Introduction

Shingles, clinically known as herpes zoster, occurs when the dormant chickenpox virus, varicella-zoster, is reactivated throughout the nervous system resulting in a painful, blistering rash. Shingles is much less contagious than chickenpox, but someone with shingles still has the potential for spreading the virus. If the varicella-zoster virus spreads to someone who has not had it, they will develop chickenpox; not shingles. Newborns and those with a weak immune system have the highest risk for contracting the virus from someone who has shingles. Shingles is not life threatening but it may develop other serious complications. For example, post-herpetic neuralgia; eye problems (such as glaucoma, corneal scarring, and even blindness (known as herpes zoster ophthalmicus); and blisters that has a high likelihood of becoming infected. Shingles is most common in individuals who are 50 years old and older.

Causes

Unfortunately, there is still no known reason why the varicella-zoster virus begins to proliferate. One theory is that shingles occurs when something weakens the immune system, prompting the virus to reactivate. The varicella-zoster virus spreads when someone with shingles has open blisters and someone comes into direct contact with those blisters. Once the blister develops into a scab, the person is no longer contagious. Other known high-risk causes for developing shingles can be seen in those who: have a current illness/condition, have high levels of stress/anxiety, and take specific medications or therapies.

Symptoms

Shingles tends to cause more pain and less itching than chickenpox. Common signs and symptoms are: areas on the skin that burn, itch, and/or tingle (these symptoms may fluctuate); a red rash and blisters on the affected skin; flu-like symptoms (headache, fever); and severe pain. The pain can last for months after the blisters clear.

Diagnosis

We will begin by asking for your complete medical history; for example, whether you are on any medications, recent injuries or illnesses, mental health, and any family members with any history of shingles. Next, we may complete a physical examination assessing your skin. In some cases, we may perform a fluid biopsy by scraping a rash to extract some fluid. The sample is then sent to the laboratory for confirmation whether shingles is present.

Treatment

Without treatment, the rash may clear in a few weeks; however, many people experience pain, numbness, itching, and tingling that can last for months or even years. Thus, it is strongly recommended that you seek treatment for shingles. First line treatments include: pain-relief medications, anti-viral medications, corticosteroids, and nerve block injections. Second line treatments may include: anti-depressant medications, anesthetic creams/patches, and anti-seizure medications. Second line treatments are typically utilized once the rash has cleared up.