Shingles

Shingles (Herpes zoster) is a nerve infection caused by the chicken-pox virus.  Shingles results from reactivation of chicken-pox virus that has remained in your body since you had chicken-pox perhaps many years ago.  The virus activation begins in a nerve root.  That accounts for the pattern of the rash, which usually stops at the body’s midline.  The nerve involvement explains the stinging, burning, or pain common in shingles.  Some patients have discomfort before the rash appears. 

The rash of shingles begins as red patches that soon develop blisters.  The blisters may remain small or can become large.  They will follow the path of the affected nerve and remain limited to either the left or the right side of the body.  The rash may form on the scalp, face, neck, arm, leg or trunk.  It may occur before, after or at the same time the patient notices the nerve pain and many times.  Patients often don't realize the rash and the pain are connected.  The blisters heal in two to four weeks or they may leave scars and many people are left with chronic nerve pain in the area that doesn't respond even to narcotics. 

Some patients mistakenly believe that “nervousness” causes shingles.  This is incorrect; shingles is a viral infection of a nerve and has nothing to do with being “nervous”. 

Is it contagious? 

You don’t have to quarantine yourself.  Until your rash has healed, however, you should keep away from persons who have never had chicken pox such as infants or young children, those who are ill, or are unable to fight infection because of a disease or a medication.  Persons who have not had chicken pox can occasionally catch chicken pox from someone with shingles.  Contact with healthy adults appears safe.  

Treatment

Call your doctor as soon as you think you may have shingles; the sooner you start treatment, the more effective it is. Antiviral drugs such as Valtrex pills (prescription required) can help to heal the skin eruption if started early enough after the rash first appears.  If the rash is still present, treatment with antiviral medication should be undertaken to prevent or limit the nerve damage.

The pain can be reduced with Homeopathic Hypericum, aspirin, Tylenol, or ibuprofen.  If these are insufficient, the doctor can prescribe something stronger.  Pain is often difficult to control and may persist for months or years after the blisters have healed.

While blisters and oozing are present, cool compresses will make you feel more comfortable.  Mix ¼ cup of white vinegar in two quarts of water.  Soak a washcloth or towel in the solution.  Then lightly wring out the towel so it is not dripping.  Apply this to the blisters for ten minutes several times per day.  Stop this when the blisters have dried up.

If the trunk or extremities are affected, pain may be reduced by covering with cotton and then wrapping firmly with an elastic (Ace) bandage.

Prevention 

A relatively new vaccine is available for persons 60 and older called Zostavax; however one study concluded that people who practice tai chi exercises were protected against shingles about as well as people who got the vaccine.  Taking  Vitamin C in doses of 1-3 g per day improves the immune system and may also be antiviral. More information can be found at www.webMD.com.