Shingles

This dermatological condition is caused by the reactivation of the varicella zoster virus (VZV)—the same virus responsible for chickenpox. The VZV virus never leaves the body, so anyone who had the disease in childhood can develop shingles. It can remain dormant for decades without causing any symptoms before suddenly reactivating and travelling from the nerve cells to the skin. Some patients who develop shingles do not remember having chickenpox as a child because their symptoms were mild enough to go unrecognized. The bottom line is that you cannot develop shingles without having had the chickenpox.

Shingles usually develops on one side of the body or face. Common signs and symptoms of this skin disorder include the following:

• Pain, burning, numbness, and tingling
• A red rash
• Skin sensitivity
• Clusters of fluid-filled blisters
• Itching
• Sensitivity to light
• Fatigue
• Headaches
• Fever
• Upset stomach
• Muscle aches

Though the rash can appear anywhere—including the face and groin—it most commonly develops on the chest and stomach areas, on the forehead, or surrounding one of the eyes. The word “shingles” comes from the Latin word meaning “belt,” and the rash typically forms a single strip/“belt” over the patient’s left or right side. Vision loss or other eye problems may occur if the rash erupts on the face.

Tingling, itching, and pain are the earliest signs and may develop several days before the rash appears in the same area. The pain can be severe and may be mistakenly assumed to be a symptom of another medical condition (e.g., heart attack if the left chest is involved). Once the rash appears, the correct diagnosis is made.

The blistering rash will typically scab over within seven to 10 days. The associated symptoms may take two to four weeks to completely resolve. Scars may form in the affected area after healing. Some patients experience prolonged pain in the involved area, referred to as postherpetic neuralgia, which can last for years.

Anyone who has had the chickenpox is at risk. Adults over the age of 60 have a significantly higher chance of developing shingles when compared to younger people. Certain cancer medications, steroid medications, long-term stress, trauma, and a weakened immune system are other known risk factors.

Shingles is typically diagnosed based on the distinctive appearance of the rash. A viral culture can also be performed if the clinical presentation is not diagnostic. Dermatologists will recommend antiviral and pain medications to help patients manage the uncomfortable symptoms. Currently, patients over the age of 50 are advised to receive a vaccine to decrease the risk of developing it.

Acyclovir, valacyclovir, and famciclovir are some examples of antiviral medications that reduce the length and severity of an outbreak, but they work best if the patient takes them as soon as possible after the rash appears. There are also home remedies that might help to ease the discomfort, including cool compresses, calamine lotion, and oatmeal baths.