What is shingles?
Shingles or Herpes Zoster is caused by the varicella zoster virus, the same virus that causes chickenpox in children.
After the spots from the chicken pox has disappeared the virus sticks around. The virus lies dormant in the nerve roots for years; for those unlucky enough to develop shingles later in life, the virus travels along the nerve pathways to the skin causing the shingles rash.
Before the rash appears though, patients may experience sensitivity to light and a headache, like a flu but without a fever.
The shingle rash
The shingles rash occurs when the immune system is depressed, the virus reactivates, causing the painful burning shingles rash. The severity of the rash varies from person to person. Some people will get a severe rash, some mild, and some almost no rash at all with just the general flu like symptoms of shingles.
The rash is generally found on one side of the body or face, usually in a strip. It is painful and itchy, characterized by fluid filled blisters that will burst and crust over during the healing process.
Is shingles dangerous?
Well that’s a yes and a no; while the rash itself is not dangerous, complications can arise from shingles.
If the rash appears near to the eyes and nose it can cause vision damage, any patient who is presenting with the rash around the eyes and nose should see a doctor immediately.
Another potential complication can occur if the blisters are not kept properly clean; infection. This is more likely if the area that the rash is resenting in is hard to keep dry, like the groin or under the breast.
Shingles can be treated at its onset to lessen the severity of the rash and risk of Postherpetic neuralgia. The medication is Valacyclovir hydrochloride or Valtrex and it is used to treat herpes zoster. The medication does have side effects, but most often less serious than the effects of the shingles. The side effects most often include:nausea, stomach pain;headache, dizziness, tired feeling, depression, joint pain, menstrual pain, mild skin rash, stuffy nose, and sore throat.
Depending on the severity of the shingles rash, some patients may receive antiviral medication to shorten the duration of symptoms, that combined with the patient immune state will dictate recovery time (usually a few weeks).
Generally most patients will recover from shingles no worse for wear; but scaring can occur if the rash is severe enough.
A more serious after effect is Postherpetic neuralgia or PHN.
This can happen if the virus and rash damage the nerve fibers. Because the virus uses the nerve pathways to emerge, it can cause a post viral pain without a rash.
The pain will generally go away without treatment, or with pain medication, but can take anywhere from weeks to a few years to disappear entirely.
What can we do to prevent it?
The easiest and most effective way to reduce your risk of severe shingles is to get vaccinated.
While the Government of Canada does not yet cover the cost of the vaccines (Zostafax), many insurance companies do, and the cost is only about $200.
While it will not guarantee immunity (remember the virus lives in the nerves already) it reduces the the risk of shingles by about 51%, and the risk of developing PHN post shingles by around 67%.
Shingles can be a painful and potentially dangerous condition; but it can be treated and potentially prevented.
It presents with sensitivity to light and a headache, followed by the shingles rash
If the condition is recognized early it can be treated with Valacyclovir hydrochloride
A potential complication of shingles is damage to nerve fibres resulting in Postherpetic neuralgia, a long term complication.
It can potentially be prevented with vaccination, but the MSP does not yet cover the cost and patient will need to pay out of pocket.