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Shingles - Causes, Symptoms and Treatment


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Shingles is a viral infection of the nerve roots. The virus responsible for shingles is called Varicella zoster. The virus responsible for shingles can be spread by direct contact with the lesions, or by touching any dressings, sheets or clothes soiled with discharge from the spots. Most people who get shingles will not get the disease again, although it does come back in a few people. Anti-viral medications work best if administered within 24 hours of the onset of a shingles rash. Early signs of shingles include burning or shooting pain and tingling or itching, usually on one side of the body or face. The pain can be mild to severe. Although shingles affects millions of adults by the time they reach 80, it is not uncommon for younger people to develop the virus. After an individual has chickenpox, this virus lives in the nerves and is never fully cleared from the body. After a few days, a rash appears as a band or a patch of raised dots, usually on one side of the body. The rash can appear around the waistline or on one side of the face or the trunk. The rash eventually develops into red, fluid-filled, round, painful blisters. Usually, these blisters begin to dry out within a few days or weeks.

Shingles is also more common in people with a poor immune system. Shingles can affect the eyes. This is due to the fact that the eyes are connected to nerves that may be infected with the virus. Shingles usually affects the nerve supply on one side of the body. The main symptoms are pain and a rash. Chickenpox or shingles in the early months of pregnancy can harm the fetus, but luckily this is rare. The fetus may be infected by chickenpox in later pregnancy, and then devlop shingles as an infant. Occasional clusters of shingles cases are reported. It is suggested that contact with someone who has chickenpox or shingles may cause one's own virus to reactivate. In elderly and undernourished patients the blisters are deeper. Healing may take many weeks and be followed by scarring. Muscle weakness arises in about one in twenty patients because the muscle nerves are affected as well as the sensory nerves. Facial nerve palsy is the most common result. Early diagnosis and treatment is important to minimize the symptoms and reduce the risk of complications that may compromise vision.

Causes of Shingles

Shingles is more common in older adults and those who have weak immune systems. The virus responsible for shingles is called Varicella zoster. Anyone who has previously had chickenpox may subsequently develop shingles. Blisters can occur in more than one area and the virus may affect internal organs, including the gastrointestinal tract, the lungs and the brain. If you have a weak immune system, it is best to avoid close contact with someone with shingles.

Common causes and risk factors of Shingles:

  • Injury of the skin where the rash occurs.
  • Varicella-zoster virus.
  • Stress.
  • Radiation treatments.
  • A weakened immune system.

Signs and Symptoms of Shingles

The main symptom of shingles is often extreme sensitivity or pain in a broad band on one side of the body. The pain and general symptoms subside gradually as the eruption disappears. In uncomplicated cases recovery is complete in 2-3 weeks in children and young adults, and 3 to 4 weeks in older patients. The pain may be just in one spot or it may spread out. The patient usually feels quite unwell with fever and headache. The lymph nodes draining the affected area are often enlarged and tender.

Sign and symptoms may include the following :

  • High fever.
  • Sensitivity to light.
  • Flu-like symptoms without a fever.
  • Muscle weakness.
  • Loss of memory.

Treatment for Shingles

There is no cure for shingles, but treatment may shorten the length of illness and prevent complications. You may find that wearing loose fitting clothing helps to reduce the irritation that is caused by the rash. Also, using ice cubes (wrapped in a flannel or plastic bag) will cool the affected area, and using wet dressings may also help to reduce the pain. Antiviral medicines, such as aciclovir, famciclovir, and valaciclovir, are usually taken in tablet form, and are effective if taken during the early stages of shingles.

Treatment may include:

  • Antiviral medications, sometimes in combination with corticosteroids, to reduce the pain and duration of shingles.
  • Capsaicin cream may be helpful for pain relief for post-herpetic neuralgia.
  • Steroids and antiviral drugs can help prevent long-term pain after shingles if they are started within the first two days of the appearance of the rash.
  • Pain medication is often necessary.
  • In some circumstances, systemic steroids may also be recommended.
  • Oral antibiotics may be needed for secondary infection, usually flucloxacillin or erythromycin.