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Shingles (Herpes Zoster)

Updated on March 13, 2012

Overview

Shingles is a viral infection characterized by painful rash appears usually as a strip of blisters on one side of the torso of the body; however, it may occur anywhere in the body. It is caused by Varicella Zoster Virus or VZV, the same virus that cause chickenpox.

View Slideshow: Shingles...
View Slideshow: Shingles...
Pain, rash and itching are the most common symptoms of Shingles...
Pain, rash and itching are the most common symptoms of Shingles...

Photos of Shingles:

Click thumbnail to view full-size
#1: a photo showing a group of boils on the back.#2: localized group of herpes boils over the back.#3: Single blister of herpes zoster.#4: Single large boil of herpes zoster on the leg with few boils scattered around.#5: The most common sites affected with Shingles.#6: Groups of boils over the back of a patient.#7: Groups of herpes boils located on both sides of the back.
#1: a photo showing a group of boils on the back.
#1: a photo showing a group of boils on the back.
#2: localized group of herpes boils over the back.
#2: localized group of herpes boils over the back.
#3: Single blister of herpes zoster.
#3: Single blister of herpes zoster.
#4: Single large boil of herpes zoster on the leg with few boils scattered around.
#4: Single large boil of herpes zoster on the leg with few boils scattered around.
#5: The most common sites affected with Shingles.
#5: The most common sites affected with Shingles.
#6: Groups of boils over the back of a patient.
#6: Groups of boils over the back of a patient.
#7: Groups of herpes boils located on both sides of the back.
#7: Groups of herpes boils located on both sides of the back.

Symptoms

The signs and symptoms of shingles are usually well localized to one side of the body, especially the left or right side of the torso, around one eye or in one side of the face or neck. These symptoms include:

  1. Pain: It is the main symptoms accompanying shingles. It is aching, numbing or burning in nature, and it may be intense.
  2. Rash: It appears few days after the onset of pain. Some people may experience pain only without rash.
  3. Blisters: They are fluid filled papules that may break open. And, the fluid inside is dried, then, forming a crust.
  4. Itching.

Other minor symptoms may accompany shingles, such as:

  • Headache and fatigue.
  • Fever and chills.


Causes

Shingles is caused by Varicella Zoster Virus VZV, the same virus for chickenpox. It only comes after chickenpox infection; as shingles is the secondary infection of VZV. After recovery from chickenpox or the primary infection, some viruses may enter the nervous system, and become dormant in the nerve tissue for years. These dormant viruses may, then, reactivate and travel along the nerve pathway to the skin, and produce shingles.

Open sores of shingles are contiguous until they crust, and they can pass the virus to anyone contacting you directly, and hasn’t been infected with chickenpox before. Once infected, he or she will develop chickenpox rather that shingles. You should be cautious; as shingles may be very dangerous to certain people, such as:

  1. People with weak immunity.
  2. Pregnant woman.
  3. Newborns.


High risk Group for Shingles:

Click thumbnail to view full-size
#1: people with weak immunity are more susceptible to infections including Herpes zoster.#2: During pregnancy, the pregnant woman may also develop herpes zoster.#3: Newly born infants are also of high risk of developing herpes infection.
#1: people with weak immunity are more susceptible to infections including Herpes zoster.
#1: people with weak immunity are more susceptible to infections including Herpes zoster.
#2: During pregnancy, the pregnant woman may also develop herpes zoster.
#2: During pregnancy, the pregnant woman may also develop herpes zoster.
#3: Newly born infants are also of high risk of developing herpes infection.
#3: Newly born infants are also of high risk of developing herpes infection.

Risk Factors

The major risk factor of shingles is being previously infected with chickenpox. Shingles can never occur to a person who hasn’t chickenpox before. You may have this question:

There are other risk factors that may increase the risk of shingles such as:

  1. Age: As one grows older, the immune system becomes weaker. Shingles is common above the age of 50 years old.
  2. Disease: Certain diseases such as cancer, HIV/AIDS increase the risk of shingles; as they decrease immunity.
  3. Cancer Treatment: Radiotherapy and chemotherapy make the immunity weaker, increasing the risk of shingles.
  4. Medications: Drugs that decrease immunity such as the drugs used after organ transplantation or prolonged steroid usage, increase the risk of shingles.


