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Shingles


Shingles is a viral infection that causes a painful rash. Shingles is caused by the varicella-zoster virus, the same virus that causes chickenpox. If you’ve had chickenpox or the varicella vaccine, the virus remains inactive in your nerve tissue – years later it may reactivate as shingles. Shingles tends to present in people with lowered immunity to infections, this includes older adults, and anyone with a compromised immune system or under significant stress.

 

Shingles outbreak usually affects a small section of one side of the body, typically along the right or left side of the torso. The signs and symptoms include:

  • Pain, burning, numbness, itching or tingling sensation

  • Sensitive to touch

  • A red rash that emerges a few days after the pain

  • Fluid-filled blisters that break open and then crust over

Some people also experience:

  • Fever

  • Headache

  • Sensitivity to light

  • Fatigue

  • Difficulty breathing or vision changes are emergency complications from shingles that require immediate medical assistance

Shingles is contagious and can be passed from one infected person to another who isn’t already immune to chickenpox. Transmission usually occurs through direct contact to any open lesions. Once infected a person will develop chickenpox, not shingles. Until your shingles blisters scab over, you are contagious, should keep lesions covered and avoid contact with anyone who is not already immune to the chickenpox virus. Children less than one year old, pregnant women, and immunocompromised individuals should be avoided during an active shingles infection.

 

Contact your doctor if you suspect shingles, and especially in any of the following situations:

  • The pain/rash is located near the eye – this can lead to permanent eye damage

  • You are 60 years old or older – advanced age increases the risk of complications

  • You or a family member have a weakened immune system (pregnancy, cancer, chronic illness)

  • The rash is widespread and painful

Shingles can be prevented with vaccination with the chickenpox vaccine (varicella) and the shingles vaccine (varicella-zoster). The varicella vaccine has become a routine childhood immunization to prevent chickenpox and is recommended for adults who have never had chickenpox. The vaccine does not guarantee you won’t get chickenpox or shingles, but it can reduce the severity and chances of developing complications.

The shingles vaccine is used only as a preventative strategy and cannot treat an active outbreak of shingles. It is a recommended vaccine for people age 50 or older. Like the chickenpox vaccine, the shingles vaccine doesn't guarantee you won't get shingles, but it will help reduce the severity of the disease.

Your Dermatologist can confirm shingles with examination. While there is no cure, prompt treatment with prescription antiviral drugs can speed healing and reduce your risk of complications. Antiviral drugs used are Acyclovir and Valacyclovir.

 

To soothe associated pain your doctor may prescribe:

  • Capsaicin topical patch

  • Numbing agents like lidocaine

  • Pain medications like codeine

  • Corticosteroids injections

  • Nerve blocking medications like gabapentin and pregabalin

 

Shingles generally lasts between two and six weeks. Most people get shingles only once, but it is possible to get it two or more times.