Shingles (herpes zoster) is a disease characterized by a painful rash. It occurs when the virus that causes chicken pox, varicella-zoster virus (VZV), is reactivated. Approximately one in three Americans will develop shingles, primarily those who are over 60, have compromised immune systems or have such other medical conditions as leukemia) VZV stays dormant in the nerve cells after a person recovers from chicken pox and can reappear years later as shingles.
Symptoms
A painful sensation in the skin, often on only one side of the body near or around the midsection, is usually the first sign of shingles. This pain is almost always accompanied by a blistering or red rash in the same area within days or weeks. The pain and skin lesions follow a pathway of nerves because the virus attacks the nerve cells. Shingles can also affect your face, eyes, ears and limbs. Other indications of shingles may include fever, headache, fatigue, general achiness and chills.
Diagnosis
See your physician as soon as you suspect that you have shingles. Receiving early anti-viral treatment can often significantly reduce potentially painful and prolonged complications, especially if received within the first 72 hours of the outbreak. Your doctor will look at your skin, review your medical history and may take a few tests including blood or, in some cases, skin tests.
Treatment
Your doctor might prescribe such anti-viral medications as acyclovir, valacyclovir or famcyclovir to help reduce the duration and complications of shingles. If pain and fever are present, anti-inflammatories (steroids) and pain relievers may be prescribed An oral or topical antihistamine can help the itchiness that may accompany the rash. Rest and proper hydration can aid in your recovery time.
Complications
The shingles rash will usually crust over and resolve itself within two to four weeks, especially if you are otherwise healthy. However, a serious complication is postherpetic neuralgia (PHN), which is residual chronic pain resulting from damage to the nerves that can last for months or years. This is very debilitating, and can adversely affect the quality of your life. Other complications of the VZV reactivating include additional attacks of shingles, blindness (if shingles involved the eye), deafness and infections.
Vaccinations
In 2006, the Food and Drug Administration (FDA) approved Zostavax as a vaccine for shingles. According to Science Daily, as reported in the May 2005 New England Journal of Medicine," the Shingles Prevention Study found that the vaccine reduced shingles cases by 51 percent. Pain and discomfort were reduced by 61 percent in people who received the active vaccine but still got shingles. The vaccine also reduced the number of cases of postherpetic neuralgia by two-thirds compared with the placebo. This study was conducted in collaboration with the Department of Veterans Affairs, National Institute of Allergy and Infectious Diseases, and drug maker Merck. It involved more than 38,000 veterans age 60 and older.
The FDA recommends Zostavax for those over 60 and those at highest risk for developing shingles, in particular those with compromised immune systems. This vaccination is for prevention only and has not been shown to help with active cases of shingles.
Prevention
The primary way to prevent shingles is to avoid getting the chicken pox. There is now an effective vaccine that the CDC says protects eight to nine out of every 10 people against the chicken pox virus. If you have had chicken pox and are in any of the higher risk categories for developing shingles, talk to your doctor about getting the Zostavax vaccination.
