Information about Shingles

Remember that chickenpox virus you had as a child? The shingles rash you now have may be a reactivation of that same virus, which has remained in your body. Although shingles can sometimes be painful, there are certain medications and even some home remedies that can make you more comfortable until the rash resolves. By understanding what happens when you have shingles, you can take steps to make this "second time around" less discomforting than the first.

What causes shingles?

Shingles, known to doctors as herpes zoster, is a nerve infection caused by the varicella-zoster virus-the same virus that causes chickenpox. Herpes zoster is caused by the activation of the chickenpox virus that has remained in your body since you had chickenpox, perhaps as a child. An outbreak of shingles can be brought on by stress, injury, surgery, or anything that reduces your immunity (but often happens without any identifiable stress).

Before the appearance of the shingles rash, you may have a slight fever and feel mildly fatigued. Because shingles involves infection of a nerve, you may experience some stinging, burning, or pain even before the rash appears, however, this is sometimes mistaken for the pain of an ulcer, heart attack, ruptured disk, or other disease. The fever will subside at about the same time as the rash breaks out. The rash begins as red patches; these develop into blisters within 24-48 hours. The blisters may remain small or, in some cases, become enlarged. These blisters may continue to appear for several days and last for 1-2 weeks.

As shingles progresses, it is usual for these blisters to fill with pus and turn from blisters into pustules within 48-72 hours. They will then go on to crust, scab, and heal. As long as you do not open or puncture them, they should not become infected and will heal on their own. The shingles rash appears most commonly on the trunk and the back, in a bandlike distribution. In some cases, however, shingles may affect the eye and the face, and blisters may appear on the tip of the nose; if this occurs, you should see your doctor immediately so that medication to prevent spreading of the blisters can be administered.

Treatment is most effective if started within 3 days of the onset of the rash. After 3 days, medication appears to make little difference in the course of the illness (however, your doctor may still choose to prescribe it, depending on the circumstances of your particular case of shingles). A variety of oral antiviral medicines may be used, like acyclovir, Famvir and Valtrex. Sometimes, prednisone is added. Some people find soaking the blisters in Burow's solution (using Domeboro powder packets or effervescent tablets diluted in water) for 30 minutes four times a day to be soothing. Pain medicines, including narcotics like Percocet and Vicodin, might be needed in severe cases.

If your doctor tells you that you have shingles, you do not need to quarantine yourself - contact with healthy adults appears to be safe. Until your rash has healed, however, you should keep away from persons who have never had chickenpox (especially small children and pregnant women), who are ill, or who are unable to fight infection because of a disease or medication. These people are more susceptible to the varicella-zoster virus and may develop more severe cases of CHICKENPOX (NOT shingles). If possible, keep the area covered when out in public.

In most patients, the discomfort of shingles lasts for a few weeks until the rash disappears (usually in about 2 weeks). Some patients, however, complain of discomfort for months after the rash has subsided; this pain is referred to as "postherpetic neuralgia". If your pain persist, see your doctor to discuss treatment options.