Shingles – Diagnosis and treatment

Shingles – Overview A viral infection that causes a painful rash is known as shingles. Although shingles can appear anywhere on the body, it most often appears as a single line of blisters that wraps around either the left or the right side of the torso. Shingles is caused the same virus that causes chickenpox […]

Shingles – Overview

A viral infection that causes a painful rash is known as shingles. Although shingles can appear anywhere on the body, it most often appears as a single line of blisters that wraps around either the left or the right side of the torso.

Shingles is caused the same virus that causes chickenpox i.e. varicella-zoster virus. The virus lies inactive in nerve tissue near your spinal cord and brain after having chickenpox. Years later, the virus may reactivate as shingles.


Shingles can be very painful but not a life threatening condition. Vaccines can help decrease the risk of shingles, while treatment being conducted early can help reduce a shingles infection and lessen the possibility of complications.

Shingles – Symptoms

A small section of one side of the body usually affected can show the signs and symptoms of shingles. These signs and symptoms may include:

  • Pain, burning, numbness or tingling
  • Touch sensitivity
  • A red rash that begins a few days after the pain
  • Fluid-filled blisters that break open and crust over
  • Itching

Some people have also experienced:

  • Fever
  • Headache
  • Sensitivity to light
  • Fatigue

The first symptom of shingles is usually pain which can be intense for some people. Depending on the area where the pain is, it can sometimes be mistaken for a symptom of problems affecting the heart, lungs or kidneys. Some people have experienced shingles pain with developing no rash.

Sometimes the shingles rash appears around one eye or on one side of the neck or face.

Contact the doctor promptly if shingles is suspected, but especially in the following situations:

  • The pain and rash appear near an eye. If not treated, this infection can lead to damage of the eye permanently.
  • Aged 60 or older, because age significantly increases the risk of complications.
  • Having a weakened immune system (due to cancer, medications or chronic illness).
  • The rash is widespread and painful.

Shingles – Causes

As mentioned previously, shingles is caused by the varicella-zoster virus, the same virus that causes chickenpox. Anyone who had chickenpox in the past may develop shingles. After recovering from chickenpox, the virus can enter the nervous system and lie inactive for years.

It may reactivate eventually and travel along nerve pathways to the skin developing shingles. But, not everyone who had chickenpox in the past will develop shingles.

The reason is not clear for developing shingles. But it may be developed due to lowered immunity to infections as growing older. Shingles is more regular in older adults and in people who have immune systems which is weak.

Varicella-zoster is one of a group of viruses called herpes viruses, which includes the viruses that cause cold sores and genital herpes. Because of varicella-zoster, shingles is also known as herpes zoster. But the virus that causes chickenpox and shingles is not the similar virus which is responsible for cold sores or genital herpes which is a sexually transmitted infection.

A person with shingles can transfer the varicella-zoster virus to anyone who has not been immune to chickenpox. This is generally occurred through direct contact with the open sores of the shingles rash. Once the person is infected, the person will develop chickenpox but not shingles.

For some people chickenpox can be harmful. Until the shingles blisters scab over, the person should avoid physical contact with anyone who does not have chickenpox or the chickenpox vaccine in the past as it can be contagious, especially people with weakened immune systems, pregnant women and newborns.

Shingles – Risk factors

Shingles can be developed by anyone who had chickenpox in the past.

Factors that may increase the risk of developing shingles are mentioned below:

  • Age older than 50. Shingles is most common in people who are aged older than 50. The risk of developing shingles increases with age. Some experts evaluate that half the people of age 80 and older will have shingles.
  • Certain diseases. Diseases can increase the risk of developing shingles as immune system is weakened with these diseases, such as HIV/AIDS and cancer, can increase your risk of shingles.
  • Undertaking cancer treatments. Shingles can be triggered as radiation or chemotherapy can reduces the resistance to diseases.
  • Taking certain medications. Risk of shingles can be increase by drugs that are designed to prevent rejection of transplanted organs which can prolong use of steroids, such as prednisone.

Shingles – Complications

Complications from shingles may include:

  • Postherpetic neuralgia. For some people, shingles pain may continue long after the blisters have been cleared. This condition is called as postherpetic neuralgia, and it occurs when the nerve fibers which are damaged send confused and exaggerated messages of pain from the skin to brain.
  • Loss of vision. Shingles in the eye or around an eye (ophthalmic shingles) can cause eye infections which can be painful that may result in vision loss.
  • Neurological problems. Depending on which nerves have been affected, shingles can cause swelling of the brain (encephalitis), facial paralysis, or hearing or balance problems.
  • Skin infections. If shingles blisters are not treated properly, bacterial skin infections may develop.

Shingles – Prevention

There are two vaccines that may help in preventing shingles are the chickenpox (varicella) vaccine and the shingles (varicella-zoster) vaccine.

Chickenpox vaccine

To prevent chickenpox the varicella vaccine also known as varivax has become a routine childhood immunization. The vaccine is also suggested for adults who’ve never had chickenpox in the past. Though it is not guaranteed that the vaccine you won’t get chickenpox or shingles, it can decrease the chances of complications and reduce the severity of the disease.

Shingles vaccine

There are two options for people who are looking to receive the shingles vaccine which are Zostavax and Shingrix.

Zostavax vaccine that has been approved by the Food and Drug Administration (FDA), had shown to provide protection against shingles for about five years. It’s a vaccine which is live and given as a single injection, usually in the upper arm.

Shingrix vaccine was approved by the FDA in 2017 and is the favored alternative to Zostavax. Studies recommend Shingrix vaccine gives protection against shingles beyond five years. It’s a vaccine which is a nonliving vaccine made of a virus component, and is given in doses of two, with two to six months between doses.

Shingrix is approved and suggested for people who are aged 50 and older, including those who’ve previously received Zostavax vaccine. Zostavax isn’t suggested to people until the age of 60.

He shingles vaccine’s most common side effects are redness, pain, tenderness, swelling and itching at the injection site, and headaches.

As with the chickenpox vaccine, the shingles vaccine doesn’t guarantee of developing shingles. But this vaccine will likely decrease the course and intensity of the disease and decrease the risk of postherpetic neuralgia.

The shingles vaccine is given only as a prevention strategy. It’s not given with the intention to treat people who are currently having the disease. Doctor should be consulted about the options which are suitable

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