Shingles

Shingles is caused by the same virus that causes chickenpox (varicella zoster virus or VZV). Shingles often occurs many years or decades after having chickenpox. That is why it is more common in adults older than 50 years. The virus reactivates and breaks out as an infection in a nerve root.

SYMPTOMS

  • The initial feeling (sensations) may be pain. This pain is usually described as:

  • Burning.

  • Stabbing.

  • Throbbing.

  • Tingling in the nerve root.

  • A red rash will follow in a couple days. The rash may occur in any area of the body and is usually on one side (unilateral) of the body in a band or belt-like pattern. The rash usually starts out as very small blisters (vesicles). They will dry up after 7 to 10 days. This is not usually a significant problem except for the pain it causes.

  • Long-lasting (chronic) pain is more likely in an elderly person. It can last months to years. This condition is called postherpetic neuralgia.

Shingles can be an extremely severe infection in someone with AIDS, a weakened immune system, or with forms of leukemia. It can also be severe if you are taking transplant medicines or other medicines that weaken the immune system.

TREATMENT

Your caregiver will often treat you with:

  • Antiviral drugs.

  • Anti-inflammatory drugs.

  • Pain medicines.

Bed rest is very important in preventing the pain associated with herpes zoster (postherpetic neuralgia). Application of heat in the form of a hot water bottle or electric heating pad or gentle pressure with the hand is recommended to help with the pain or discomfort.

PREVENTION

A varicella zoster vaccine is available to help protect against the virus. The Food and Drug Administration approved the varicella zoster vaccine for individuals 50 years of age and older.

HOME CARE INSTRUCTIONS

  • Cool compresses to the area of rash may be helpful.

  • Only take over-the-counter or prescription medicines for pain, discomfort, or fever as directed by your caregiver.

  • Avoid contact with:

  • Babies.

  • Pregnant women.

  • Children with eczema.

  • Elderly people with transplants.

  • People with chronic illnesses, such as leukemia and AIDS.

  • If the area involved is on your face, you may receive a referral for follow-up to a specialist. It is very important to keep all follow-up appointments. This will help avoid eye complications, chronic pain, or disability.

SEEK IMMEDIATE MEDICAL CARE IF:

  • You develop any pain (headache) in the area of the face or eye. This must be followed carefully by your caregiver or ophthalmologist. An infection in part of your eye (cornea) can be very serious. It could lead to blindness.

  • You do not have pain relief from prescribed medicines.

  • Your redness or swelling spreads.

  • The area involved becomes very swollen and painful.

  • You have a fever.

  • You notice any red or painful lines extending away from the affected area toward your heart (lymphangitis).

  • Your condition is worsening or has changed.