Shingles is an inflammation of a nerve which causes pain, itching, a rash, or all three. It affects an estimated 300,000 people in the United States each year.
The word shingles comes from the Latin cingulus meaning a girdle. It has been known from biblical times as the creeping eruption that girdles the body.
Shingles has nothing to do with "nerves" in the emotional sense. You might hear someone say, "Oh! She's a nervous wreck. That's why she came down with the shingles." Nonsense. Because shingles affects a nerve, many people mistake this to mean that it is a nervous condition.
The condition has affected its share of celebrities-Golda Meir, Arthur Rubinstein, and former President Nixon immediately come to mind-and that notoriety also has led to many misconceptions about it.
Is Shingles Contagious?
Shingles, the technical name for which is herpes zoster, is caused by a virus. It's the same virus that's responsible for chicken pox; it actually represents a reactivation of latent chicken pox viruses from an earlier infection. Like chicken pox, shingles is usually a once-in-a-lifetime condition. Unlike chicken pox, however, it is only slightly contagious .
Although shingles can affect any age group, it's more prevalent and more painful in older people. And since shingles can attack any nerve, no area of the body surface is immune. Depending upon the severity of the pain and the location of the nerve involved, one can mistake shingles in its early stages for attacks of appendicitis, kidney stones, gallbladder trouble, pleurisy, and even facial neuralgia and toothache.
The virus of shingles attacks a nerve root in the brain or spinal cord and follows the course of that nerve only. Early symptoms include a feeling of fatigue, headache, a slight fever, and a mild drawing pain over the involved area. The pain characteristically involves only one side.
The infected areas of the skin become red and itchy, and a rash, made up of small blisters, often follows, usually in groups, along the path of the affected nerve. These blisters last for about two weeks and then rupture, forming crusts.
Because each nerve extends to a very specific part of the body on either the left or right side, the blisters usually have a ribbon like or branching configuration, forming a semicircle on one side of the body.
In children and young adults, shingles usually runs a mild and quick course, and the average sufferer will recover without any therapy. In older people, however, the pain may be excruciating, the itching may be intense, and the blisters may become crusted and infected.
Complications can arise from even the mildest form of shingles, so it is important that a physician examine any suspected case. Your doctor can prescribe various internal medications, such as antibiotics, cortisone-like drugs, analgesics and antihistamines, to relieve the pain, itching and inflammation, as well as soothing salves and ointments to relieve the dermatitis and possibly prevent spread of the disease.
When shingles involves the eye, you should consult an ophthalmologist (a physician who specializes in diseases of the eye) to prevent severe damage to the cornea. Arthur Rubinstein, one of the country's greatest pianists, had to retire from the concert stage in 1976, when an attack of shingles left him nearly blind.
Other complications of shingles which may occur are scarring where the blisters had been, extreme fatigue and malaise during the period of recovery, and persistent dull or severe pain (postherpetic neuralgia) which may linger for months or longer after the rash has disappeared.
Occurring in more than half the patients over the age of fifty, this oftentimes exquisite pain that follows an episode of herpes zoster, can be extremely disabling. A variety of attempts to control or reduce this relentless torment has met with variable success. A new topical medication, capsaicin, holds some promise in relieving some of this distressing symptom. This over-the-counter product, called Zostrix, should be applied three or four times a day, with relief of the pain anticipated in about two or three weeks. It should be continued for a period of several months, and for those who have been suffering from chronic pain, treatment over several years should be expected.
While there are no cures, as such, for shingles, many dermatologists have been prescribing acyclovir (Zovirax) orally in large doses in an attempt to shorten the course of the disease and, possibly, to diminish some of the complications.
There are no measures known to prevent shingles. You may save yourself some worry, however, by avoiding direct contact with someone who has shingles. If you are older, and therefore more susceptible to shingles, you should also avoid young children who have chicken pox. Doctors will sometimes prescribe injections of gamma globulin for patients who are otherwise very ill and who have been exposed to persons who have either chicken pox or shingles.
If you do have shingles-some dermatologists call this "second-time" chicken pox-refrain from contact with infants and children who have never had chicken pox, and avoid people who are undergoing chemotherapy.
Shingles almost always limits itself to one side of the body. So, if you have a rash on both sides, chances are that shingles is not the culprit.
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