SHINGLES (HERPES ZOSTER)

What is Shingles?

Shingles (herpes zoster) is an outbreak of rash or blisters on the skin that is caused by the same virus that causes chicken pox - the varicella-zoster virus.

The first sign of shingles is often burning or tingling pain, or sometimes numbness, in or under the skin. You may also feel ill with fever, chills, headache, or upset stomach.

After several days, a rash of small fluid-filled blisters, reminiscent of chickenpox, appears on reddened skin.

The pain associated with shingles can be intense and is often described as "unrelenting." 

Anyone who has had chickenpox is at risk for shingles.  Scientists think that in the original battle with varicella-zoster, some of the virus particles leave the skin blisters and move into the nervous system.  When the varicella-zoster virus reactivates, the virus moves back down the long nerve fibers that extend from the sensory cell bodies to the skin and cause the characteristic blisters of shingles .

Is there any treatment?

The severity and duration of an attack of shingles can be significantly reduced by immediate treatment with antiviral drugs, which include acyclovir, valcyclovir, or famcyclovir.

Antiviral drugs may also help stave off the painful after-effects of shingles known as postherpetic neuralgia. 

Other treatments for postherpetic neuralgia include steroids, antidepressants, anticonvulsants, and topical agents. 

What is the prognosis?

For most people, the lesions heal, the pain subsides within 3 to 5 weeks, and the blisters leave no scars. 

However, shingles is a serious threat in immunosuppressed individuals - for example, those with HIV infection or who are receiving cancer treatments that can weaken their immune systems. People who receive organ transplants are also vulnerable to shingles because they are given drugs that suppress the immune system.