What are shingles?

Shingles is a painful infection of the nerve roots that is most often found in older persons with deficient immune systems.  Nerve roots extend from both sides of the spinal cord and join together to comprise the spinal nerves that pass between the vertebrae.  From there, branches from these nerves wind their way throughout the body.

The immune deficiency is most often caused by age, illness, injury, stress, or some medications. 

What causes shingles?

Shingles is caused by the chickenpox virus.  After recovering from chickenpox, the virus in the nerve roots becomes dormant and exhibits no symptoms.  In most people, the dormancy will last for the rest of their lives.  However, particularly in people that are susceptible because of immunity issues, the virus may reawaken and manifest itself in the form of shingles, not chickenpox.  Why this happens is not clear, but the disease is not contagious.  However, if you have never had chickenpox, you should avoid contact with anyone with shingles since exposure could give you chickenpox.

What are the symptoms?

The symptoms most often appear slowly and in stages.  Initially, you may suffer from a headache or feel like you are coming down with the flu, absent a fever.  Over time, you may start to feel itching or pain that will be followed by the appearance of a rash on one side of your body.  The rash area will blister, crust over, and will heal within a few weeks.  The symptoms may vary from person to person as some experience sensitivity to light, weakness, dizziness, vision changes, and inability to think clearly.  Some people show no signs of rash, only a mild rash, or extensive rash that spreads to their face.

Video: Shingles Pathophysiology

The long-term effects may include chronic pain as well as aching and burning sensations in the areas that were affected by the rash.  This may be accompanied by sensitivity to touch in the same areas, and may make it difficult for some people to sleep, eat, and lead normal lives.

How shingles is transmitted

Shingles only occurs in people who have previously had chickenpox, so the disease is not transmitted like most other diseases.  Those who have not had chickenpox can get that disease through exposure to the fluid in the rash blisters.  The best defense is for these people to stay away from anyone who still exhibits such symptoms.  If that's not possible, the blisters should be covered with a dressing that absorbs the fluids and protects the affected areas.  Most people who get shingles will not get it again.

How shingles is treated

While there is no cure for shingles, proper treatment can help ease pain and avoid serious complications.  A doctor should be consulted as early as possible to monitor your care and treatment options.  If antiviral medicines are prescribed within the first couple of days, this lowers the chance of future problems such as postherpetic neuralgia, a condition that causes headaches and persistent pain.  These medications can be supplemented by pain suppressors such as corticosteroids, aspirin and ibuprofen, and topical applications for additional relief.  In the case of surface skin infection, topical antibiotics may be required.

Creams and other natural remedies may also provide temporary relief.  Capsaican, found in hot chili peppers, as well as calamine lotion are often used.  Apple cider vinegar dabbed directly on the affected areas may help dissipate itching and burning sensations.  In addition to providing relief from itching, aloe vera gel helps to heal sores and blisters.  Proteolytic enzymes, found in foods such as pineapple and papaya, have been shown to provide pain relief and aid in healing of the skin.  Supplements are available that are derived from these natural sources, and most have minimal side effects.  It's wise to check with a doctor to ensure that these remedies will not cause any reactions when used with other medications that may be prescribed.

Long-term treatments and prevention methods

Video: Shingles

Postherpetic neuralgia usually affects 10% to 20% of those who have shingles, and can last for months or even years.  Possible treatments include codeine, anticonvulsants, antidepressants, and topical anesthetics.  While most cases last no more than a year, the most extreme cases may require surgery to block specific neural pathways.  If the rash appears on your face or around an eye, an ophthalmologist should examine you immediately. 

Zostavax has been approved for those over sixty who have already had chickenpox.  It is essentially the vaccine given to children for chickenpox, administered in a booster dose.  It will prevent shingles or lessen the pain and duration of the disease should you contract it.