What is shingles? Shingles is a disease in the family of herpes (the same family as chickenpox and cold sores). It causes itching, rashes, and pain. The virus that causes it, which is known as the varicella-zoster virus (VZV), only stays in your body for a short time when you get chickenpox. But sometimes, it lays dormant in your nerve cells, and it can reactivate later on in life (usually decades after) to cause shingles.
While we are not exactly certain what causes this reactivation to occur, the risk of the varicella-zoster being reactivated in the form of shingles when a person:
- Undergoes physical or emotional stress
- Is aged 50 years or older
- Has a weakened immune system due to human immunodeficiency virus (HIV), cancer, diabetes, or long-term medications such as steroids
- Is of poor nutrition and health
- Has a major physical injury
Clinical features of shingles include:
- Pain, burning sensation
- Itching
- Flu and fever-like symptoms, such as headaches and fatigue
- Sensitivity to light and touch
- Raised red rash, which usually appears a few days after pain. They appear as fluid-filled vesicles that are often painful. They may also often appear on one side of the body.
The symptoms of shingles usually last about 3 to 5 weeks, although some people have recurring episodes for many years.
While the onset of shingles can be mistaken for more common skin conditions like skin allergy, cellulitis, eczema, or insect bites, a medical professional should be able to diagnose shingles by looking at the clinical presentation of the disease or by conducting a lab analysis. One should consult a medical professional quickly as treatment is most effective when it is started within 72 hours of the appearance of a rash.
There are several treatment options, including but not limited to:
- Antiviral drugs, typically in oral or topical form, such as Acyclovir and Valacyclovir
- Cool compresses
- Medicated lotions and numbing creams containing lidocaine, capsaicin, or calamine to reduce pain and itching
- Over the counter painkillers such as acetaminophen, ibuprofen, and naproxen
- Prescription painkillers, such as codeine, for intense pain
- Antiseizure medications
- Antidepressants
Suppose shingles is left untreated for an extended period of time. In that case, shingles can lead to complications that last long after the rash is gone and may occur if the infection has not been treated appropriately. Approximately 1 to 4% of people who get shingles are hospitalized for complications, and the chances of older adults and people with weakened or suppressed immune systems being hospitalized are much higher. In fact, it is said that approximately 30% of people hospitalized for shingles have a weakened or suppressed immune system (CDC, 2020). There are many complications which include:
- Postherpetic neuralgia
- Loss of hearing and balance problems
- Loss of taste
- Bacterial infection of the skin, causing increased swelling, redness, warmth, pain, tenderness, and pus formation
- Inflammation of the brain
- Facial nerve paralysis
- Loss of vision (if shingles spread toward and affect the eyes)
Fortunately, shingles is largely preventable. Here are some ways you can prevent getting shingles:
- Getting the chickenpox or shingles vaccination. Depending on your age group and test results for the varicella-zoster virus, a doctor may recommend getting one over the other. People who have had chickenpox or shingles before can still get vaccinated as well. People who should avoid getting vaccinated include those with 1) a history of allergic reaction to the first dose of the shingles vaccine; 2) a history of allergy to any of the ingredients in the vaccine; 3) current, ongoing shingles infection; 4) other current ongoing infections; 5) pregnancy or currently breastfeeding (Radhakrishnan, 2021). Getting vaccinated for chickenpox or shingles should not be delayed or discontinued because of the current COVID-19 pandemic (unless one is suspected or confirmed to have COVID-19).
- Avoid people with active chickenpox or shingles and stay away from children who have not received the vaccine, even if they do not show symptoms of infection. The virus is contagious even before any signs and symptoms appear (during this time, it is called viral shedding).
Here are some ways that a shingles sufferer can help in preventing transmission:
- Avoid touching the rash and its fluids, and wash hands frequently.
- Covering the skin with clothing, nonstick dressing, or a towel when you are in public to reduce the risk of spreading the virus. Loosely bound dressing or loose clothing should be sufficient.
- Try not to share any personal items such as towels, sheets, or utensils with others.
In conclusion, shingles is caused by the reactivation of the varicella-zoster virus, which was originally acquired in childhood following an infection with chickenpox. The virus is contagious and can be transmitted from person to person, especially when coming into contact with a chickenpox/shingles sufferer or someone who has never received the vaccine before. Thankfully, there are preventative measures one can take at home as well as in acquiring vaccinations from medical professionals. While shingles can be easily mistaken for a myriad of other common skin conditions, the best way to find out if one has shingles is by seeing a doctor. Shingles is a serious disease that should be treated as soon as possible to avoid devastating complications. There are a variety of treatments available to help reduce viral activity and to ease the discomfort of symptoms.
CDC. (2020, October 5). Clinical overview of Herpes Zoster (shingles). Centers for Disease Control and Prevention. Retrieved November 6, 2021
Radhakrishnan, R. (2021, June 30). Can you get shingles if you have had chickenpox? MedicineNet. Retrieved November 7, 2021