Shingles

I'm sure that most of you have heard of shingles, but you may not actually know that much about it.  Shingles is a rash which is a concentrated area of blisters that typically scab over in 7 to 10 days.  The rash then slowly clears up completely over the next 2-3 weeks.  This rash is typically quite painful, although the severity of the pain can vary from one person to another.

What causes Shingles?
Shingles is caused by the varicella-zoster virus, which is the exact same virus that causes chicken pox.  After you recover from having chicken pox, the virus enters your nerves, where it can lie dormant for years and years.  Later on in life, the virus can be reactivated to cause shingles.

Reactivation of the virus can happen for many reasons, usually related to low immunity.  Once the virus is reactivated, it travels down the nerve and causes a rash on the skin wherever that nerve comes to the skin surface.   It is usually only reactivated in one nerve at a time. This is why the rash usually develops on one side of the body, often on the face or torso, in a horizontal line that is fairly small in area.

Is Shingles contagious?
Since the shingles rash contains live varicella-zoster virus in the blisters, a person with shingles can actually transmit this virus to anyone who is not immune to chicken pox.  Once exposed, this person would get chicken pox, not shingles.  Shingles is contagious until all blisters have scabbed over.  Chicken pox can be dangerous for some people, so people with shingles should be careful not to expose others.

Who is at risk for Shingles?

• Anyone older than 50, with the risk increasing the older you get.
   
• Anyone with a disease that weakens the immune system.
    
• Anyone taking medications which suppress the immune system.  This includes cancer treatments, medications to prevent transplant rejection, steroids, and many of the newer medications to treat autoimmune diseases.

What are the possible complications of Shingles?

• Post herpetic neuralgia is the most common complication of shingles.  This causes pain, sometimes severe, that can last from weeks up to years, after the shingles rash improves.
   
• Vision loss can happen if the shingles rash affects the eye.
   
• Skin infections are not uncommon if the shingles blisters are not treated properly.
   
• Neurologic problems such as inflammation in the brain, facial paralysis, or balance or hearing problems can happen, depending on which nerve is actually affected.

Can you prevent Shingles?
There is a very good vaccine to prevent shingles.  Next week I will tell you all about it!

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Dr. Anita Bennett MD - Health Tip Content Editor