Hi Alex.
Shingles (also termed herpes zoster) is a disease caused by reactivation of the herpes zoster virus (varicella-zoster virus, or VZV) that results in a painful localized skin rash, usually with blisters (fluid filled sacks) on top of the reddish skin. This same virus causes the childhood illness chickenpox. The chickenpox virus (varicella) remains in a dormant state in the body in the root of nerves that control sensation. In about one out of five people, the virus "wakes up," often many years after the chickenpox infection. The virus then travels along a sensory nerve into the skin and causes shingles. The majority of patients who get shingles are over the age of 60; it infrequently occurs in younger people. Investigators estimate that about 1 million cases of shingles occur per year in the U.S.
• The term shingles is derived from the Latin and French words for belt or girdle, reflecting the distribution of the rash in a broad band. This band is usually only on one side of the body and represents a dermatome -- the area that a single sensory nerve supplies in the skin.
• Anyone who has had the chickenpox infection or vaccine can carry the herpes zoster virus that causes shingles. Older people (over 50 years of age); those with cancer, HIV, or organ transplant, or people that have a decreased ability to fight off infection have a greater chance of getting shingles.
• The majority of people with shingles, however, are healthy. No special tests need to be done to see if your immune system is strong.
CAUSES OF SHINGLES
No one knows for sure what causes the chickenpox virus to become reactivated to cause shingles. Some investigators suggest that the following conditions may participate in virus reactivation, but this lists only some of the major conditions that may trigger reactivation:
• stress;
• fatigue;
• a weakened immune system (This may be age-related, disease-related, or a drug-related decrease in ability to keep the chickenpox virus in an inactive state.);
• cancer;
• radiation treatments;
• injury of the skin where the rash occurs; and
• HIV/AIDS.
SYMPTOMS OF SHINGLES
Depending on the nerves involved, shingles can affect many parts of the body.
• The first symptom of shingles is often extreme sensitivity or pain in a broad band on one side of the body. The sensation can be itching, tingling, burning, constant aching, or a deep, shooting, or "lightning bolt" pain. If these symptoms appear on the face, especially near the eyes, seek medical help immediately. Other nonspecific symptoms that can occur at the same time are fever, chills, headache, and itching.
• Typically, one to three days after the pain starts, a rash with raised, red bumps and blisters erupts on the skin in the same distribution as the pain. They become pus-filled, then form scabs by 10-12 days.
• The rash disappears as the scabs fall off in the next two to three weeks, and scarring may result.
• Some patients develop postherpetic neuralgia, in which the localized pain remains even after the rash is gone.
WHEN TO SEEK MEDICAL CARE?
Call your doctor if you have pain or rash in a band on one side of your body. If you think you have shingles, you should be seen as soon as possible. Antiviral medication is effective only if given early (24-72 hours after the rash develops).
• If the rash with blisters is on your nose or near your eyes, you should be seen immediately because the virus may spread to the eye and cause eye damage or vision loss.
• You should also be seen as soon as possible if you have a medical illness that decreases your ability to fight off infection. You may be able to avoid complications if treated in the early stage of the disease.
Go to a hospital's emergency department if these conditions develop:
• pain, redness, or rash (with or without blisters) on the face, especially if near the eye(s);
• if you have shingles and a high fever or feel sick; or
• if the blisters are spreading to other areas of your body.
TREATMENT OF SHINGLES...Self-Care at Home
If you think you have shingles, you should see your doctor as soon as possible, because antiviral medication is effective only if given early.
• Do not scratch. This may increase the risk of secondary bacterial infection and scarring. Antihistamines and topical creams can relieve the itching.
• Pain medication is often necessary.
• Apply cool tap-water compresses to weeping blisters for 20 minutes several times a day to soothe and help dry the blisters. This also aids in removing the scabs and decreases the potential for bacterial infection. Tap-water compresses must be stopped once the blisters have dried, so the surrounding skin does not become too dry and itchy. Remember that weeping blisters contain the virus and are contagious to individuals that are susceptible to the chickenpox virus.
• Keep the area clean with mild soap and water. Application of petroleum jelly can aid in heali