Complications

Shingles may lead to development of complications such as:

  1. Post-herpetic neuralgia: It is a condition persistent pain after clearance of blisters. And, it is due to damage of nerves making them send exaggerated pain pulses from the skin to the brain.
  2. Skin infection: If not treated properly, bacterial skin infections may develop.
  3. Neurological problem: Shingles may lead to nerve damage. And, according to the affected nerve, it may lead to encephalitis, facial palsy, hearing or balance disturbance.
  4. Vision loss: In case of shingles around the eye, painful eye infection may occur, and may lead to vision loss.


Painful boils of herpes zoster around the eye. It is a dangerous situation and may end in blindness.
Painful boils of herpes zoster around the eye. It is a dangerous situation and may end in blindness.

Diagnosis

Shingles is usually diagnosed depending on your history of pain in localized area, along with the presence of rash or blisters. Doctor may, also, take a scrapping of your skin or culture of the blister for laboratory investigations.


Treatment

There is no cure of shingles; it is the role of your own immunity. However, antiviral drugs may speed up healing and decrease the development of complications. Antiviral drugs include Acyclovir (Zovirax), Valacyclovir (Valtrex) and Famciclovir (Famvir). Also, pain killers are prescribed to relieve severe pain, such as:

  1. Numbing agents as Lidocaine.
  2. Burning painkiller as gabapentin (Neurontin)
  3. Aching pain killer as Amitriptyline.
  4. Medications containing narcotics as Codeine.


Chickenpox Vaccine (Varivax)
Chickenpox Vaccine (Varivax)
Shingles Vaccine (Zostavax)
Shingles Vaccine (Zostavax)

Shingles: How to Prevent?

Shingles or herpes zoster is threatening one out of every four persons in the United States according to CDC (Centers for Disease Control and Prevention).


Is Shingles contagious?

NO. You may think that shingles is contiguous due to the boils and eruptions which are usually accompany it. The virus that cause shingles, Varcella zoster virus, can be actually transmitted from one person to another. However, in this case, that person will get chickenpox, and not Shingles, if he/she hasn't got chickenpox before. There is no transmission of Shingles.

Fortunately, effective vaccines against shingles are now available. They can provide life-long protection against Varicella Zoster Virus (VZV).


Prevention of Shingles

There are two different types of vaccines available that provide protection against Varicella Zoster Virus (VZV). And, their use depends on the condition of the recipient whether he/she has been infected with Chickenpox before or not. These vaccines are:

  1. Chickenpox Vaccine (Varivax): It is indicated for anyone who has never had chickenpox before. It is now a routine childhood vaccine in many countries including USA. It can reduce the susceptibility of being infected with Varicella Zoster Virus. And therefore, it provides protection against both Chickenpox and Shingles.
  2. Shingles Vaccine (Zostavax): It is indicated for those who are above 50 years old, and have been infected with Chickenpox before. It reduces the risk of developing Shingles. But, it shouldn’t be given to those who are already infected with Shingles or have weak immunity. It may make their condition worsens.

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    • ananceleste profile image

      Anan Celeste 5 years ago from California

      Very interesting and scary at the same time. Specially for those that are at risk. Thank you for sharing!

    • Dr Rabea profile image
      Author

      Dr Rabea 5 years ago

      @ananceleste: Herpes zoster is no more scary. Effective vaccinations against it is now available, and they provide lifelong protection.

      Thank you for your interest.

    • cloverleaffarm profile image

      Healing Herbalist 5 years ago from The Hamlet of Effingham

      Very interesting. I just had a discussion with a doctor who buys my lemon balm about all the side effects of the medicines. Many people don't realize there are natural ways to help heal shingles as well.

      Great info to help people! Vote up.

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