Anywhere from 600,000 to a million people contract shingles in the U.S. each year. Twenty percent of shingles patients experience postherpetic neuralgia – persistent nerve pain.
Shingles is a skin rash caused by the same virus that causes chickenpox. After a person contracts chickenpox, the virus, called Varicella zoster, lies dormant in the nerves. Things such as severe emotional stress or deficiencies in the immune system can trigger or re- activate the virus, causing shingles. It strikes only one side of the body and is often accompanied by severe pain radiating along the course of one or more nerves.
Pregnant women, adults who have never had chickenpox, and persons with compromised immune systems should avoid direct contact with anyone suffering from shingles.
The early onset of shingles may produce flu-like symptoms, including chills and upset stomach, followed by these symptoms:
- Bruised feeling on one side of the face or body.
- Tingling, itching, or prickling skin and an inflamed, red skin rash.
- A group or long strip of small, fluid-filled blisters.
- Deep burning, searing, aching, or stabbing pain, which may be continuous or intermittent.
Shingles develops in three stages:
- Prodromal: The flu-like period before the rash appears.
- Active: The period of active infection (from 2- 6 weeks) in which a rash of painful blisters is present.
- Postherpetic: This chronic pain stage, which may continue for months or even years after the blisters heal.
Diagnosing shingles before the rash breaks out can be difficult because the pain could be symptomatic of a number of other disorders.
Once the rash appears, however, your doctor can easily distinguish shingles from chickenpox and other eruptions. Shingles always forms a band or cluster that appears only on one side of the body. To confirm diagnosis, your doctor may take a swab or scraping of cells from the blisters and send it to a laboratory for testing.
The goals of treatment are to shorten the duration of the eruptive stage, relieve discomfort, reduce the duration of the chronic stage, and speed the healing of blisters.
Antiviral medications are typically prescribed during the early stages of a shingles infection, in fact, the earlier the better. While these medications do not relieve postherpetic neuralgia, they can decrease the likelihood of developing this chronic pain symptom or at least shorten the duration of symptoms. Research studies suggest that taking tricyclic antidepressants also lessens the risk of developing postherpetic neuralgia after shingles and sometimes doctors prescribe both antivirals and tricyclics.
To relieve the itching and pain of shingles:
- Apply calamine lotion to the blisters
- Apply cool, moist compresses
- Soak in a tub with cornstarch or oatmeal
Do not to scratch the blisters. Scratching can result in infection and can also help spread the rash.
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