In our ongoing look at shingles, let’s get a deeper understanding of the disease.
Shingles is caused by the same virus that causes chicken pox in children.
According to the CDC, if you’ve had chicken pox, there is a 1 in 3 chance you will develop shingles sometime in your life. This common virus, the varicella zoster virus, is also known as herpes zoster.
Shingles occurs when the chicken pox virus which has been lying dormant in the nerve cells, near the brain and spinal cord, awakens.
The trigger may be stress, illness, an immune system weakened by drugs, and is more likely if you are over the age of sixty. The first symptoms are pain, burning, or a tingling sensation in the area that will become affected. Pain is usually the most definitive sign of shingles and it can be severe. Typically the pain will begin several days to a week before the rash appears. You may also have sensitivity to light.
Most commonly, the shingles outbreak occurs as a rash that wraps around either the left or right side of your torso. The rash may involve the face, mouth, ears, or eyes. The rash generally turns into red patches on the skin, followed by small blisters. New blisters continue to form over three to five days and progressively dry and crust over. They usually heal in two to four weeks. There may be permanent pigmentation changes and scarring on the skin. On occasion, there may be severe pain, but typically shingles blisters NEVER appear, which can lead to difficulty in diagnosing.
Other symptoms may include fever and chills, headache, joint pain, and swollen glands (lymph nodes). If shingles affects the nerves in your face, the symptoms may also include difficulty moving some of the muscles in the face, drooping eyelid (ptosis), hearing loss, loss of eye motion, taste problems, and vision problems.
Once diagnosed, shingles is treated with antiviral medicines, often combined with medicines for pain.
A physician will usually prescribe antiviral medicine which should be started within 72 hours of when pain and burning occurs. Ideally the antiviral medicine should be started before the blisters appear which is most effective because there will be less pain, and the rash will heal faster. If you have pain or if a rash occurs near an eye, seek immediate medical treatment as the infection can lead to permanent eye damage.
Shingles usually clears in 2 to 4 weeks and rarely returns
However, sometimes the blisters can become infected with bacteria, causing a cellulitis or bacterial infection of the skin. Medical treatment for the cellulitis will be required.
Another side effect is the excruciating pain, especially in the elderly, which can lead to depression, increased anxiety, loss of appetite, weight loss, and can interfere with activities of daily living (ADL’s), like bathing, dressing, eating, cooking and shopping. If the virus affects the nerves that control movement (the motor nerves), you may have temporary or permanent weakness or paralysis. A non-medical home care agency can provide assistance with the ADL’s, including grocery shopping and preparing meals.
Other complications may include: another attack of shingles, skin infections, blindness (if shingles occurs in the eye), deafness, infection (including encephalitis, in persons with a weakened immune system), and Ramsay Hunt Syndrome (if shingles affects the nerves of the face/ear.)
At times, the pain in the area where the shingles occurred may last from months to years. This pain is called postherpetic neuralgia and it occurs when the nerves have been damaged after an outbreak of shingles. Pain ranges from mild to very severe. Postherpetic neuralgia is more likely to occur in persons over age 60.
In 2006, the FDA approved a vaccine that is effective in reducing the risk of developing shingles.
The CDC has approved this vaccine for individuals of 50 years and older. The vaccine is effective for 6 years. then re-vaccination is required. Once you receive the vaccine, there is a 51% chance that you will not end up with shingles. We highly recommend talking with your doctor and/or pharmacist about getting the vaccine!
Want to learn more?
Here are several articles on shingles if you would like to learn more.
Helen Trowsdale, President of AA Care Services, is a nurse administrator with over 30 years of experience as a BSN, psychiatric nurse, and geriatric care manager with adults as well as pediatrics in hospitals, private duty home health care agencies, and residential home health care. Her team of caregivers are dedicated to serving their clients with home care in San Antonio, New Braunfels, and Austin; providing clients with consistent, quality care while minimizing the number of caregivers in the home. Learn more about AA Care Services.