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Shingles

                                    December 2009 

Shingles

shinglesA girl friend rang the other day to say she had shingles. I had always thought of it as rather a light disease, one of those things that are a nuisance rather than serious. But my friend said it really has pulled her right down, it has been quite painful and not only has she been on anti-viral drugs but also on painkillers.

So I thought it was time I investigated shingles – especially as it really is extraordinarily common; one in five people will have shingles at some point in their lives and it is most common in people over the age of 50.

The medical name for shingles is herpes zoster and basically it is an infection of a nerve and also the area of skin which is supplied by that nerve. It is caused by a virus, the same one that causes chickenpox. If you have had chickenpox in the past, then you may develop shingles later.

This is because the chickenpox virus does not always completely disappear; the virus can remain inactive in the nerve roots next to spinal cord where they cause no harm or symptoms. However, sometimes they can begin to reactivate, and then travel along the nerve to the skin to cause shingles. This can happen years and years after you first had chickenpox and in many cases there appears no apparent reason. Occasionally this reactivation can be triggered by stress or illness, and it is also more common in older people when their immune system may have weakened slightly. Treatments such as steroids or chemotherapy which can weaken an immune system can also create the conditions when the virus can reactivate to cause shingles.

The virus usually only affects a single nerve just on one side of the body and this manifests itself in pain and a rash in the area served by that nerve. Sometimes two or three adjacent nerves can be affected.

Most commonly, the nerves affected are those that supply the skin on the chest or the abdomen, often on the side; and occasionally the nerves supplying the upper face and eye can be affected.

The first symptom of shingles is pain in the area served by the affected nerve. The area of skin becomes tender and there can be a dull, constant pain or burning sensation; occasionally sufferers experience a sharp sudden pain that comes and goes.

The real clue is when the rash appears, usually a couple of days after the pain begins. Red blotches are the first sign, and then these develop into itchy blisters looking like chickenpox. New blisters can appear for up to a week afterwards, but they dry up, form scabs and then disappear although occasionally there can be minor scarring.

Of course there are always variations – some experience the rash with no or minimal pain, others have a band of pain without a rash on the skin. As with my friend, people can also feel generally unwell and tired and can also become feverish.

Inidividuals can react differently to shingles and there can be some complications. For older people the most common problem is when the pain persists after the rash has gone. Sometimes the pain can last up to a month but it will gradually ease in the end.

The skin around a rash can become infected, in which case a course of antibiotics is usually prescribed. Shingles, when it is in the nerve to the upper face, can also cause inflammation of the eye.

You can’t catch shingles from another sufferer, but if you have not had chicken pox then you can catch this, although many people today have their own immunity to chickenpox after having had it in childhood. The virus is passed on by direct contact with the blisters, so to ensure you are safe from catching the disease, you need to avoid any contact with the rash and that includes not sharing towels in the home.

There are two main treatments for shingles. The first is to ease any pain and discomfort with a painkiller. The second is to stop the virus from multiplying thought an antiviral drug. But every case is individual and a doctor will advise the best treatment for each specific case.

 


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