Shingles – Everything you wanted to Know

Shingles, also known as herpes zoster, is a viral infection that can occur anywhere on your body, but is most commonly seen on the torso or back. It is not a life threatening condition, but is usually extremely painful. It is a short-term infection which is treatable and resolves within a couple of weeks.

Cause

Shingles is caused by the varicella zoster virus – the same virus that causes chickenpox. Individuals who have had chicken pox are likely to harbor the virus in their bodies – specifically, in the nerve tissue of the spinal cord or brain. It lies dormant for years, and one day gets reactivated and travels along the skin’s nerve fibers, manifesting as shingles. You can get shingles even if you’ve never had chicken pox through someone who has shingles, as it is a contagious disease.

Symptoms

The most noticeable symptom is a stripe shaped rash which contains numerous fluid filled blisters; this stripe is usually seen wrapped around one side of the torso, back or waist, but it can also appear on the face, neck, thighs, near the eyes, or in the ears.

Some symptoms are experienced just before the rash makes its appearance, like:

• Severe pain
• Itchy skin
• Tingly feeling on skin
• Burning sensation on skin

The next stage is:

• Red striped rash
• Blisters filled with fluid that break and crust
• Pain
• Indigestion
• Dizziness

Some patients have also reported the following symptoms:

• Rise in temperature
• Fatigue
• Headache
• Sensitivity to light

Who is at Risk?

• Risk of developing shingles increases with age; specifically, after the age of 50
• Those who lead very stressful lives, and are suffering from chronic stress, without taking adequate help or medical treatment for the same are more prone to developing shingles.
• The Shingles virus attacks people who have a weak immunity. This could be due to diseases like HIV/AIDS, cancer, or they may be born with a weak immune system.
• Patients undergoing radiation or chemotherapy may have lower resistance to certain viruses and bacteria, making them at high risk for Shingles.
• Individuals who have undergone organ transplants are usually administered immunity suppressing medications to eliminate chances of organ rejection by the body. Such people may also develop Shingles because of their weakened immunity.

Treatment

Shingles usually resolves in 8 to 10 days, but it is a very painful infection, and may cause great discomfort to the patient. If the pain is extreme, painkillers may be prescribed; antiviral medication like Acyclovir or Valacyclovir etc. may be prescribed to help fight the virus. You may also be prescribed topical applications to help soothe your irritated skin, like calamine lotion. Topical lotions containing corticosteroids may also be prescribed in combination with oral medicines to speed up healing.

How soon does it resolve?

The infection is said to be gone once the blisters have dried up and disappeared. They usually break and crust, and then scab over. In about 3 to 4 weeks, the skin comes back to its normal appearance, with the redness, rash and pain gone. However, in some individuals, the pain, itching, burning sensation and discomfort may last for several weeks or even months.

Is it Contagious?

Yes, Shingles is a contagious infection; however, actual contact with the fluid in the blisters is required for an infected person to pass the virus to another person. The infection is at its most contagious when the blisters are forming, and if there is contact with the open sores (before the blisters crust over)

What are the Complications of Shingles?

Though Shingles typically resolves within a couple of weeks and leave no trace whatsoever, in some cases, it may take longer, or may cause complications. This is especially so if the person has a compromised immune system, or is of advanced age, or the shingles appeared in tricky areas like the eyes and ears. A small percentage of Shingles patients – about 4% – 0 develop complications and are hospitalized for it.

The most common complication is chronic pain caused by nerve damage which often lasts for months or even years. This condition is called post-herpetic neuralgia. Other complications include:

• Chronic, severe itching in the area where rash had appeared
• Sleeplessness
• Unexplained weight loss
• Depression

If the individual developed Herpes Zoster Oticus – or Shingles in the ear, they may experience severe ear infections and pain, and even drastic complications like loss of hearing, and also find it difficult to balance.

Herpes Zoster Opthalmicus is Shingles that affects the eyes; this is also dangerous because it can cause eye pain, infections, and temporary or even permanent blindness.

In some extreme cases, Shingles may cause major problems in the brain or spinal cord as the virus resides in the nerves in the brain and spine and travels along nerve fibers. Encephalitis, or inflammation of the brain, and Bell’s Palsy, or facial paralysis, are two of the potential complications. Some people also suffer from chronic bacterial skin infections which necessitate constant monitoring and treatment.

Can Shingles be prevented?

Yes. Shingles can be prevented by taking vaccines. It is recommended that you take the vaccine at the appropriate prescribed age so that you avoid the pain and discomfort that goes with Shingles.

Types of Vaccines for Shingles

There are basically two types of vaccines for Shingles:

• If you are in the age group of 50-59, take the Shingrix vaccine. This is administered in 2 doses, with the second shot given 2-6 months after the first dose. This vaccine contains a dead virus, along with an adjuvant which increases the body’s capability to resist the disease. It lasts long, and is more effective than other vaccines – it lowers the risk of developing Shingles by about 90%.
• People aged 60 and over can take the Zostavax vaccine. This is a single dose vaccine, and it lasts for 5 years; this means at age 65, you need another shot. This contains a weakened strain of the virus, and offers a 51% lower risk of developing the disease.

If an individual is allergic to Shingrix, they can be given Zostavax. You can take the Shingrix vaccine even after you’ve had the Zostavax – just ensure that there is a gap of 2 months between shots. You can also take the Shingrix vaccine if you’ve already had the disease once, because Shingles can manifest a second time.

It is also advisable to vaccinate children against chickenpox with the Varivax vaccine to protect them from contracting chickenpox. Adults who have not had chickenpox can also take this vaccine.

Are there any Side Effects for the Vaccine?

Yes, just as for every vaccine, the Shingrix or Zostavax vaccine also has some mild side effects, like moderate pain, redness, itching or soreness. These symptoms usually wear off in a couple of days, and are much milder than the actual Shingles symptoms.

When should you not take the Vaccine?

If you’re currently infected with Shingles, you should wait till the infection is completely gone before you get your shot. Expectant and breastfeeding moms should avoid taking the vaccine, and consult their physician or Ob-Gyn for advice. If you have any other illness, like say, flu, indigestion etc., or have a body temperature over 101, it is advisable to wait till you’re well before getting your vaccine. Some people are allergic to the Shingrix vaccine; if you have had an adverse reaction to an earlier dose of the vaccine, it’s best to avoid it, and take Zostavax instead.

• You’re allergic to any ingredient in the vaccine, or have had a reaction to a previous dose of Shingrix
• You have Shingles now
• You’re pregnant or breastfeeding
• You are sick
• You have a temperature of 101 degrees F or higher

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