Shingles: Everything you must know about this viral infection

Shingles is a viral infection that manifests itself in the form of painful blisters and rashes. Varicella-zoster virus, the same virus that causes chickenpox, is the culprit behind shingles. As per the Centers for Disease Control and Prevention (CDC), around 1 out of every 3 people in the United States will develop shingles, in their lifetime. These include adults and children. Adults over 50 years of age may be more susceptible to this infection. Therefore, two doses of the Shingrix vaccine is advised as a way to prevent shingles.

What is shingles?

Shingles, also referred to as herpes zoster, is a painful rash that may result in permanent damage to the nerves or visual impairment, defines the World Health Organization. It is caused by the varicella-zoster virus, which is the same culprit behind chickenpox. It is believed that anyone who has had chickenpox is at risk of developing the infection. In other words, while chickenpox fades, the virus persists as it lies dormant within nerve cells.

Shingles is characterised by a red skin rash that causes pain and burning sensation. Unlike chickenpox, it show up on one side of the body, remaining restricted to one specific area. It usually appears on your torso, neck or face. While most cases of shingles disappear within 3-5 weeks, the condition can recur more than once. It can affect quality of life, with symptoms like aching, burning, and stabbing pain, along with complications such as post-herpetic neuralgia. Vaccination reduces the risk, with recommendations for those over 50, immunocompromised individuals, and others. It isn’t contagious unless contact is made with the blisters by someone not immune to chickenpox, tells the expert.

What are the symptoms of shingles?

As per CDC, the first symptom is pain and burning, affecting one particular side of your body. It usually affects a certain area of the skin called a dermatome, which is followed by a red rash. Here are the common symptoms of shingles you must know:

1. Pain and burning

Shingles often begins with a burning sensations in a specific area of the body, such as pain, burning, tingling, or numbness. This discomfort may be mild to severe and is usually localized to one side of the body. It can occur anywhere on the body but commonly affects the torso or face, says Dr Dipak Patade.

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2. Red rash

Within a few days of the onset, you may notice a red rash which will appear on one side of the body or face. Typically red in colour, the rash may appear dark pink, purplish or brown depending on your skin tone. The rash can cause itchiness and burning sensation.

3. Blisters

As the rash progresses, it may lead to the formation of fluid-filled blisters that develop on the reddened skin. These blisters can be small or large in size. They may break easily and are usually surrounded by inflamed skin and can be extremely painful, explains the expert.

4. Flu-like symptoms

Some people may experience symptoms similar to the flu, such as a low-grade fever, headache, fatigue and muscle weakness. Fever is the body’s response to infection and inflammation and may accompany more severe cases of shingles.

5. Itching and sensitivity to touch

“Along with the pain, the affected area may become itchy. Scratching the rash can exacerbate discomfort and increase the risk of infection. Additionally, the skin may become sensitive to touch, causing even gentle contact to produce pain or discomfort,” explains Dr Patade.

6. Scabbing

After a few days, the blisters may break open, leading to the formation of shallow ulcers. These ulcers then form scabs or crusts as they begin to heal.

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What causes shingles?

Shingles is caused by the varicella-zoster virus, which is also the virus that causes chickenpox. While it can affect anyone who has had chickenpox, it is unclear why it only affects some people and not everyone. Some other causes of chickenpox include:

• Weakened immune system
• Stress
• Ageing
• Certain medications
• Someone undergoing surgery
• Underlying medical conditions that compromise immunity

Also, ageing itself is a risk factor, as the immune system naturally weakens with age, making it harder to control latent viruses like the varicella-zoster virus.

What are the complications of shingles?

If left untreated, shingles can lead to some complications including:

• Vision loss: Shingles can affect the nerves around your eyes, which can lead to eye inflammation, infections, and temporary or permanent vision loss.
• Postherpetic neuralgia (PHN): The most common complication of shingles which is characterised by persistent nerve pain in the area where the rash occurred.
• Skin infections: It can lead to bacterial infections that can cause blisters and sores caused by shingles, leading to further scarring or discomfort.
• Neurological problems: Shingles may cause inflammation of the brain, facial paralysis or problems with balance or hearing if you leave shingles untreated.

Treatment of shingles

There are several treatment options available to treat shingles, and some of which include:

1. Antiviral medications

Drugs such as acyclovir, valacyclovir, or famciclovir are often prescribed to reduce the severity and duration of shingles symptoms, especially in the initial stage. These medicines inhibit the replication of the varicella-zoster virus, speeding up the healing process and decreasing the risk of complications.

2. Pain relievers

Over-the-counter pain relievers such as ibuprofen (Advil, Motrin) or acetaminophen (Tylenol) can help alleviate the discomfort associated with shingles. These medications can reduce pain, inflammation, and fever. For more severe pain, prescription pain medications may be necessary, advised the expert.

3. Keeping the rash clean and dry

Keeping the affected area clean and dry can help prevent secondary bacterial infections, which can occur if the blisters become broken or irritated. Gentle cleansing with mild soap and water followed by thorough drying is recommended. Avoid wearing tight clothes that may rub against the rash as it can also help prevent irritation.

4. Lotion or oatmeal baths

Applying lotion can provide relief from itching and discomfort associated with the shingles rash. Applying calamine lotion to the affected area can soothe the skin and reduce itching. Oatmeal baths, made by adding colloidal oatmeal to bathwater, can also help relieve itching and inflammation.

6. Vaccination

There is a vaccine available for shingles that people aged 50 and above can receive. It is called Shingrix but you have to check with your doctor before getting vaccinated.

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Frequently asked questions (FAQs)

1. Is shingles contagious?

It is not a contagious infection, as per the data by National Health Services. However, the virus that causes shingles can spread to other people who have not had chickenpox, and cause chickenpox. It only spreads when someone comes in contact with a blister so make sure you are keeping the rash clean and covered. Maintaining proper hygiene is important is important when it comes to managing this infection.

2. Is shingles painful?

While some people who develop shingles experience mild symptoms such as a tingling sensation, it can be painful for some.

3. Do you shingles once?

While it usually occurs once, it can appear more than once. A study published in the Journal of Korean Medical Science found there is a 5.3 percent chance of developing shingles.

4. Is shingles a serious problem?

While it may subside within a few weeks, it can lead to some serious complications. It can cause vision loss, especially when singles rash can become infected with bacteria.