Shingles

Shingles is caused by the same virus that causes chickenpox. After you have chickenpox, the virus that caused it, called varicella, remains in your body. It’s always inside you, lying dormant (or asleep) in your nerve cells. At some point later in life, your immune system may weaken, allowing the virus to resurface as Shingles.

The Shingles rash usually affects only one part of the body. Most often, the Shingles rash occurs in a band or strip on one side of the body. This band is called a dermatome, which is the area where one of the nerves from your spinal cord connects with the skin. Shingles usually appears along a dermatome, each of which is located on one side of the body. Shingles may also appear on a single side of the face, for example, in the area around the eye and the forehead. But Shingles can strike any dermatome on the body.

The pain associated with the Shingles rash can be constant, or it can come and go. Sometimes the pain is so intense that even a slight breeze can cause discomfort. The rash itself may range from mild to severe.

Symptoms

The signs and symptoms of shingles usually affect only a small section of one side of your body. These signs and symptoms may include:

  • Pain, burning, numbness or tingling
  • A red rash that begins a few days after the pain
  • Fluid-filled blisters that break open and crust over
  • Itching
  • Fever and chills
  • General achiness
  • Headache
  • Fatigue

Pain is usually the first symptom of shingles. For some, it can be intense. Depending on the location of the pain, it can sometimes be mistaken for a symptom of problems affecting the heart, lungs or kidneys. Some people experience shingles pain without ever developing the rash.

Most commonly, the shingles rash develops as a stripe of blisters that wraps around either the left or right side of your torso. Sometimes the shingles rash occurs around one eye or on one side of the neck or face.

 

Resources

Resources

  • Shingles: Hope through research. National Institute of Neurological Disorders and Stroke. http://www.ninds.nih.gov/disorders/shingles/detail_shingles.htm. Accessed June 24, 2011.
  • Shingles: Clinical overview. Centers for Disease Control and Prevention. http://www.cdc.gov/shingles/hcp/clinical-overview.html. Accessed June 24, 2011.
  • Habif TE. Herpes zoster. In: Habif TP. Clinical Dermatology: A Color Guide to Diagnosis and Therapy. 5th ed. Edinburgh, U.K.; New York, N.Y.: Mosby Elsevier; 2010. http://www.mdconsult.com/books/about.do?about=true&eid=4-u1.0-B978-0-7234-3541-9..X0001-6–TOP&isbn=978-0-7234-3541-9&uniqId=230100505-57. Accessed June 24, 2011.
  • Ferri FF. Herpes zoster. In: Ferri FF. Ferri’s Clinical Advisor 2011: Instant Diagnosis and Treatment. Philadelphia, Pa.: Mosby Elsevier; 2011. http://www.mdconsult.com/books/about.do?eid=4-u1.0-B978-0-323-05610-6..C2009-0-38600-6–TOP&isbn=978-0-323-05610-6&about=true&uniqId=230100505-53. Accessed June 24, 2011.
  • Shingles vaccine: What you need to know. Centers for Disease Control and Prevention. http://www.cdc.gov/vaccines/pubs/vis/downloads/vis-shingles.pdf. Accessed June 24, 2011.

Treatments

There’s no cure for shingles, but prompt treatment with prescription antiviral drugs can speed healing and reduce your risk of complications. These medications include:

  • Acyclovir (Zovirax)
  • Valacyclovir (Valtrex)
  • Famciclovir (Famvir)

Shingles can cause severe pain, so your doctor may prescribe:

  • Anticonvulsants, such as gabapentin (Neurontin)
  • Tricyclic antidepressants, such as amitriptyline
  • Numbing agents, such as lidocaine, delivered via a cream, gel, spray or skin patch
  • Medications that contain narcotics, such as codeine
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