live dormant in the nervous system for life. Sometimes the virus
remains dormant forever, but in other cases, the virus reactivates along a
nerve of sensation.
Causes of Shingles Virus Reactivation
·
Disease
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Stress
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Aging
Each
of these factors can weaken the immune system, resulting in shingles. However,
usually a cause for the reactivation of the virus is never found. If the virus
reactivates, it can only cause shingles, and does not cause widespread
chickenpox again.
Shingles Rash Pictures
The
shingles rash appears as painful skin blisters that appear on only one side of
the face or body along the distribution of nerves in the skin. The rash may
occur around the chest, upper back, abdomen, face, the limbs, neck, or lower
back.
Who Is at Risk of Shingles Virus?
Shingles
is most common in people over 60 years of age, although anyone who has ever had
chickenpox is at risk.
Risk Factors for Shingles Reactivation
·
Weakened immune systems
·
Immune deficiency (from AIDS or
chemotherapy)
·
Emotional stress
·
Cancer
Up
to 1,000,000 cases of shingles are estimated to occur each year in the U.S.
Shingles Symptoms: Before the Rash
The
pain of shingles may develop even when there is no rash. The patient may notice
several days to a week of burning pain and sensitive skin before the rash
appears. In this situation it may be difficult to determine the cause of the
often severe pain.
How Pre-Rash Shingles Pain Is Described
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Itching
·
Burning
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Tingling
·
Constant aching
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Deep, shooting pain
Other Symptoms That May Occur Before Shingles Rash
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Fever
·
Chills
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Upset stomach
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Headache
Shingles Symptoms: The Rash
The
characteristic rash of shingles rash starts as small blisters on a red base.
New blisters continue to form for three to five days. The blisters appear along
the path of individual nerves in a specific "ray-like" distribution
(called a dermatomal pattern) and appear in a band-like pattern over an area of
skin.
Shingles Symptoms: After the Rash
Just
like the blisters of chickenpox, the blisters in shingles eventually burst, and
the area starts to ooze. The blisters will then crust over and heal. Before the
blisters crust over, the VZV virus can be spread to anyone who is not immune to
chickenpox through vaccination or previous infection. The scabs eventually fall
off, and the rash disappears. Sometimes scarring may result.
How Long Does Shingles Last?
An
outbreak of shingles can last for 3 to 4 weeks. Sometimes the pain is present
but the blisters never appear. This can be a very confusing cause of pain. Some
affected people develop postherpetic neuralgia (PHN), in which the localized
pain remains even after the rash is gone.
Shingles Complications: Postherpetic Neuralgia
Postherpetic
neuralgia (PHN) is the most common complication of shingles. This is defined as
persistence of the nerve pain associated with shingles beyond one month, even
after the rash is gone. It occurs from irritation of the sensory nerves by the
virus. The pain of PHN can be severe and debilitating. Up to 15% of people with
shingles develop PHN. Typically, this occurs in people over 50 years of age.
Treatment of shingles with antiviral drugs can reduce the duration and
occurrence of postherpetic neuralgia.
Is Shingles Contagious?
Shingles
is contagious. Shingles can be spread from an affected person to babies,
children, or adults who have not had chickenpox. Instead of developing shingles,
these people develop chickenpox. Once they have had chickenpox, people cannot
catch shingles (or contract the virus) from someone else. Once infected with
VZV, however, people have the potential to develop shingles later in life.
Shingles
is contagious to people who have not previously had chickenpox when there are
new blisters forming and old blisters healing. Like with chickenpox, the time
prior to healing or crusting of the blisters is the contagious stage of
shingles. After all of the blisters are crusted over, the contagious period is
over and the virus can no longer be spread.
Other Shingles Complications
Usually,
shingles heals well and remaining problems are minimal. However, complications
may arise from time to time.
Cellulitis
On
occasion, shingles blisters can become infected with bacteria, resulting in
cellulitis. Cellulitis is a bacterial infection of the skin. When cellulitis
occurs, the skin area turns reddened, warm, firm, and tender.
Vision Loss
A
more worrisome complication occurs when shingles affects the face (forehead and
nose), which may spread to the eye and lead to loss of vision.
How Is Shingles Diagnosed?
The
clinical appearance of shingles is usually sufficient for a doctor to establish
the diagnosis. Diagnostic tests are not usually required. However, particularly
in people with impaired immune function, shingles may sometimes not have the
characteristic clinical pattern. In this situation, samples from the affected
skin may be examined in a laboratory, either by culturing the tissue for growth
of the virus or by identifying the genetic material of the virus.
Shingles Treatment
You
can take steps to reduce the duration of a shingles outbreak, but in the end,
the virus must often simply run its course. There is no cure for shingles.
