CONDITIONS
Shingles
Shingles, also known as Herpes zoster (HZ) disease is a viral infection caused by varicella zoster virus – the same virus that causes chicken pox. A person earlier affected with chicken pox may have the virus in the body for the rest of their lives and result in shingles many years later.
Shingles infection causes a painful rash, although it is not life-threatening. The mean age of onset among adults is 59.4 years, with 68% of cases occurring in those 50 years and older. In Asia, the overall HZ incidence is around 5 per 1000 person-years.
What are the symptoms of Shingles?
Pain is usually the first symptom of shingle. Characteristically, the shingles rash develops as a stripe of blisters that wraps around either the left or right side of the torso. The symptoms usually affect only a small section on one side of the body.
These symptoms may include:
- Pain, burning or tingling.
- Sensitivity to touch
- A red rash beginning few days post pain.
- Fluid-filled blisters that break open and crust over
- Itching
Other symptoms:
- Fever
- Headache
- Sensitivity to light
- Fatigue
What is the cause of Shingles?
Shingles is caused by the varicella-zoster virus. This virus also causes chickenpox and hence, anyone who suffered from chickenpox in their life may develop shingles. Post recovering from chickenpox, the virus enters the nervous system and stays inactive for years.
The reason why this virus gets active is unclear, but it may be because of lowered immunity to infections as people get older.
What are the stages of Shingles?
A person with Shingles may go through all 3 stages of it or even 1. These stages are:
- Pre-rash – General symptoms of a virus such headache, fatigue, and a general feeling of being unwell are experienced 48 hours before the rash appears.
- Eruptive – Painful blisters begin to appear on the body and this stage lasts 2-4 weeks.
- Chronic – In case of long-term shingles infection, the pain lasts for more than 4 weeks.
Some factors increase the risk of contacting Shingles. These are:
Is Shingles contagious?
Yes. A person with shingles may pass the virus to anyone who hasn’t yet suffered from chicken pox and is not yet immune to chickenpox. Once infected the person develops chickenpox rather than shingles.
Transfer of infection occurs through direct contact with the open sores of the shingles rash.
Chickenpox can be dangerous for some people and until the open rash in a person with the disease is healed, that person is contagious.
How is Shingles diagnosed?
The doctor diagnoses shingles by taking the medical history, assessing symptoms, and doing a physical exam. A test of a small sample of fluid from the blisters may also be conducted and sent to the lab for analysis.
What are the treatment options for Shingles?
There’s no definite cure for shingles. However, early treatment with antiviral drugs may help faster healing and lower the risk of complications, especially if taken within 3 days of rash development.
The medications for the pain management in shingles could be any of the following or a combination.
- Anticonvulsant medicines such as gabapentin
- Medicated lotions
- Numbing medications such as lidocaine
- Over-the-counter drugs such as painkillers paracetamol or ibuprofen
- Prescription painkillers such as codeine
- Tricyclic antidepressants such as amitriptyline
- Topical patches that contain capsaicin
- Injections of steroids and local anesthetics
Can Shingles be prevented?
A shingles vaccine may be the best way to prevent shingles and is recommended for people age 50 and older, irrespective of experiencing shingles. Shingrix is also recommended for people who are 19 years of age and older who have weakened immune systems due to disease or medication. Contact the doctor to assess if the shingles vaccine is made for a person. People without chicken pox infection or without the chickenpox vaccine should avoid people with infection.
What care should be taken by people suffering from Shingles infection?
For people suffering from the infection, the following steps may help to avoid spreading the virus:
- Covering the rash.
- Avoid touching the rash, especially scratching it.
- Washing hands frequently for at least 20 seconds.
- Avoiding contact with people who are more prone to infection, including pregnant women, newborns, and people with weakened immune systems.
References
- Patki A, Vora A, Parikh R, Kolhapure S, Agrawal A, Dash R. Herpes zoster in outpatient departments of healthcare centers in India: a review of literature. Hum Vaccin Immunother. 2021 Nov 2;17(11):4155-4162.
- Yawn BP, Gilden D. The global epidemiology of herpes zoster. Neurology. 2013 Sep 3;81(10):928-30.
- Mayo Clinic. April 2024. https://www.mayoclinic.org/diseases-conditions/shingles/diagnosis-treatment/drc-20353060
- WebMD. April 2024. https://www.webmd.com/skin-problems-and-treatments/shingles/shingles-skin
