Shingles Symptoms, Diagnosis and Treatment: Shingles is a viral infection which is characterised by a painful rash with blisters. It is present in a localised area, usually the torso of the patient. It is caused by a virus Varicella Zoster which is the same virus that causes Chicken Pox. Once you have Chicken Pox, the virus stays in your body in inactive form. This virus can become active again due to a variety of reasons and can lead to the development of Shingles.
The main symptom of the infection is the rash however in some cases, the patients may feel a tingling sensation over the area before the development of the rash. The rash usually occurs on your face, neck or body.
The risk of developing shingles increases with your age and it is most commonly seen in people over the age of 50 years. The infection usually clears on its own in 7 to 10 days and the patients do not require further medications however some cases may develop nerve pain which can last even after the rash has cleared up.
Shingles is a viral disease which is also known as Herpes Zoster. It can affect anyone who has come in contact with the Varicella Zoster virus. The virus first causes Chicken Pox which is characterised by itchy blisters which show up on your back, face and whole body.
The second time that the virus gets active it leads to Shingles with the painful rash showing up on only one side of the body. The virus can remain dormant in the host nerve cells for years or even decades after which it can reactivate. It can then travel along these nerve cells to the skin and cause the rash. The rash can last for 7 to 10 days but it can last longer in people with weak immune systems.
The disease is not usually fatal however it can lead to long term nerve damage which is known as postherpetic neuralgia. Shingles can be prevented by getting the Shingles Vaccine before the infection of Chickenpox.
Stages of Shingles
Shingles develops and matures in the following stages.
- First the patient will experience a tingling sensation over the area which is going to be affected by the Shingles. This usually occurs in the dermatome of the nerve through which the virus travels.
- A raised red rash appears usually on one side of the body. The commonly affected areas are the face, neck, chest and torso but they are not the only areas to be affected by the virus.
- In three to five days, the rash becomes completely red and also contains open blisters filled with fluid.
- In about 10 days, the blisters start drying up and the rashes start calming down.
- The marks and scabs disappear in about three to four weeks.
- The pain however may last in some cases giving rise to Postherpetic Neuralgia.
Symptoms of Shingles
Shingles may present a variety of symptoms which may lead to a misdiagnosis. You will need to monitor your symptoms carefully and report them to your doctor for an accurate diagnosis. The patients will present the following symptoms if they are infected with Shingles.
- Painful Rash and blisters over one side of their body
- Tingling sensation in the area affected by the rash
- Sensitivity to touch
- Nausea or vomiting
- Itchy rash
- Muscle weakness
- Rash over your eye
- Loss of hearing or intense pain in your ear
Causes of Shingles
Shingles occur due to the Varicella Zoster virus. After the resolution of Chickenpox in your body, the virus moves in your nerve cells and stays near your spinal cord and your brain.
It then gets reactivated and moves along the nerve cells and gets to your skin where it causes irritation of the nerve cells and leads to the development of the rash. There are possible risk factors which can lead to the reactivation of the virus in your body.
- Age- Shingles can affect anyone of any age however it is more commonly seen in people older than 50 years of age.
- Weak Immunity- People who have been suffering from HIV, Cancer or other long term conditions tend to have weaker immunity which can lead to the reactivation of Shingles virus and thus lead to the development of Shingles.
- Long term medications- People who have been taking steroid medications for long durations tend to have weak immune systems which can lead to the reactivation of the Herpes Virus.
- Stress- People who are suffering from stress or psychological trauma can develop Shingles as the Immune system gets weak under long term psychological stress.
The Shingles virus can spread to a person who has not suffered a Chickenpox infection. This can lead to the development of Chickenpox in that person as it will be their first encounter with the virus.
Diagnosis of Shingles
Shingles is easy to diagnose once the rash appears as no other disease produces a rash in the same pattern. If the rash is not present then other diagnostic methods are used in order to make an accurate diagnosis and rule out other conditions.
- Visual Inspection of the Rash- The doctor will inspect the rash and the blisters visually to determine whether they are present in a dermatomal pattern or not. This means that the rash appears only in the area of the nerve from which the virus has travelled.
