What is the Shingles and can it be prevented

by Cindy

What is the shingles (herpes zoster)?

Shingles (herpes zoster) is a viral infection that is caused by a reactivation of the chicken pox.  Most adults have had exposure to chicken pox as children and this virus remains dormant in the body.  While dormant, this virus is present in the nerve roots of the spine and in times of stress, illness or old age, it can reactivate causing a painful rash that follows the distribution of the nerve (dermatome).

What are the symptoms of shingles?

Many patients will notice an abnormal sensation along the distribution of the affected nerve. This can be mild irritation, itching or severe pain.  Eventually a rash will erupt along the same region, staying on one side of the body. The shingles rash looks like clusters of little blisters and the skin under the blisters will appear red.  Typically multiple patches of clusters of blisters will erupt along the nerve distribution.  The rash can be quite painful and will usually scab over within 7-10 days before it resolves completely over the course of several weeks. Of greatest concern for patients with the shingles is that it can affect the eye if it appears on the face.  There is also a well known risk of severe pain called post-herpetic neuralgia that can persist for weeks, months or even years after the rash is gone.

Treatment of shingles

If you do develop shingles, it is important to see your doctor because anti-viral drugs can be prescribed to reduce the risk of painful post-herpetic neuralgia.  It is also important to monitor the rash for signs of secondary bacterial infection that may need antibiotics.

Prevention of shingles

If you have had the chicken pox, then you could develop shingles.  Since 2006 a vaccine called Zostavax has been used for prevention of shingles.  The Advisory Committee on Immunization Practices (ACIP) recommends at all adults over the age of 60 be vaccinated with the shingles vaccine.  The vaccine is not perfect, it is not 100% effective at preventing the shingles but it significantly reduces the risk of both the rash and post-herpetic neuralgia.  It is a live vaccine, so there are some limitations as to who should get the vaccine.  The shingles vaccine can be given by your doctor or at the pharmacy.

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