If you had chickenpox as a child, you may find yourself suffering from shingles later in life. Most of us think of chickenpox as an unpleasant but harmless childhood illness, but shingles (which is caused by the same strain of the herpes virus) can be a painful and debilitating condition. It affects older people; over half a million Americans have shingles each year. If our immune system isn’t functioning well—for example if we’re feeling a bit run down or under stress—then the virus that’s lying dormant in our bodies can reactivate, giving us shingles.
What causes shingles?
When the chickenpox virus reoccurs, it travels through the nerves on one side of the body, resulting in pain and a nasty rash wherever the nerve reaches the skin. Because it’s caused by a reactivation of the virus, you can’t catch shingles from someone with shingles or chickenpox. However, if you haven’t had chickenpox before, you can catch it from a person with shingles.
There are three stages of the illness.
Before the rash appears (Predomal stage)
The first sign of shingles is a strange sensation in the area affected—patients have described this as tickling, tingling, numbness or actual pain. This frequently occurs on the back or the chest, but other areas can also be affected, such as the stomach, face, neck, or perhaps one arm or leg. You may also have flu-like symptom, including chills, stomach pains, diarrhea and—rarely—a fever. Occasionally, your lymph nodes may feel sensitive or become swollen. This stage normally lasts just a few days.
Once the rash appears (Active stage)
The shingles rash is similar to a chickenpox rash, with red blisters that are filled with a clear fluid (which sometimes becomes cloudy over time). This rash is generally in a small patch or band along the path of the nerve endings. Sometimes it’s very mild, but it can also be painful and itchy. The blisters then break and seep before crusting over—a process that typically takes about five days. The rash usually heals up within two to four weeks, although it sometimes takes a little longer, and occasionally you may be left with some scarring.
Shingles can also affect your head, in areas like your cheeks, nose and forehead. But a more serious complication involves the eyes (known as ‘herpes zoster opthalmicus’), and if this develops then you must seek treatment immediately in order to reduce the risk of long-term damage to your eyesight.
After the rash has healed
Many people recover from shingles quite quickly, but sometimes patients develop a longer term complication known as ‘post-herpetic neuralgia.’ This causes significant ongoing pain at the site of the rash, which is often felt as a deep ache, a burning pain or a stabbing sensation. You may also have a great sensitivity to the lightest of touches, and PHN can make everyday activities like sleeping or sitting almost impossible, causing misery for patients. This stage may only last a month or so, but it can become a permanent condition.
How to treat shingles
Prescription painkillers can be used to treat the pain of shingles quite effectively. It’s also important to manage the rash carefully, to minimize discomfort. Although it’s tempting, resist scratching or picking at the scabs, as this can increase the risk of scarring. If the blisters are itchy, try a topical cream or a soothing lotion such as calamine. If you prefer a more natural solution, consider dabbing baking soda or cornstarch on to help dry out the spots. Soaking the affected area in tepid water will encourage the crusts to dissolve safely, and if the rash gets infected then your family doctor can prescribe an antibiotic cream.
The shingles vaccine
A vaccine for shingles has now been developed, and it cuts the risk of developing shingles by over 50%. It’s currently recommended for those over 60, as they’re most likely to be affected.
If you think you may be suffering from shingles, it’s a good idea to visit your family doctor as soon as possible, because prompt treatment can help you recover more quickly and lessen the likelihood of longer term symptoms developing.