- Test of the Blisters- If the doctor still needs confirmation then they will test the fluid of the blisters for the presence of the virus.
Although blood tests are rarely required to make the diagnosis of Shingles as the rash alone is enough, sometimes your doctor may run a blood test in order to confirm the diagnosis.
Treatment of Shingles
There is no cure for Shingles as it is caused by a virus but you can treat the pain and the rash in order to minimise it. The treatment methods also focus on reducing the complications and on postherpetic neuralgia.
- Analgesics- They are given to patients for the treatment of mild to moderate pain. Topical lotions available over the counter are also used in order to soothe the rash and the blisters.
- Antivirals- Your doctor may also prescribe you antiviral drugs to reduce the severity and the duration of the infection. However this does not prevent Postherpetic neuralgia.
- Steroids- Corticosteroids have been used for the treatment of shingles as they reduce inflammation and the pain of the rashes. They do not have a lot of side effects on the patients.
- Antihistamines- They are prescribed to patients who report a lot of itching on their rashes. They can also reduce the extent of rashes.
- Numbing creams- Numbing creams have also been prescribed to be applied over the rashes and the blisters in order to decrease the pain and the itching.
You can also try the following home remedies to treat your rashes and blisters.
- Take cool baths and showers to clean and soothe your rashes and blisters.
- Apply ice packs on your rashes to soothe them and to reduce the itching.
- Eat foods containing Vitamins and nutrients to boost your immunity.
Complications of Shingles
Shingles is not life threatening but it can lead to the development of some serious complication in patients over the age of 50 years.
- Postherpetic Neuralgia- It is the persistence of nerve pain even after the rash and the blisters have cleared up. The pain occurs because of damaged nerve cells which transfer exaggerated response to normal stimuli.
- Vision loss- If the rash has affected your eye then it can lead to loss of vision in that eye as the virus can damage the optic nerve.
- Hearing Loss- If the rash and blisters occur in your ear canal then it can lead to the damage of auditory nerve and thus lead to loss of hearing in that ear.
- Meningitis and other infections- The open blisters can attract bacteria which can lead to the development of some serious infections such as meningitis, facial nerve palsy, etc. These infections can require hospitalisation and long term care.
- Recurrence of Shingles- Shingles can reoccur in these patients as the virus can become active again and again.
- Ramsay Hunt Syndrome- It is a rare complication but it can occur. In this, half of your face is paralysed affecting your ability to communicate and hear properly.
Prevention of Shingles
The only way to prevent Shingles is to get the Chickenpox Vaccine before you suffer Chickenpox. This will prevent you from contracting the virus even when someone you know has become infected.
The vaccine can contain live attenuated virus or an adjuvanted subunit. You can also prevent the spread of Shingles from one person to another by taking the following preventive measures-
- Clean and cover the blisters- You should clean the blisters and cover them properly so that the fluid in the blisters does not get in contact with another person.
- Wash your hands often- If you are taking care of a Shingles patient then make sure to wash your hands regularly so that you do not spread the virus to other people.
- Eat a balanced diet- Take a balanced diet so that your immune system can function properly and keep the dormant virus in check.
- Avoid contact with an infected person- Do not come in contact with a person who has Shingles if you have not had Chickenpox in your life as the virus can get transmitted to you.
- Take care of your Immunity- If you are suffering from long term conditions such as HIV, Cancer, etc then it means that your immunity is weak and hence you will need to take extra care of yourself as the virus can get activated in your body.
FAQs Related to Shingles
The virus causing Chicken Pox stays dormant in the body even after the infection has resolved. This virus can get reactivated when the immunity of the host weakens thus leading to the development of Shingles.
The Shingles vaccine does not guarantee 100% protection of the host against Shingles. If you do get Shingles even after you are vaccinated then the vaccine will help you to prevent the extent and duration of the infection.
The most common and severe complication of Shingles is Postherpetic Neuralgia which can lead to severe pain in the patient. Other complications include Loss of vision, hearing, meningitis and rarely Ramsay Hunt Syndrome.