If you have ever had chicken pox and 95% of Americans have you are at danger for the burning rash and severe pain of shingles. Individuals who get shingles are usually interested to wait for the problem to clear up on its own. But waiting is the worst thing you can do.
Without prompt treatment with antiviral medication, shingles pain may become chronic. We asked University of California virologist Dr. Michael N. Oxman all about shingles
• What is shingles, and who gets it?
Shingles is a disease of skin and nerves caused by reactivation of the varicella zoster virus (VZV) the same virus that causes chicken pox.
After a bout of chicken pox, the virus doesn’t leave the body. It travels up sensual nerve fibers through the skin and begins dormant infections in sensual ganglia which last for the rest of an individual’s life.
We don’t yet know what causes reactivation. We do know that shingles occurs most frequently in people with reduced immunity individuals taking corticosteroids or immuno-suppressant medicines, undergoing chemotherapy, or dealing with HIV infection.
In certain circumstances, shingles might even be caused by emotional stress.
Shingles is common among individuals over 50 probably because immunity drops with age. Amongst people who live to 85, half get the illness.
• Is shingles transmittable?
You cannot get shingles until you’ve had chicken pox and you can’t catch shingles from somebody who already has shingles. Though, if you’ve not ever had chicken pox, you can catch chickenpox from a shingles victim.
Shingles virus is comparable to herpes simplex virus, that affects genital herpes. Different herpes simplex virus, although, VZV is not spread by sexual interaction.
What are the indications?
Shingles commonly starts with pain on single side of the body normally on the trunk or round the eye. The pain usually quite extreme is caused by swelling made as the virus reproduces in nerve tissue.
Pain is followed by rash in comparable part 1-3 days late. Till the revealing rash appears, shingles is really tough to detect. Depending on where the pain is, shingles can look like a heart attack, appendicitis, kidney stone, gall bladder attack or a broken spinal disk. Shingles may even be wrong for glaucoma, if the eye is affected.
Once your doctor has lined out these diseases, keep a near watch for the rash. It’s essential to begin treatment as soon as the rash appears.
If treatment isn’t started quickly, the virus may spread to other nerve cells. This may lead to hearing loss, muscle weakness or other difficulties.
Most common complication: Chronic pain. Some patients with this disorder called post-herpetic neuralgia (PHN) are so sensitive that even the pressure of clothing on the skin can cause excruciating pain.
• How is shingles treated?
Until a few years ago, there was no treatment. Then it was found that the antiviral drug acyclovir (Zovirax) was effective. But acyclovir must be taken in very high oral doses or injected.
Some doctors used to prescribe steroids along with acyclovir. The thinking was that by reducing inflammation, steroids might prevent PHN.
Studies have shown that steroids do not prevent PHN. Moreover, they can lead to stomach ulcers and raise blood pressure.
Better: Two new antivirals, famciclovir (Famvir) and valacyclovir (Valtrex), are more easily absorbed than acyclovir and these are far more effective.
• What about controlling the pain?
Aspirin, ibuprofen or acetaminophen may be enough in some cases. For severe acute pain, doctors should prescribe codeine or another narcotic.
• What if the pain becomes chronic?
Consult a doctor who specializes in pain management. Tricyclic antidepressants prescribed at lower doses than for depression are effective in 60% to 70% of patients with PHN. Some patients appear to get relief from alternative treatments such as acupuncture or electrical stimulation.