Shingles
Shingles is a painful rash caused by the varicella-zoster virus. It is also known as herpes zoster or just zoster. It is caused by the same virus that is responsible for chickenpox in children. The virus hides in one's nervous system and presents again in senior citizens as the immune system weakens with age. This reactivation of the virus is the cause of shingles and the reason why so much nerve pain is associated with this rash.
Anyone who has the virus that causes chickenpox (varicella-zoster virus) or even the chickenpox vaccine can get this condition. However, it typically occurs in those over 50. People age 70 or above are 15 times more likely to get it than younger adults. Approximately 1 million people in the United States each year develop it. Even those who have had the vaccine can develop shingles.
Signs or Symptoms
Group vesicles formed on a red rash along the distribution of a nerve are often shingles. Early signs include itchy papules on one side of the body starting in the back and moving to the front of the body. After several days these bumps become larger and develop into a single rash along the path of the nerve. Because it affects a nerve, it usually does not cross the midline of the body. When on the face, it can affect the eye and become a medical emergency. Pain and itching can proceed long after the rash has resolved. This painful manifestation is called postherpetic neuralgia. Early treatment with antiviral medications can help prevent these painful long-term side effects.
Treatment Options
Early treatment is critical in curing the infection. Oral antiviral medication such as acyclovir (Zovirax), valacyclovir (Valtrex), and famciclovir (Famvir) can help treat it if given within 72 hours after the first lesions have appeared. The main benefit of early treatment is reducing the time one has the rash and decreasing the chance of getting the painful side effect, postherpetic neuralgia. If you have this infection on the face, it is important to see an eye specialist to evaluate if the virus is affecting your eyes and vision.
There is a vaccine that decreases the likelihood and severity of the outbreak. This vaccine is recommended for anyone over the age of 60 and known commercially as the Zostavax vaccine. Of those who have had the vaccine, approximately half will develop the condition. Furthermore, for those who develop the rash, two thirds fewer will be impacted with the chronic pain associated with zoster.