Shingles affects 25 percent of Americans over the age of 40, according to the National Institute of Neurological Disorders and Stroke. The disease results from reactivation of the varicella-zoster virus, the same virus that causes chicken pox, within clusters of sensory nerves that doctors refer to as dorsal root ganglia. An active episode of shingles usually lasts anywhere from two to four weeks. However, some people experience persistent symptoms after having shingles.
Pain
Stinging, burning, itching, tingling or aching pain accompanies an active episode of shingles and often lasts for one to two months after skin symptoms subside, according to the American Academy of Family Physicians. In some cases, it may last six months or longer, a condition known as post-herpetic neuralgia. Most people describe the pain as mild to moderate; however, for some people, it can be severe and disabling. Pain due to shingles localizes in the skin. A light breeze or contact with clothing can be enough to set it off. The duration and severity of post-shingles pain generally increases with age, explains the Centers for Disease Control and Prevention.
Skin Changes
An active episode of shingles produces a blistering skin rash that often takes two to four weeks to heal completely, advises Richard J. Whitely, M.D., professor at the University of Alabama School of Medicine. Patients who pick at lesions and those whose lesions become co-infected with bacteria often develop permanent scars. The affected area also often exhibits abnormal pigmentation for several weeks or even months. In dark-skinned individuals, the affected area may be lighter than surrounding skin. In fair-skinned individuals, the area usually appears pink or reddish compared to surrounding skin.
Sensory Deficits
It's also not uncommon, says Whitely, for patients to report decreased sensitivity to light touch and temperature on the affected skin. If shingles affects the face, ringing in the ears, decreased sense of taste and mild hearing loss may last weeks or months. Sometimes, shingles strikes the optic nerve, a condition known as zoster opthalmicus. Without prompt intervention with antiviral drugs and steroids, warns the Mayo Clinic, blindness due to shingles may be permanent.
Behavioral Changes
Patients who develop post-herpetic neuralgia after shingles often exhibit changes in behavior and personality. Common symptoms, according to the National Institute of Neurological Disorders and Stroke, include sleeplessness, unintentional weight loss, depression and inability to work. A 2010 study in the journal "BioMed Central Medicine" found that 40 percent of people with post-herpetic neuralgia reported impaired ability to perform activities of daily living such as bathing, dressing, eating, performing household chores, shopping and attending social activities. For a smaller number, post-herpetic neuralgia can trigger thoughts of suicide and suicide attempts.
References
- National Institute of Neurological Disorders and Stroke: Shingles
- "Harrison's Principles of Internal Medicine, 23rd Edition;" A.S. Fauci et al.; 2008
- American Academy of Family Physicians: Shingles
- Centers for Disease Control and Prevention: Shingles: Disease FAQs for Providers
- "BioMed Central Medicine;" Impact of Herpes Zoster and Post-Herpetic Neuralgia on Quality-of-Life; R.W. Johnson et al.; Jun. 2010
