Shingles (Herpes Zoster)

SHINGLES (HERPES ZOSTER)

Last Updated December 20th, 2021

Overview

Humans frequently come into contact with viruses. Not all viruses are necessarily capable of causing disease, though. Those that do, cause infections by invading the cells of our bodies and taking over the resources of these cells to facilitate the reproduction of viral DNA or RNA in order to form multiple ‘daughter’ viruses. This causes the death of the host cell, releasing the new virus units to invade other cells in a similar fashion, spreading further and further and causing symptoms.

Viral infections are generally short-lived and self-limiting. However, even after symptoms have subsided the viruses can remain in a dormant state within the cells. The immune system, having once identified the pathogen and successfully countered it, is capable of preventing its spread. But sometimes, the immunity becomes weakened, allowing the dormant virus to reactivate. This is known as a latent infection. For example, the chickenpox virus can reactivate some time after the initial infection to give rise to a condition called ‘shingles’ or ‘herpes zoster’.

 

What is Shingles?

SHINGLES (HERPES ZOSTER) eyesIndividuals who have suffered chickenpox will never again suffer a repeat of that disease. But the virus responsible for it, the varicella-zoster virus, remains dormant in certain nerve cells and can give rise to a painful skin condition called shingles if it reactivates. This virus is highly contagious and it is estimated that as many as one in every four or five individuals will experience an episode of shingles during their lifetime.

The main symptoms are pain, itching, and a blistering skin rash. Generally, this rash forms a band or stripe across one part of the body. Although it can potentially develop anywhere including the face, it is more common to find this rash appearing on the abdomen or the chest. An episode of shingles is self-limiting and tends to run its course within two to four weeks. Yet, the blisters may leave behind scarring and the patient may continue to suffer nerve pain for some time afterward.

 

Who Can Develop Shingles and How?

The rash itself cannot spread from one person to another. However, the virus responsible certainly can, usually through direct contact with the fluid contained in the blisters. Initial infection with the varicella-zoster virus can produce chickenpox. Anyone who has once experienced a bout of chickenpox is at a potential risk of developing shingles later in life. This is because the varicella-zoster virus remains present in the body in an inactive form, within certain nerve cells called dorsal root ganglia. Under the right conditions, the dormant virus can return to an activated state and cause symptoms such as fever and a painful skin rash. Conducive conditions become available to the virus when the host’s immunity is weakened for a variety of reasons. These include:

  • Being older than 50 years of age is associated with an increased risk of developing shingles.
  • Pregnancy.
  • If a woman suffers chickenpox during pregnancy, her baby is likely to develop shingles during the first two years of life.
  • Menopause.
  • Taking immunosuppressant medications for receiving an organ transplant.
  • Severe injury.
  • Severe stress.
  • HIV infection.
  • Illness such as cancer.
  • Taking chemotherapy or radiation therapy for cancer.

 

What are the Signs of Shingles?

SHINGLES (HERPES ZOSTER)The onset of the main symptoms is preceded by a headache or sensitivity to light in some cases. This is followed by localized sensations like itching, tingling or pain. This is because the virus causes inflammation of sensory nerve roots. A few days later, a red rash will usually develop at the same site, along with blisters. It can take a few weeks for these blisters to dry up, crust over and heal. Not everyone necessarily develops a rash and some may have only a mild one. A fuller list of symptoms appears below. A few or more of these may develop in an individual case of shingles:

  • A headache.
  • Photosensitivity.
  • Abnormal sensations such as pain, prickling, and itching. Patients often complain of sharp stabs of severe pain.
  • A blistering rash with clusters of fluid-filled blisters and localized reddening of the skin. This rash is usually unilateral.
  • Fever.
  • Chills.
  • Nausea.
  • Dizziness.
  • Fatigue.
  • Diarrhea.
  • Difficulty in passing urine.

 

Other Variants of Shingles

Apart from the typical presentation described above, there are certainly less common variants of shingles.

  • Ophthalmic shingle is a condition in which one of the eyes is directly affected. This occurs when the virus reactivates in the trigeminal nerve which is partially responsible for sensory and motor function in the facial area. This can give rise to conjunctivitis and even lead to permanent damage to vision. The rash develops in the area around the affected eye, on the forehead and nose.
  • Intraoral shingles involve a toothache in some instances along with undefined lesions mimicking the more common canker sores or mouth ulcers. In this case, too, the virus affects the trigeminal nerve.

 

Can There Be Any Complications?

