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Microsoft word - shingles
What is "shingles"?
Shingles is a skin rash caused by the same virus
that causes chickenpox. The virus responsible
for these conditions is called Varicella zoster. After an individual has chickenpox, this virus
lives in the nerves and is never fully cleared from the body. Under certain circumstances, such as emotional stress, immune deficiency
(from AIDS or chemotherapy) or with cancer, the virus re- activates causing shingles. In most
cases, however, a cause for the reactivation of the virus is never found. The herpes virus that
causes shingles and chicken pox is not the same as the herpes virus that causes genital herpes
(which can be sexually transmitted) and herpes mouth sores. Shingles is medically termed Herpes zoster.
How do shingles start and progress?
Before a rash is visible, the patient may notice
several days to a week of burning pain and sensitive skin. Shingles start as small blisters on
a red base, with new blisters continuing to form for 3-5 days. The blisters follow the path of individual nerves that comes out of the spinal
cord (called dermatomal pattern). The entire path of the nerve may be involved or there may be areas with blisters and areas
without blisters. Generally, only one nerve level is involved. In a rare case, more than one nerve will be involved. Eventually, the blisters pop and the area starts to ooze. The
area will then crust over and heal. The whole process may take 3-4 weeks from start to finish. On occasion, the pain will be present but the blisters may never appear. This
can be a very confusing cause of local pain! Are shingles catching?
Yes. Shingles can be spread from an affected person to children or adults who have not
had chickenpox. Instead of developing shingles, these people develop chickenpox. Once they have had chickenpox, people cannot catch shingles (or contract the virus)
from someone else. Once infected, however, persons have the potential to develop shingles later in life.
Shingles are contagious, to persons that have not previously had chicken pox, as long as there are new blisters forming and old blisters healing. Once all of the blisters are
crusted over, the virus can no longer be spread. What is the treatment for shingles? Should I visit my health care worker?
There are several effective treatments for shingles. Drugs that fight viruses
(antivirals), such as acyclovir (Zovirax) or famciclovir (Famvir) can reduce the duration
of the rash if started early (within 48 hours of the appearance of the rash). The addition of steroids may also limit the length of time that a patient has pain with shingles. However, the benefit of both of these drugs is limited.
In addition to antiviral medication, pain medications may be needed for symptom control. The affected area should be kept covered and dry. However, bathing is
permitted and the area can be cleansed with soap and water. An aluminum acetate solution (Burows or Domeboro's solution, available at your pharmacy) can be used to
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