Shingles: Causes, Symptoms, Exams and Tests, Treatment, medicines, Possible complications

Shingles

It is a painful, blistering skin rash due to varicella-zoster virus that causes chickenpox.

Causes

After you get chickenpox, the virus remains inactive (dormant) in certain nerves. Shingles occurs after the virus reactivates in these nerves after many years.

The reason why the virus becomes active again is not clear. Often only one attack.

Shingles can develop in any age group, but one is more likely to develop the condition if:

* Has over 60 years
* He gave chickenpox before their first birthday
* Your immune system is weakened by medications or disease

If an adult or child has direct contact with the herpes zoster rash and has not had chickenpox as a child or has not received the vaccine against this disease, can develop chickenpox rather than shingles.

Symptoms

The first symptom is usually pain on one side, tingling or burning. The pain and burning may be severe and generally occur before any rash appears.

In most people, form patches on the skin, followed by small blisters.

* The blisters break, forming small ulcers that begin to dry and form scabs, which fall in two to three weeks. Scarring is rare.
* The rash usually involves a narrow area of the spine around the front of the ventral or chest.
* The rash may involve the face, eyes, mouth and ears.



Additional symptoms may include:

* Abdominal pain
* Chills
* Difficulty moving some of the muscles in the face
* Drooping eyelid (ptosis)
* Fever and chills
* General ill feeling
* Genital lesions
* Headache
* Hearing loss
* Joint pain
* Loss of eye movement
* Swollen lymph nodes
* Problems with taste
* Vision problems

It also may have pain, muscle weakness and a rash that involves different parts of the face if shingles affects a nerve in the face.

Exams and Tests

The doctor can diagnose by looking at your skin and asking questions about your medical history.

Rarely tests are needed, but may include taking a skin sample to see if you are infected with the virus that causes shingles.

Laboratory tests may show an increase in white blood cells and antibodies to the chickenpox virus but can not confirm that the rash is due to shingles.



Treatment

Shingles usually disappears spontaneously and only need treatment for pain relief.

Your doctor may prescribe a medicine that fights the virus, called antiviral, which helps reduce pain and complications and shorten the course of the disease. You can use acyclovir, famciclovir and valacyclovir.

The medications should be started within 24 hours of feeling pain or burning, and preferably before the blisters appear. Usually, the drugs are given as pills, in much higher doses than those recommended for herpes or genital herpes. It is possible that some people need to be administered the drug intravenously (IV).

Strong anti-inflammatory medications called corticosteroids such as prednisone, can be used to reduce inflammation and risk of continued pain. These drugs do not work in all patients.

Other medicines may include:

* Antihistamines to reduce itching (taken by mouth or applied to the skin)
* Analgesics
* Zostrix, a cream containing capsaicin (an extract of pepper) to prevent post-herpetic neuralgia

They can be used wet and cold compresses to reduce pain. Soothing baths and lotions such as colloidal oatmeal bath, starch baths, or calamine lotion can help relieve itching and discomfort.

It is also recommended bed rest until the fever goes down.

You must keep the skin clean and reuse contaminated items. Similarly, non-disposable items should be washed in boiling water or otherwise disinfected before reuse. The person may need to be isolated while lesions are oozing to prevent infection of others, especially pregnant women.
Forecast

Shingles usually clears up in two or three weeks and rarely recurs. If the virus affects the nerves that control movement (motor nerves) may be weakness or temporary or permanent paralysis.

Sometimes the pain in the area where the shingles occurred may last from months to years.

Possible complications

Sometimes the pain in the area where the shingles occurred may last for months or years. This pain is called postherpetic neuralgia and occurs when nerves are damaged after an outbreak of shingles. The pain ranges from mild to very severe and more likely to occur in people over 60 years.

Other complications may include:

* Another attack of shingles
* Blindness (if lesions occur in the eye)
* Deafness
* Infection, including encephalitis or sepsis (blood infection) in people with weakened immune systems
* Bacterial skin infections
* Ramsay Hunt syndrome if shingles affects the nerves in the face

When to Contact a Medical Professional

Call your doctor if you have symptoms of shingles, particularly if you have defenses or if symptoms persist or worsen. Shingles that affects the eye can lead to permanent blindness if you do not receive emergency medical care.
Prevention

Avoid touching the rash and blisters of persons with shingles or chickenpox if you have never had chickenpox or has not been immunized against this disease.

The varicella vaccine may be recommended for teenagers or adults who have never had chickenpox. Medical evidence has shown that older adults who receive the vaccine are less likely to have complications from shingles. Adults over 60 should receive the vaccine as part of routine medical care.

Alternative Names

Shingles