Shingles – Risk Factors, Symptoms and Treatment

Shingles is caused by reactivation of Varicella Zoster Virus which causes chicken pox.

After chicken pox resolves, the virus travels from skin and resides in nerve roots for life. Normally, the virus will stay there without causing any problems. However, at some points, it becomes active again and travels back to the skin causing painful rash on areas that nerve supplies.

Risks factors of reactivation are stress, lack of sleep, weak immune status and increasing age. Elderly people are at an increased risk of developing zoster and its complications such as more extensive spread of the lesion, bacterial infection and neuropathic pain (pain along the nerve in your skin). These complications are less likely if the patients received antiviral medication within 3 days after the onset of the symptoms. The patients in this group are also more likely to have dry skin so applying moisturizer or lotions over the affected areas may help prevent neuropathic pain.
Symptoms:

Pain, itch, tingling, or burning sensation with groups of blisters on red base, sometimes with crust and pustules are the common signs and symptoms of shingles. The skin lesions usually occur on one side of body.

Treatment

Oral antivirus for 7-10 days with better results if the medication is started within 3 days after symptoms occur.
Oral or topical pain killer medications.

Vaccine

We now have an US FDA approved vaccine for zoster, Zostavax®. Zostavax® is recommended in patient aged 60 and above whom have had varicella (chicken pox) but may or may not have zoster in the past. One dose can reduce the chance of developing zoster and its severe complications.

Shingles Tips

You are more likely to get eyes symptoms from shingles, such as keratitis if you have skin blisters or rash on the tip of nose or around the eye.
Shingles is contagious by direct contact to patients who never had chicken pox but remember that it will cause chicken pox, not shingles!
Even after shingles resolve, some patients will still have pain or unpleasant sensation along previous infected areas for weeks to months, which can be controlled with oral or topical pain killer medications.