Introduction

Shingles is also referred to as herpes zoster. The condition triggers very painful skin rashes. Shingles appear different than the skin area surrounding them. They present differently on various skin tones. They may appear greyish, pink or brown on black or brown skins.

Shingles generally lasts between 2 and 6 weeks. Mostly, people develop it only once. However, there are chances  that a person can get it more than two times.

 

 Key Facts & Statistics

What are the key facts and statistics about shingles?

• It is estimated that 1 million persons get shingles in the United States per year.
• 1 out of 3 persons who had chicken pox in the United States of America (USA) later  develops shingles.
• Any person who initially suffered from chicken pox is likely to develop shingles later on, even if it means after many decades.
• Less that 100 individuals succumb to shingles annually.
• Approximately one-third of patients hospitalized for shingles have a weakened or suppressed immune system.
• It is not contagious. However, having direct contact with fluid from a shingles rash of an infected person can make you catch chickenpox.

 

 Risk Factors

What are the risk factors for shingles?

• Poor or weak immune system.
• Having developed chicken pox  earlier in life.
• Age. Being 50 years of age and above.
• Medications. Chronic intake of steroids or other medications that can make the immune system weak.
• Having serious physical injury.
• Having HIV, cancer or any other immuno-suppressive condition.

 

 Causes

What is the causative agent of shingles?

Shingles is caused by the same virus that causes chickenpox. This viral micro-organism is referred to as varicella zoster.

Having shingles simply means varicella zoster virus has attacked you twice.

 

 Signs & Symptoms

What are the signs and symptoms of shingles?

Signs and symptoms of shingles:

• Itching.
• Sensitivity to touch.
• Pain and burning sensation.
• Blisters that are filled with fluid. They break open and crust over.
• Fever.
• Headache.
• Fatigue.
• Chills.

 

Stages

What are the stages of shingles?

The following are the stages of shingles:

 

Pre-rash stage

• It is also referred to as pre-eruptive phase.
• It lasts 48 hours before rashes appear.
• The skin becomes sensitive.
• Body parts can feel painful.
• There is also headache and fatigue.

 

Eruptive stage

• It is the most painful stage.
• Appearance of painful blisters on the body, which may burst and crust over.
• It lasts for 2-4 weeks.
• The patient is most contagious. Coming into contact with fluids from shingles rashes can make you catch chickenpox, and nit shingles.

 

Chronic stage

• Pain lasts longer than 4 weeks.
• Strange sensations are experienced since the nerves become affected.

 

 Diagnostic Procedures  & Tests

How is shingles diagnosed?

• Review of patient’s history (history of pain on one side of the body).
• Review of symptoms- rashes and blisters.
• Tissue culture in a lab. A tissue sample from the blisters is taken and sent to the lab for culture.

 

 Treatment and Management

Does shingles have a cure?

Shingles does not have a cure.

 

How is shingles treated?

• Early treatment with anti-viral agents may speed up healing, apart from lowering the risk of complications. These drugs may include:

1.  Acyclovir.
2.  Famciclovir.
3.  Valacyclovir.

 

• Being that shingles can cause severe pain, the following drugs can be administered deal with pain:

1. Over-the-counter medications such as paracetamol.
2. Tricyclic anti-depressants (TCAs) such as amitriptyline.
3. Anticonvulsants such as gabapentin.
4. Capsaicin topical patch.
5. Numbing agents such as lidocaine in the form of a spray or a gel.
6. Injections of steroids and local anaesthetics.

 

 Complications

What are the complications of shingles?

• Post-herpetic neuralgia (PHN). This is chronic nerve pain. Almost 10%-18% of persons with shingles also experience PHN, but the risk increases with age  (above 40 years old). it occurs at the location of the rash (even after the rash is cleared) and lasts long (up to years). being very painful, it is known to cause interference with normal daily activities.
• Vision problems such as;

1. Glaucoma.
2. Cataracts.
3. Double vision.
4. Permanent loss of vision.

• Pneumonia.
• Encephalitis.
• Death.

 

Prevention

How do we prevent shingles?

Vaccination against shingles is available and can be administered to eligible persons, in this case:

•   Adults above the age of 50 years.
•  Adults over the age of 19 years who have a weakened immune system.

 

To prevent spreading the virus to other individuals:

•  Keep the rashes covered well.
• Do not touch or scratch the rash.
• Wash hands frequently with soap and clean water.
• Stay away from susceptible persons such as people with weak immune system.