Shingles

Shingles is a condition that anyone who has had chickenpox as a kid is at risk of getting in later life. Shingles can be a very painful condition, however there are some very good treatments that may make an attack of shingles bearable and that may reduce problems that may last into the future.

What are they?

Shingles is a virus known as the herpes zoster virus and this is the same virus that causes chickenpox. After you have suffered from chickenpox the virus never leaves your body and instead lives on the nerve cells. In most cases the virus will stay in the nerve cells without causing any problems. This is because we have a good immune system that is able tokeep it at bay. If this immune system becomes weak, or as you get older the virus may wake up and become active again resulting in the condition known as shingles. The virus will begin replicating in your nerves that can cause a very painful rash and make you quite ill. It is important to note that you can only get shingles if you have had chickenpox in the past. You cannot catch shingles from someone who has either chickenpox or shingles, however you can catch chickenpox if you have not had it before.

Symptoms?

When you get shingles the first thing that you may notice is that you will begin to feel tired, unwell and have a headache. Then you may notice that an area of your skin will begin to feel sore or tingly and this feeling may get worse if you touch it. After a day with this condition you will start to get a rash with small blisters that usually occurs on one side of your body. The rash may be on your chest, forehead, or waist. This rash can be very painful and sensitive and if you have any of these symptoms then you should see your doctor quickly. Treatment is more effective if you begin taking it within days of the onset of symptoms. Generally your doctor can diagnose shingles just from looking at the rash and by talking to you about the symptoms that you have had. In general terms it is unlikely that you will require any tests.

Treatments:

Having treatment during an attack of shingles will lower the number and severity of symptoms that you have and decrease your chances of getting long lasting pain even after the symptoms go away. Some people will get long lasting pain after having shingles and if this is the case then there are treatments that can help.

There are some things that you can do yourself to make the pain better such as taking over the counter painkillers like paracetamol. You should wear loose and cool cotton clothing, protect your rash with a sterile, non-stick and loose dressing, cool the rash by taking a cool bath or using an ice pack, or use calamine lotion to soothe the pain and itching. If you have pain even after taking simple painkillers then you must see your doctor for help.

When you have an attack of shingles you should take antiviral tablets. These will help your pain to go away sooner and your rash to clear up more quickly. If you have a rash on your face then taking these antiviral tablets may decrease your risk of getting eye problems. There are many types of antiviral tablets that will do the trick, however your doctor will advise you of the table they think is best for you. Some of the common antiviral tablets include Aciclovir, Famciclovir and Valciclovir. Sometimes doctors will prescribe an antiviral cream in addition to tablet medication for those who have a rash close to the eyes. This is to increase the amount of antiviral medication that gets to the virus. Corticosteroids used to be prescribed for the shingles virus, however this is not done very often anymore.

For those who get long lasting pain there are drugs that are called tricyclic antidepressants, which can help to relieve long lasting pain after the shingles virus. There is research that shows half of the people who take tricyclic antidepressants get a good deal of pain relief. These medications are also used in the treatment of depression, however at a low dose they are effective for this form of nerve pain. The most common type of tricyclic antidepressant is known as amitriptyline. You will be required to take these medications for several weeks before they start to become effective. Some of the side effects that you can get taking these drugs include feeling drowsy, having a dry mouth, and having trouble urinating. If these drugs do not work then it is possible that your doctor may prescribe anticonvulsant medications that are also used for epilepsy. These are also effective in the treatment of long lasting pain after the shingles virus. If you suffer from very bad pain then you can use strong painkillers called opioids, however these will need to be prescribed by a doctor. In some cases patches or creams that contain lidocaine that is a local anesthetic work well in reducing pain. Also there is a chili pepper extract called capsaicin that is used in creams and gels to help treat the pain in shingles, however it can sometimes cause stinging and burning.

Outcome?

The rash that you get from shingles will usually last for about two to four weeks and the blisters generally crust over and heal up. In some cases they can change the color of your skin or leave a small scar. In some cases the pain does not go away when the rash heals and this is known as post herpetic neuralgia or long lasting pain. This pain can last for months, or even years following an attack of shingles. This happens as the virus can damage the nerve endings, however treatment can help. You must see your doctor immediately if you get a rash near your eye as this can be dangerous.


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