Shingles is a viral infection that causes a painful rash. Although shingles can occur anywhere on your body, it most often appears as a single stripe of blisters that wraps around either the left or the right side of your torso. Shingles is caused by the varicella-zoster virus — the same virus that causes chickenpox. After you’ve had chickenpox, the virus lies inactive in nerve tissue near your spinal cord and brain. Years later, the virus may reactivate as shingles. While it isn’t a life-threatening condition, shingles can be very painful. Vaccines can help reduce the risk of shingles, while early treatment can help shorten a shingles infection and lessen the chance of complications.
Why it Occurs
Shingles is caused by the varicella-zoster virus — the same virus that causes chickenpox. Anyone who’s had chickenpox may develop shingles. After you recover from chickenpox, the virus can enter your nervous system and lie dormant for years. Eventually, it may reactivate and travel along nerve pathways to your skin — producing shingles. The reason for the encore is unclear. But it may be due to lowered immunity to infections as you grow older. Shingles is more common in older adults and in people who have weak immune systems.
Varicella-zoster is part of a group of viruses called herpes viruses, which includes the viruses that cause cold sores and genital herpes. Because of this, shingles is also known as herpes zoster. But the virus that causes chickenpox and shingles is not the same virus responsible for cold sores or genital herpes, a sexually transmitted infection.
Are you contagious?
A person with shingles can pass the varicella-zoster virus to anyone who isn’t immune to chickenpox. This usually occurs through direct contact with the open sores of the shingles rash. Once infected, the person will develop chickenpox, however, not shingles.
Chickenpox can be dangerous for some groups of people. Until your shingles blisters scab over, you are contagious and should avoid physical contact with: anyone who has a weak immune system, newborns and pregnant women.
The signs and symptoms of shingles usually affect only a small section of one side of your body. These signs and symptoms may include:
• Pain, burning, numbness or tingling
• A red rash that begins a few days after the pain
• Fluid-filled blisters that break open and crust over
Some people also experience: fever and chills, general achiness, headache and fatigue.
Pain is usually the first symptom of shingles. For some, it can be intense. Depending on the location of the pain, it can sometimes be mistaken for a symptom of problems affecting the heart, lungs or kidneys. Some people experience shingles pain without ever developing the rash.
Most commonly, the shingles rash develops as a stripe of blisters that wraps around either the left or right side of your torso. Sometimes the shingles rash occurs around one eye or on one side of the neck or face.
When to see a doctor
Contact your doctor promptly if you suspect shingles, but especially in the following situations:
• The pain and rash occur near an eye. If left untreated, this infection can lead to permanent eye damage. This is a medical emergency and care should be sought at earliest time possible.
• You’re 65 or older, which increases your risk of complications.
• You or someone in your family has a weakened immune system (due to cancer, medications or chronic illness).
• The rash is widespread or painful.
There’s no cure for shingles, but prompt treatment with prescription antiviral drugs can speed healing and reduce your risk of complications. These medications include:
• Acyclovir (Zovirax)
• Valacyclovir (Valtrex)
• Famciclovir (Famvir)
Shingles can cause severe pain, so your doctor may prescribe:
• Anticonvulsants, such as gabapentin (Neurontin)
• Tricyclic antidepressants, such as amitriptyline
• Numbing agents, such as lidocaine, delivered via a cream, gel, spray or skin patch
• Medications that contain narcotics, such as codeine
If the episode is done and the rash has cleared, there still may be chronic persistent pain in the affected nerve area. This can lead to chronic pain syndrome called post herpetic neuralgia. The treatment can be as above with medications or can include epidural corticosteroid injections if indicated. These may need to be repeated for hard to resolve cases.