Shingles

Overview and facts

Shingles is an acute infectious condition affecting the nerve areas caused by a virus known as Vericella Zoster Virus/Herpes Vericellae. It is the same virus that causes chickenpox. Anyone who has had an exposure to chickenpox can develop this condition at any time in their life. One of five people above 50 years of age, at least once have suffered from shingles in their life. It has been estimated that up to 500,000 cases of shingles occur each year in the U.S.

Symptoms

Burning
Pain
Sensitive skin
Rashes and blisters
Fever
Malaise
Paresthesia
Asymmetrical involvement of the nerve
Chills
Nausea
Vomiting
Diarrhea
Usually affected areas are chest, abdomen and sometimes face including the eye

Causes

Shingles can be initiated by increased stress, immunodeficiency and immune-compromised conditions. People suffering from cancer and AIDS also usually develop Shingles.

Diagnosis and Tests

The medical history and the physical examination are though enough to diagnose the condition. But for further confirmation, tests can be done including

Viral culture of skin lesion.
Tzanck test of skin lesion CBC may show elevated WBC (a nonspecific sign of infection) specific immunoglobulin measurement demonstrates elevation of varicella immune globulin.

Treatment & care

The main treatment aim is to reduce the symptoms while treating the underlying cause as well.
Analgesic drugs
Analgesics like paracetamol, paracetamol combined with codeine, ibuprofen, oxycodone and tramadol are the commonly prescribed drugs, with paracetamol and ibuprofen also being available as over the counter drugs.

Antiviral drugs- Aciclovir, famciclovir, and valaciclovir are the most commonly used ones. An antiviral drug does not kill the virus but works by stopping the virus from multiplying and limit the severity of symptoms of the shingles episode. Antiviral drugs may only be affected if used within the first three days of the onset.
Topical anti itching lotions- Such as calamine lotion, may also provide relief from itching and burning. Aluminum acetate solution (Burow's or Domeboro solution) can help in drying up of the blisters and will stop oozing.
Steroid medications- Prednisolone can be helpful in reducing the inflammation and will help in fast healing.
Antidepressants- Amitriptyline, imipramine, and nortriptyline may not only relieve form the depression but will also ease neuralgia (nerve pain).

Apart from the medication use, there are some other things that need to be taken care of including hygiene, diet and general health. A few points that need to be considered are

Use absorbent, loose fitted clothes
Pain and itching can be relieved by cool baths, ice packs etc
Do a short 3 days cleansing diet, to detoxify the body from acids
Shift on fruit and vegetables as diet rather than eating cooked foods
Flax seeds can reduce inflammatory signs
Rest will help your body's defenses come to your rescue
Do not touch or pop the blisters
Use salt baths to neutralize the acidity of the blisters
Take a carrot, beet or cucumber juice each day.
Avoid being in humid areas.
Avoid foods which contain amino acid such as chocolate, cereal grains, nuts and seeds.

Prognosis

For healthy people with normal immune system, the prognosis is good and the chances for complications are low, if given the proper treatment at right time. If treated properly they may get rid of Shingles within 3-5 weeks. But in immunosuppressed, immunodeficient and immunocompromised people there are risks of developing complications and the prognosis can be bad if not treated urgently.

Risk factors

People taking high dose of corticosteroids
People with organ transplant
People taking immunosuppressant drugs or arthritis drugs
People receiving chemotherapy
People with serious systemic health conditions such as cancer, tumor, HIV, AIDS, bone marrow diseases, White Blood Cells disorders and blood dyscrasias.

Living, coping & managing

It is better to get a vaccination once a person ahs reached 60 years of age, to prevent shingles; especially once a person is immunocompromised. Once it has activated, rush to your doctor because if treated early than the prognosis is good. Remember, shingles can be transmitted to other people especially if they have not had chickenpox. However, it may appear as chickenpox on them.

Prevention

In 2006, the Food and Drug Administration approved a Vericella Zoster Virus vaccine (Zostavax) for use in people 60 and older who have had chickenpox. Researchers found that giving older adults the vaccine reduced the expected number of later cases of shingles by half. And in people who still got the disease despite immunization, the severity and complications of shingles were dramatically reduced.

Home remedies

Powder two aspirin tablets and mix it in 2 tbsp of chloroform or alcohol. Apply this paste on the affected area.
Make a solution by mixing aloe Vera gel, raw honey and leek juice to be applied on the rash.
Baking soda and water solution can also be applied as a cold compress.
Sponge the blisters or rashes by use of vitamin E oil, apple cider vinegar, cool goldenseal, mugwort or peppermint tea.

Complications