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Shingles: symptoms and treatment options

Shingles, also known as herpes zoster, is a viral infection caused by the varicella-zoster virus. This is the same virus that causes chickenpox. After a person recovers from chickenpox, the virus can remain dormant in the nerve cells. However, later in life, the virus can reactivate and cause shingles.

Shingles typically presents as a painful, blistering rash that usually appears on one side of the body or face. The rash follows the path of a nerve and is often accompanied by itching, burning, and tingling sensations. While shingles itself is not life-threatening, it can be quite uncomfortable and can lead to complications, especially in older adults or individuals with weakened immune systems.

Risk factors for shingles

The exact triggers for the reactivation of the virus are not fully understood, but certain factors can increase the risk of shingles:

  • Age: The risk of shingles increases with age, particularly in individuals over 50. As the immune system weakens with age, the virus may be more likely to reactivate.

  • Weakened immune system: Conditions or treatments that weaken the immune system, such as HIV/AIDS, cancer treatments (chemotherapy or radiation), and organ transplants, can increase the risk of shingles.

  • Stress: High levels of stress or emotional trauma can potentially weaken the immune system and contribute to the reactivation of the virus.

  • Illness: Certain illnesses or medical conditions that affect the immune system can make a person more susceptible to shingles.

  • Medications: Certain medications, such as steroids or immunosuppressive drugs, can suppress the immune system and increase the risk of shingles.

  • Injury or trauma: Physical injury or trauma to a specific area of the body can sometimes trigger the reactivation of the virus along the corresponding nerve pathway.


Shingles prevention tips

  • Get vaccinated: The most effective way to prevent shingles is by getting vaccinated. The shingles vaccine, known as Shingrix, is recommended for adults aged 50 and older. It provides strong protection against shingles and can also help reduce the severity of symptoms if the infection occurs.

  • Stay healthy: Maintain a strong immune system by adopting a healthy lifestyle. Eat a balanced diet rich in fruits, vegetables, whole grains, and lean proteins. Engage in regular physical activity and get enough sleep to support your immune system's function.

  • Manage stress: Chronic stress can weaken the immune system and potentially trigger the reactivation of the varicella-zoster virus. Practice stress-reduction techniques such as meditation, deep breathing, yoga, or engaging in hobbies you enjoy.

  • Avoid close contact with shingles patients: If you haven't had chickenpox or the chickenpox vaccine, avoid close contact with individuals who have active shingles to prevent exposure to the virus.

  • Maintain hygiene: Wash your hands frequently, especially after coming into contact with individuals who have shingles, to reduce the risk of spreading the virus.

  • Prompt treatment: If you develop early symptoms of shingles, such as pain or tingling on one side of your body, see a St. Joseph Health primary care provider promptly. Early treatment with antiviral medications can help shorten the duration and severity of the illness.

  • Stay informed: Learn about the symptoms and risk factors of shingles so you can take appropriate precautions and seek medical care if needed.


Diagnosing shingles

  • Clinical symptoms: The characteristic symptoms of shingles, such as a painful, blistering rash that follows the path of a nerve, are often a key factor in diagnosis. The presence of a rash that is localized and unilateral (on one side of the body) is a significant indicator.

  • Physical examination: A healthcare provider will examine the rash and assess its appearance, location, and distribution. They will also inquire about your medical history and any recent illness or stressors.

  • Medical history: Providing information about your medical history, including any history of chickenpox, can help in the diagnosis. Shingles is caused by the reactivation of the varicella-zoster virus, which is responsible for chickenpox.

  • Laboratory tests: In some cases, especially if the diagnosis is uncertain or if complications are suspected, laboratory tests may be performed. These tests can include:

    • Viral culture: A sample of fluid from the blisters may be collected and tested in a laboratory to confirm the presence of the varicella-zoster virus.

    • Polymerase Chain Reaction (PCR): This test detects the genetic material of the virus and can be used to confirm the diagnosis.

    • Blood tests: Blood tests may be conducted to measure antibodies against the varicella-zoster virus. Rising antibody levels can indicate recent infection.


Shingles treatment options

Treating shingles involves managing the symptoms, promoting healing, and preventing complications. Here are some steps and approaches commonly used for shingles treatment:

  • Antiviral medications: If you seek medical attention within the first 72 hours of symptom onset, your doctor may prescribe antiviral medications, such as acyclovir, valacyclovir, or famciclovir. These medications can help reduce the severity and duration of the shingles rash and may also help prevent postherpetic neuralgia (persistent nerve pain).

  • Pain management: Over-the-counter pain relievers, such as ibuprofen or acetaminophen, can help alleviate the pain and discomfort associated with shingles. Your doctor may also prescribe stronger pain medications if needed.

  • Topical treatments: Calamine lotion or creams containing capsaicin (an ingredient found in chili peppers) can provide relief from itching and discomfort. Be cautious when using capsaicin creams, as they can cause a burning sensation initially.

  • Cool compresses: Applying cool, damp compresses to the affected area can help soothe the skin and reduce itching.

  • Keep the rash clean: Gently cleanse the shingles rash with mild soap and water to prevent infection. Avoid excessive scrubbing or picking at the blisters.

  • Eye involvement: If the shingles rash is near your eye, seek immediate medical attention to prevent potential vision complications.

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