February 2, 2015 | Dr. Terrio

What you need to know about shingles.

More and more, we seem to be hearing about shingles. This is for good reason; the painful blistering rash can be devastating. The shingles rash is caused by the same virus that causes chicken pox. When we get chicken pox as a child, the virus settles into our spinal nerves and lays dormant. As we get older our immune system weakens because of age, medications, disease or other factors, the virus comes back out along the distribution of a nerve and causes the characteristic blisters and pain. At first you may notice tingling or burning along a specific area of your skin. It then can become quite painful, like a searing, burning pain. The skin can be exquisitely painful and tender to touch. This is usually followed by the characteristic blistering rash along a dermatome- the distribution of a nerve-and typically is only on one side of the body. The rash typically lasts 7 to 10 days then crusts over.

If having a tremendously painful blistering rash isn’t bad enough, shingles can be much worse. First of all, the neuropathic burning pain often doesn’t go away with the rash. Many patients have severe pain that lasts weeks, months, or even longer. This condition is known as post-herpetic neuralgia, and is difficult to treat. A serious consequence occurs if the shingles occurs on your face and involves the eye. This can cause a serious inflammation in the eye and cause permanent damage and blindness.

Thankfully, there are some things you can do to combat this sinister affliction. First of all, if you are over 60, or have a weakened immune system, ask your doctor about the shingles vaccination. This single dose can boost your immune systems defense against the virus and either prevent the rash, or minimize it if you do become afflicted. Also, it is important to be on the lookout for this illness, and contact your doctor immediately when you suspect you could have shingles. Shingles is treated with an antiviral medication such as acyclovir or valacyclovir, and these medications are most effective when initiated early on in the disease process. It is also imperative that you seek medical attention immediately if you suspect shingles in the area of the face or eye. Early intervention, usually with an ophthalmologist, is imperative to help prevent eye damage and blindness. The shingles neuralgia can be treated with medications that dull nerve pain, such as gabapentin, and some success is achieved with topical lidocaine.

In conclusion, shingles can be a devastating and painful condition. I recommend you speak with your physician about a shingles vaccine if appropriate. If you develop pain or a rash that you think might be shingles, contact your doctor quickly because early treatment is crucial. If you suspect you may be developing shingles in the face or near the eye, seek medical attention immediately.

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