Although this condition is not especially harmful in itself, the pain can be severe and certain severe complications can arise. In fact, according to statistics put out by the Centers for Disease Control and Prevention, complications appear in at least one-third of all diagnosed cases. Possible complications are:

  • If one of the eyes is affected, there is a possibility that the patient could suffer permanent damage to vision.
  • Patients may experience nerve pain at the affected site even after the rash has cleared up. This is known as postherpetic neuralgia and the reason for it is nerve damage. This pain can last anywhere from one month to a few years.
  • In immunocompromised patients, it is possible for the condition to spread beyond the skin and to organs such as the liver and brain resulting in conditions such as hepatitis, meningitis and encephalitis. While some patients develop facial paralysis or problems with hearing and balance, in others this can be a life-threatening development.

 

What Tests Help To Diagnose Shingles?

SHINGLES (HERPES ZOSTER) handsShingles is usually diagnosed on the basis of clinical presentation of symptoms and may or may not require laboratory testing.

Initially, the skin rash can be confused with signs of other dermatological conditions such as contact dermatitis, impetigo or papular urticaria.

However, a known medical history of chickenpox can help the physician diagnose shingles upon presentation of telltale symptoms such as the unilateral rash, blisters, itching, and pain.

Taking samples of skin and discharge from the site of the rash for culturing and testing helps to confirm suspicion of shingles.

 

Treatment and Prevention

Treatment – There is no known cure for shingles, but your doctor can provide you with these medications to help reduce the symptoms, speed up the healing process, and avoid complications.

  • Acyclovir
  • Valacyclovir

Since shingles are very painful, your doctor may also prescribe

  • Capsaicin topical patch.
  • Anticonvulsant, such as gabapentin.
  • Tricyclic antidepressants, such as amitriptyline.
  • Numbing agents, such as lidocaine, delivered via cream, gel, spray or skin patch.
  • Medications that contain narcotics, such as codeine.
  • An injection including corticosteroids and anesthetics.
  • Take a cool bath or using cool, wet compressions on your blisters may help in reducing the itching and pain.

Preventions 

  • Vaccination can help keep you from developing severe shingles symptoms or complications from shingles.
  • All children should receive 2 doses of chickenpox vaccine.
  • Adults who have never had chickenpox must also get the vaccination.
  • Adults who are 60 years and above need to get the shingles vaccine.
  • Avoiding people who have never had chicken pox and those who have a weak immune system.
  • Wash your hand frequently.
  • Follow a diet to strengthen your immune system.

Facts

  • In the USA, nearly 1 in 3 people will develop shingles at least once in their lifetime.
  • Anyone who has had chickenpox is susceptible to shingles.
  • The risk of acquiring shingles increases with age with half of the cases occurring in the 60-plus age group.
  • According to the CDC, there are 1 million cases of shingles in the US each year.
  • After you get chicken pox, the virus does not leave your body, it resides in your nerve tissue in a dormant state.

Facts

  • Shingle is a rash; it scabs over after 3-5 days.
  • Just over 10% of people with shingles develop complications in addition to blisters and infections.

Facts

  • Stress, stressful life events, and depressive symptoms contribute to the outbreak of shingles.
  • There is a vaccination for shingles.
  • Shingles during pregnancy may or may not cause problems to the fetus.

Related Conditions

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Dos and Don'ts

Dos
  • A local dressing with room temperature water on the rash site.
  • Keep the skin clean.
  • Rub some coconut oil once the scabs come off. This is because the skin tends to become very dry, scratched and crack at times.
Don'ts
  • Share any items with your family and friends, if it is in the blister phase it is contagious.
  • Re-use any item that have been used by you or anyone with shingles.
  • Stay in close contact with anyone for 7-9 days, until the blisters have healed.

 

 

 

