Shingles, medically called Herpes Zoster, is a rash caused by reactivation of the chickenpox virus. The rash is very itchy and usually presents with grouped blisters. The rash follows a band-like pattern on the skin, and a big clue is that it does not cross the midline. Often times, the area will feel odd, itchy, tingle or burn a few days before the rash appears.
About 20 percent of people who have chicken pox will develop shingles later in life. Shingles can occur at any age, but most cases occur after age 50. The majority of patients who develop shingles are otherwise healthy.
Why should I care about shingles?
Shingles can be contagious for anyone who has not had the chicken pox. Without treatment, when it resolves, the area can remain extremely painful for years. This is called post-herpetic neuralgia.
What causes shingles?
Once infected with the chickenpox virus, the virus remains in your body, dormant in the nerve roots. We are unsure exactly what triggers the reactivation, but illness, stress, trauma, and immune status may all play a part in causing shingles.
Also, diseases that cause immune weakness such as cancers and AIDS, and medical treatments such as prolonged steroids, radiation, chemotherapy and medicines used in transplants may cause shingles. But you have to have had chicken pox to get shingles.
How are shingles diagnosed?
Shingles are diagnosed either by the clinical appearance or by a skin biopsy of the rash. Untreated, the rash lasts two to three weeks.
Can shingles be prevented?
The shingles vaccine has been shown to prevent or greatly reduce shingles, if it does appear. The main concern is to prevent the post-herpetic neuralgia. Ask your doctor if the vaccine is right for you.
How are shingles treated?
I use a combination of both antiviral medication and anti-inflammatory medications. This combination speeds healing and reduces the chance of developing post-herpetic neuralgia.
Action steps for anyone with shingles
1) See a doctor for treatment right away, especially if the rash is on your face, as it could affect your eye/vision, or to prevent complications of shingles such as secondary infection.
2) Ask about anti-inflammatory treatment in conjunction with antiviral treatments to prevent post-herpetic neuralgia.
3) Avoid contact with all who have not had chicken pox until you are non-infectious.
Charles E. Crutchfield III, MD is a board certified dermatologist and Clinical Professor of Dermatology at the University of Minnesota Medical School. He also has a private practice in Eagan, MN. He has been selected as one of the top 10 dermatologists in the U.S. by Black Enterprise magazine and one of the top 21 African American physicians in the U.S. by the Atlanta Post. Dr. Crutchfield is an active member of the Minnesota Association of Black Physicians, MABP.org.