How to Recognize and Treat Shingles

Shingles, otherwise known as herpes zoster, is an infection of the skin that is caused by the varicella zoster virus. This is the same virus that causes chicken pox, pictured above. After causing chicken pox, the virus lives quietly in the nerve roots. For many people, the virus remains in the nerve roots forever. For others, the virus reactivates and causes shingles. Reasons why the virus can reactivate include:

• A weakened immune system
• Stress
• Immunosuppression
• Medicines
• Aging

Shingles initially presents as pain, itching, or tingling on a part of the skin. In that area, a strip or small area of rash may appear. Classically, the rash only involves one side of the body, though it may cross the midline. The rash starts as redness, then blisters, then crusts. Flu-like symptoms including fever, headache, and body aches may occur before or along with the rash.

Diagnosis of shingles is usually clinical—meaning a doctor will know it when she sees it. However, the doctor may do a skin scraping or a viral culture to confirm the diagnosis.

Shingles is treated with a prescription antiviral medication. This treatment should be started as soon as possible to decrease symptoms, duration, and complications. In addition, the doctor may recommend pain medications and anti-itch medications.

Shingles in the forehead, nose, or eyelid could signal eye involvement. Shingles in these areas, or in the eye itself, should be evaluated by a doctor immediately.

Shingles usually resolves without any sequel. The most common complication is postherpetic neuralgia.Postherpetic neuralgia is chronic pain in the area of the rash. Skin infections may also occur, especially if the lesions are picked at. Other complications are extremely rare and include vision problems and neurological problems.

Shingles is contagious, but you cannot catch shingles from shingles. Instead, you can catch chicken pox from someone with shingles if you have never had chicken pox or the vaccine. I recommend that people with shingles keep the area covered until it is healed. In addition, they should avoid people who have never had chicken pox (or the vaccine) and all pregnant persons.

Vaccines are currently available for chicken pox and shingles (separate vaccines for each). The chicken pox vaccine is routine for children and recommended for adults who have never had chicken pox. Theshingles vaccine is FDA approved for people over 50 to prevent shingles.