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L-theanine attention
L-Theanine: Better sleep, higher focus, and many other benefits Did you know that L-theanine found in green tea can make you sleep better and be focused at…
improve digestion weight loss
Power up your gut: 8 proven steps on how to improve your digestion Did you know you have a colony of bacteria in your gut that help you in digesting food?…
Plexus Slim: Is this pink slimming drink the ultimate one-stop fat burner? How effective is Plexus Slim in helping people lose weight? What are its ingredients? Can it be safely…
liver cleanse detox
14 go-to foods that are best for a complete natural liver detox Liver cleanse can be achieved by just choosing or avoiding certain types of food. Liver itself is a detoxifying…
Balneotherapy jacuzzi
5 things you didn’t know about balneotherapy and how you can do it at home Sauna baths have been popular since a long time. But how much more beneficial can balneotherapy be as…
EEG
Electroencephalogram – EEG EEG or electroencephalogram is a diagnostic tool used to access the functioning of neurons and brain activity to…
LFT-test
Liver Function Test – LFT LFT or Liver Function Test is a blood test used to determine the levels of hepatic enzymes which…
HSV-1_IGG
Herpes Simplex Virus I (HSV)-IgG Test Herpes simplex virus I(HSV)-IgG is an Immunoglobulin protein that acts as an antibody & stays in the blood…
apolipoprotein a1 test
Apolipoprotein -A1 (APO-A1) Test Apolipoprotein A-I (Apo-A1) constitutes 70% of protein content in high-density lipoprotein (HDL) and helps in lipid metabolism.
Squid-ink-spaghetti
Squid Ink: A unique food coloring and flavoring agent Want to add a unique black color to your pasta, noodles and ice-creams? How can you use squid…
Squid-ink-spaghetti
Squid Ink: A unique food coloring and flavoring agent Want to add a unique black color to your pasta, noodles and ice-creams? How can you use squid…
Squid-ink-spaghetti
Squid Ink: A unique food coloring and flavoring agent Want to add a unique black color to your pasta, noodles and ice-creams? How can you use squid…
Hepatitis A virus infected liver
Hepatitis A Virus (HAV) Total Blood test to look for IgM antibodies to know if you are infected with Hepatitis A virus (HAV),…
alcohol toxic
7 startling facts that will make you quit alcohol today Does drinking really make you friendly and happy? How many calories does a can of cold beer add…
lose weight fast
12 easy and instant steps to successful weight loss Do you want to lose weight without losing your mind? Does weight loss always mean saying goodbye to…
Jack in the box fast food
Jack In the Box : The perils of surging fast food culture in the USA Jack in the Box - How a culture of fast-food can clog your arteries, weaken your heart, fatten…
nutritional yeast bread
Nutritional Yeast : How can a fungi culture be good for your body? Nutritional yeast: How a simple culture of fungi can transform your skin, digestion, immunity , and much more.…
avocado benefits
Avocado: 15 reasons why this fruit should be a staple in your diet Did you know that the word avocado literally means "testicles". Don't get grossed out as this power-packed fruit…
Cottage cheese: What can you find in this healthy chunk of fresh milk cheese? Love cheese but scared of putting on extra pounds? With cottage cheese, you can get the best of…
General adaptation syndrome: Understanding stress, one step at a time The struggle of the body to produce hormones during a stressful situation is the main theme of general…
Inversion Therapy: The anti-gravity way of healing chronic back pain Inversion therapy involves suspending a person upside dow using different types of equipment. This works by taking the…
The Cabbage Soup Diet: The healthiest way to instant weight loss Cabbage soup diet rapid weight loss diet for those who want to shed those extra pounds in less…
How to scrub away stress and fatigue with an Epsom salt bath? Epsom salt is a popular home remedy for many skin ailments. Though there is a lack of scientific…
reflexology massage
Top reasons why you should go for a reflexology massage today Reflexology involves the application of pressure to your feet and hands to encourage self-healing. Could this be beneficial…
phenytoin test
Phenytoin test Phenytoin is a drug that is administered mainly to epilepsy patients. The phenytoin blood test measures the level…
Rubella IgM test
Rubella IgM Test The Rubella IgM test is a blood test that is performed to diagnose the presence of the rubella…
Thyroid disorders
Thyroid Profile Thyroid profile is a panel of blood tests performed to check if an individual is suffering from any…
Unbelievable health benefits of gooseberries (and a few tasty recipes) Gooseberries are antioxidant-rich tasty fruits that can be easily added in daily diet to improve overall health and…
piles fissure fistula
Allopathy vs homeopathy vs ayurveda treatment for piles, fissures, and fistula Read to know the best form of treatment among allopathy, homeopathy,or ayurveda for piles, fissures, and fistula
Optavia diet
The features of an Optavia diet The Optavia diet endorses pre-packaged meals and snacks called "fuelings" that are tasty, low in calorie, and incorporates…
sleep deprivation
Don’t let your sleep deficit grow into memory loss or heart attack Why is sleep important for us? How could sleep deprivation harm you? We bet you didn't know about…
aspartame or sugar
Aspartame – Hidden truths about this storm in a teacup Aspartame, the artificial sweetener, has gone under the scanner on several occasions for allegedly doing more harm than…
High Fiber Diet – Fire up your fiber intake for these health benefits! Regular bowels, healthy detox, higher immunity, and guaranteed weight loss - a high fiber diet can bring all…