Antiviral medication is effective only if given early, so it is important to
visit your doctor soon after an outbreak starts or is suspected Those with
facial, nose, or eye symptoms should seek medical care immediately. Early
medical attention may also prevent or reduce any scarring.
Shingles Treatment: Drugs
There
are many drugs used to fight shingles and its symptoms. This is an explanation
of those drugs and their functions.
Antiviral Drugs
Drugs
that fight viruses (antiviral drugs), such as acyclovir (Zovirax), valacyclovir
(Valtrex), or famciclovir (Famvir), can reduce the severity and duration of the
shingles rash if started early (within 72 hours of the appearance of the rash).
Pain Medications
In
addition to antiviral medications, pain medications may be given. Both
nonsteroidal anti-inflammatory medications and narcotic pain-control
medications may be used for pain management in shingles. Postherpetic neuralgia
(PHN) may require additional medications to control pain.
Topical Corticosteroids
Topical
corticosteroids are sometimes used to decrease inflammation and pain, but these
should be used only under the supervision of a health care professional since
in some patients, corticosteroids may make the condition worse.
Shingles Treatment: Home
Remedies
Bathing is generally
allowed, and the affected area can be washed with soap and water. Cool
compresses and anti-itching lotions such as calamine lotion may also provide
relief from symptoms. An aluminum acetate solution (Burow's or Domeboro solution,
available at pharmacies) can be used to help dry up the blisters and oozing.
Application of petroleum jelly can also aid in healing. Over-the-counter (OTC)
antihistamines, such as diphenyydramine (Benadryl) and pain medicines can also
help provide relief.
Wearing loose clothing
can help avoid extra pain from clothing rubbing against the rash. Avoid close
skin-to-skin contact with others who have not had chickenpox, are ill, or who
have a weakened immune system to avoid spread of the virus.
Shingles Vaccine
In
May 2006, the U.S. Food and Drug Administration (FDA) approved the first
vaccine for adult shingles. The vaccine is known as Zostavax and is approved
for use in adults ages 50 and over who have had chickenpox. The U.S. Centers
for Disease Control and Prevention (CDC) recommends the vaccine for people 60
years of age and over who have had chickenpox. It is a onetime injection that
contains a booster dose of the chickenpox vaccine that is given to children.
Tests
showed that the vaccine significantly reduced the incidence of shingles in
older adults. The single-dose vaccine was shown to be more than 60% effective
in reducing shingles symptoms, and it also reduced the incidence of
post-herpetic neuralgia (PHN) by at least two-thirds. Even if you have had shingles,
you can still have the vaccine to help prevent future outbreaks.
Who Should Avoid the Shingles Vaccine?
Some
people should not receive the shingles vaccine, including pregnant women and
those with significantly suppressed immune systems.
Pregnant Women
The
shingles vaccine should not be given to pregnant women. It is recommended that
a woman wait three months before trying to become pregnant after she has
received the shingles vaccine.
People With Weakened Immune Systems
People
with weakened immune systems due to immune-suppressing medications, HIV
disease, cancer treatment, or organ transplants should not receive the shingles
vaccine because it contains live, weakened virus particles.
People Under Age 60
There
is not enough information available to determine whether Zostavax may be
generally beneficial in people younger than 60 years of age.
Shingles Vaccine Side Effects
The
shingles vaccine has not been shown to cause any serious side effects or health
consequences. Minor side effects of the vaccine include redness, swelling,
soreness, or itching at the site of injection, and headache. It is safe for
those who have received the shingles vaccine to be around babies or those with
weakened immune systems. It has not been shown that a person can develop
chickenpox from getting the shingles vaccine, although some people who receive
the vaccine may develop a mild chickenpox-like rash near the injection site.
This rash should be kept covered and will disappear on its own.
Shingles Risks and Pregnancy
Pregnant
women are susceptible to shingles. Fortunately, shingles in pregnancy is very
rare. The antiviral medications described previously are considered safe to use
in pregnant women, as are most pain-relieving drugs. Women should not take
nonsteroidal anti-inflammatory medications such as ibuprofen (Advil) or
naproxen (Aleve) in the later stages of pregnancy, but acetaminophen (Tylenol)
is considered safe. Having chickenpox during pregnancy has the potential to
cause birth defects, depending upon when in the pregnancy the infection occurs.
The risk of birth defects is believed to be lower with shingles than with
primary chickenpox infection.
Reviewed by William C. Shiel Jr., MD,
FACP, FACR on Thursday, August
18, 2016
Shingles Rash
Pictures, Symptoms, Vaccine Facts
This tool does not
provide medical advice.
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