Shingles

Proven content

Shingles is a viral infection. It is caused by the same virus that causes chickenpox – herpes virus. The etiological factor of herpes zoster is the VZV virus, which causes smallpox at the first contact (most often in childhood) with a non-immune person. After the infection has been extinguished, the virus is not eliminated from the patient’s body, but remains dormant in the nerve cells.

The definition of shingles

Shingles is most common in adults. Usually, the cause is not a current infection, but an activation of a dormant virus in the body that caused chickenpox in the past. Less common is shingles caused by an infection from a patient with chicken pox – this applies to people who have not yet suffered from the latter disease. After the chickenpox has healed, the herpes zoster virus is still in the body, but in the form of dormant nerve cells. As soon as our immunity decreases, the virus reactivates and causes herpes zoster, which is manifested by rashes and blisters.

Shingles – causes

The herpes zoster virus has an affinity for the peripheral nervous system. It remains dormant in the sensory ganglia, and when activated, it “travels” along the nerve fibers. It is the latter process that is responsible for the clinical symptoms of shingles.

The activation of the virus and the development of herpes zoster occurs as a result of a transient or permanent decrease in immunity (e.g. after transplantation, immunosuppressive treatment, in some infections – including HIV, in cancer and in long-term exposure to stress). Therefore, each appearance of herpes zoster should be an indication for in-depth diagnostic procedure. Repeated cases of this disease require special attention. In general, the disease of herpes zoster leaves permanent immunity – however, the re-activation of the infection occurs frequently in patients who develop a secretive neoplastic process!

Shingles occurs in people who have had chickenpox before! To sum up, the group with an increased risk of developing shingles includes:

1. patients over 50 years of age,
2. people exposed to constant stress,
3. newborns,
4. patients with a low immune system,
5. people struggling with other diseases.

Diseases and treatments that cause a decrease in immunity and, consequently, herpes zoster:

1. tumor,
2. chemotherapy,
3. radiotherapy,
4. taking cortisone for a long time
5. taking medications to prevent transplant failure.

How do we get shingles?

Shingles is most often infected by contact with skin blisters in a person suffering from shingles (when scabs appear, patients stop infecting). Occasionally, the blisters can become infected and healing takes a long time. Patients with herpes zoster should see a dermatologist if pain and redness persist, as the infection can cause scarring if left untreated.

Shingles – symptoms

The symptoms of herpes zoster are associated with the invasion of peripheral nerve fibers by the virus and its movement along their course. An erythematous-vesicular rash appears along the nerves. Its main location is the face – the area provided by the trigeminal and facial nerves, and the chest – along the course of the intercostal nerves. The rash is accompanied by pain, burning, or itching on the skin supplied by the affected nerve fibers. The disease lasts for 2-3 weeks, but the pain symptoms (so-called post-herpetic neuralgia) may persist for much longer.

In addition to the typical form, shingles also occur in more dangerous varieties – ocular, disseminated, hemorrhagic and gangrenous. They can lead to complications in the form of paralysis of the affected nerves (trigeminal and facial nerves, auditory nerves, and nerves supplying the eyeball with movement).

Types of shingles

When talking about shingles, we can distinguish two types: aural and an ocular.

1. Ear shingles is a rash that appears on the skin of the auricle, the external auditory canal and the eardrum, and is accompanied by severe ear pain, tinnitus, and hearing impairment due to the involvement of the auditory nerve. The herpes zoster virus can also attack the nearby facial nerve, disturbing both its sensory functions responsible for the taste and motor sensations, causing paresis and paralysis of the facial muscles.

2. Ocular shingles attacks the branches of the trigeminal nerve, causing pain in the eye and its surroundings, a typical skin rash and ulceration on the cornea, which in extreme cases can lead to blindness.

Shingles diagnosis

Shingles is diagnosed on the basis of a visual examination of the skin and a medical history. If there is any doubt about the diagnosis, a section of the bladder or fluid inside is taken for further analysis. People with facial shingles must consult a doctor because this type of disease can even damage their eyesight.

A well-chosen treatment for herpes zoster helps to relieve pain and bothersome numbness and itching of the skin, which sometimes last for years.

Shingles – treatment

At the initial stage of shingles, analgesic treatment is initiated because the pain that accompanies shingles is troublesome. Painkillers, in addition to relieving pain, also shorten their duration. In some cases, the pain is so intense that the only way to relieve it is with an anesthetic injection.

Corticosteroids are medications used to reduce the swelling, but are not recommended very often as they cause the rash to spread more quickly.

Cold compresses and baths that relieve pain are also helpful in shingles. Rubbing the eruptions with a special lotion and covering them with a non-stick bandage also helps treat shingles, and you can wear looser clothing where the pain is most intense.

Complications after shingles

Another method is used to treat and prevent herpes zoster: vaccine. The respondents show that it allows to reduce the risk of developing the disease by up to 50%, while in patients who have the first symptoms of the disease, the pain is less compared to those who have never been vaccinated. Shingles usually does not require hospitalization, but it can cause complications in the form of neuralgia and the ocular form of the disease.

What are the side effects of shingles?

Shingles symptoms such as pain, tingling or numbness can last for months or even years. People with unpleasant neuralgia also complain of constant fatigue, trouble sleeping and lack of appetite. In people over the age of 60, even the most gentle touch may feel like severe pain.

Also read: Chicken pox and shingles – two faces of the same virus

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