Shingles Symptoms and Treatment

Shingles
The varicella-zoster virus (VZV) is responsible for the childhood illness chickenpox. This VZV remains in the dormant state at the root of nerves in the body that control the sensation. After many years after the chickenpox infection, the VZV wakes up in 20% people. It travels along the sensory nerve into the skin. Such a reactivation of the VZV is called "Herpes zoster" or "shingles". It is a neurological disease that affects the nervous system. A painful rash may appear on the skin. Anybody having the chickenpox infection or vaccine can get the VZV. Those having cancer, HIV or organ transplants or old people are more susceptible to shingles. However, it is observed that the majority of people with shingles are healthy. The word "shingles" is derived from Latin and French words meaning "belt" or "girdle". This indicates the distribution of the rash in a broad band.

Shingles symptoms

• the first symptom is extreme sensitivity or pain in a broad band on one side of the body. The sensation may be burning, itching, tingling, continuous aching or deep, shooting or lightning bolt pain
• after 1 to 3 days after the start of pain, a rash is formed. Red bumps and blisters form on the skin in a similar distribution as the pain. These are filled with pus and after 10 to 12 days form scabs
• after 2 to 3 weeks, the rash disappears, the scabs fall off and scarring may take place

During the first symptom, as the rash is absent, the diagnosis may go wrong. Migraine headache, heart attack, appendicitis, lower back problem, internal disorder or the pain of an ulcer may be inferred. The appearance of groups of blisters on a red base is a clear-cut symptom of shingles. Usually, the rash appears on the trunk, neck and back. However, it may also be seen on the eye, the face and the tip of the nose. The blisters traverse the path of the individual nerves that have come from the spinal cord. This is called as the dermatomal pattern. Along the path of the nerve, some areas are covered with blisters, while some areas are not. Usually, only one nerve is involved, but rarely more than one are also relevant. Sometimes it does happen that blisters do not appear at all and there is only pain. This proves to be a very confusing case of local pain.

Shingles treatment
The pain and discomfort can be reduced as well as the blisters and rash can be healed, but shingles does not have a cure.

To decrease the duration of symptoms in affected persons, the following antiviral medications are prescribed:

• Acyclovir (Zovirex)
• Valacyclovir (Valtrex)
• Famciclovir (Famvir)

If the above antiviral medications are started within 72 hours of the first symptom of a shingles attack, this accelerates healing and minimizes development of complications like postherpetic neuralgia (PHN).

For mild to moderate pain, the following must be taken:

• Acetaminophen (Tylenol)
• Ibuprofen (Motrin, Advil)
• Naproxen (Aleve)
• Ketoprofen (Orudis KT)

For moderate to severe pain, more potent pain killers like prescription NSAIDs (Diclofenac, Fenoprofen, Etodolac, Flurbiprofen, Ketoprofen, Nabumetone, Sulindac) or narcotic analgesics (Codeine Tablets, Morphine ER, Meperidine Oral, Fentanyl Citrate injection, Oxycodone) are recommended.

To reduce the pain, discomfort, itching, redness and inflammation of the rash and blisters, Corticosteroids are advised. Some examples are:

• Prednisone
• Cortisone
• Methylprednisolone
• Hydrocortisone

For postherpetic neuralgia, the nerve pain is given some medications like:

• lidocaine patch 5% (Lidoderm)
• capsaicin cream (Dolorac, Trixaicin, Zostrix, Zostrix-HP)
• antidepressants like Amitriptyline, Clomipramine, Desipramine, Doxepin, Imipramine, Nortriptyline
• anti-seizure drugs

In case of ophthalmic shingles, a doctor or ophthalmologist must be quickly contacted to prevent permanent eye damage. Antivirals are used to avoid spreading of the disease over the eye and face.