Shingles is a skin condition caused by the varicella-zoster virus (VZV), the same type of virus that causes chickenpox. It’s also the same virus – albeit a separate strain – that causes herpes. Shingles, however, is not sexually transmitted like herpes. Shingles is a condition that affects those who’ve previously contracted chickenpox. Once the person has recovered from chickenpox, the virus conceals itself in the nerve root ganglion of the spinal cord. If that person is feeling weak, the virus will reproduce in great numbers and spread through the nerves system in which it was hiding out in an inactive state. It is for this reason that shingles can spread throughout the body’s central nervous system and present itself on the person’s skin where there are numerous nerve endings.
The skin areas most commonly affected are the hips, buttocks, face and top of the legs. People with weakened immune systems or people who do not get enough rest on a daily basis are more likely to develop shingles, such as the elderly or breastfeeding mothers, as well as those with immune system deficiencies, such as AIDS sufferers or cancer patients. Additionally, people who are taking immunosuppressive medication, like those undergoing chemotherapy or people on steroid drugs, are also at a greater risk of getting shingles.
Symptoms that present themselves before the blistering stage of the condition, during the first 1–3 days, include muscle aching and fatigue, alongside soreness that feels like stinging or heat, as if that area of skin has been burned or scalded. The aforementioned symptoms often lead patients to seek medical attention with orthopedic specialists, who then transfer them onto dermatology experts.
Few people may also experience fever, shivers, nausea and vomiting before a red rash becomes apparent throughout the skin area with high numbers of nerve endings. The rash will gradually turn into blisters over the next two days, and also spread throughout the areas of skin that are most affected by the inflammation of said nerve endings.
The blisters will scab over during the next 1–2 weeks, whereby the aches and pains will gradually improve while and the scabs begin to fall off. However, in elderly sufferers or those who also suffer from an immune system deficiency, the symptoms may be much more severe and last for a longer period of time.
If shingles spreads to the facial area and enters the eyes, it may cause inflammation of the cornea, iris and eventually the optic nerve, which could cause a permanent vision disability. Additionally, if shingles spreads to the area of skin at the front of the ears, it can potentially lead to partial paralysis, affecting one side of the face and leaving that person unable to close one eye properly, lacking movement in one side of their mouth and suffering from paralysis of one eyebrow.
Other complications include infection from bacteria entering the blisters, something which usually occurs when patients scratch their blisters or when an irritating substance is applied or rubbed into the blistered area, thus leading to an infection and the potential for permanent scarring.
In cases where the patient’s immune system is already weak, such as in the elderly or AIDS sufferers, shingles may spread to areas with smaller numbers of nerve endings. The symptoms may be more severe and last longer, and they may have the potential to spread into the brain and other internal organs, which could eventually lead to a loss of life. While this all sounds rather scary, you should be aware that the chances of such symptoms occurring are quite low.
Normally, shingles will only present itself in one area of the body, apart from patients who already have an immune system deficiency and for whom the virus may spread into more than one area. These persons will also suffer from more severe symptoms over a longer period of time than others, and may eventually lose their lives to the condition.
With regard to treatment, doctors will usually target the symptoms of the condition and prescribe patients with the appropriate antiviral medication. As for prevention, chickenpox vaccinations are available for infants and for adults who have never contracted chickenpox before.
Shingles vaccinations are available for the elderly population. Information from the U.S. Center for Disease Control and Prevention (CDC) shows that these vaccinations can reduce the chances of contracting shingles by up to 51%. Vaccinations are available for those over the age of 60 years.*
I hope that now you’ve gotten to know and understand shingles a bit better. Those understanding the condition this will not feel the need to fear it any longer.
M.D., Faculty of Medicine Ramathibodi Hospital, Mahidol University, 1995-2001.