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SHINGLES

Shingles, otherwise called as herpes zoster, is a painful skin condition in which a person develops tingling, burning and itchy skin rashes or blisters. It is caused by herpes zoster virus, which is also responsible for causing chicken pox. It usually affects one side of the body. This condition is characterized by a stripe of blisters in the neck, torso and face. It is more common in people over the age of 50 years. Herpes zoster is contagious, and it can spread from person to person by direct contact with the fluid from an active blistering rash. Once the shingles rash has dried out and developed crusting, it is not contagious.

SIGNS AND SYMPTOMS

The signs and symptoms of shingles include:

  • Pain, burning, numbness or tingling on the affected skin
  • Fluid-filled blisters that break open and crust over
  • A red rash that develops a few days after the pain
  • Swollen lymph glands which are present near the affected area
  • Body pains
  • Headache
  • >Itching
  • Fever
  • Fatigue

CAUSES

Shingles is caused due to varicella-zoster virus which is also responsible for causing chickenpox. After recovery from chicken pox, the virus enters nervous tissue of the brain and spinal cord and stays inactive for years. Eventually, it may reactivate, travel along the nerve fiber, enter the skin and cause shingles.   Individuals who come in direct contact with the open sores of shingles can acquire this infection. Pregnant women, newborns and people with weak immune system are more susceptible to acquire this infection.

RISK FACTORS

The person who has had chicken pox once in his/her life can develop shingles later. The risk factors of shingles include:

  • Taking medications that suppress the immune system such as prednisone
  • Disease that affects immune system such as HIV/AIDS, cancer
  • Undergoing treatment for cancer
  • Age above 50 years

COMPLICATIONS

Complications of shingles include:

  • Postherpetic neuralgia: In some people with shingles, pain may persist even after blisters have cleared. This happens because the virus damages and causes inflammation of the nerve fibers below the affected nerve. This pain is referred to as prostherpetic neuralgia.<
  • Ramsay Hunt syndrome: This occurs when the virus affects the facial nerve near your ears. This condition causes facial paralysis and hearing loss in the affected ear.
  • Vision loss: Shingles involving the eyes may cause painful eye infection and loss of vision.
  • Skin infections: The skin lesions of shingles are prone to skin infections if not treated on time.

DIAGNOSIS

Herpes zoster is usually diagnosed clinically based on its distinctive rash and its distribution along a dermatome (area of the skin supplied by nerves from a single spinal root). Antibody tests, PCR test and Tzanck tests are the lab tests done to assess the presence of varicella zoster virus in a sample of the blister fluid.

TREATMENT

Medications

The doctor may prescribe antivirals drugs such asacyclovir, valacyclovir or famciclovir which can speed healing and prevent shingles from complicating

Shingles can cause pain for which the doctor may prescribe following:

  • Numbing agents, such as lidocaine, in form of a cream, gel, spray or skin patch
  • Injection including corticosteroids and local anesthetics
  • Medications that contain narcotics, such as codeine
  • Tricyclic antidepressants, such as amitriptyline
  • nticonvulsants, such as gabapentin
  • Capsaicin topical patch

Home remedies

Pain and itching can be relieved by the following methods:

  • Using cool, wet compress on blisters
  • Taking colloidal oatmeal baths
  • Applying calamine lotion
  • Wearing loose clothing
  • Taking cool shower
  • Reducing stress

PREVENTION

There are two vaccines to prevent shingles:

  • The chickenpox (varicella) vaccine:This vaccine is given as a part of routine childhood immunization to prevent chicken pox. The first dose of varicella vaccine is given by to the children between the age of 12 and 15 months, followed by a booster shot which is administered at the age of 4 to 6 years. This vaccine is also advisable for adults who have never had chicken pox. This vaccine can reduce your chances of complications and reduce the severity of the disease rather than preventing it.
  • The shingles (varicella-zoster) vaccine:This vaccine is recommended for people over the age 50 years, irrespective of whether they have had the disease or not. This vaccine can reduce the course and severity of the disease and reduce the risk of postherpetic neuralgia for the first five years after vaccination.
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