Shingles

Overview of Shingles

Shingles also known as (Aik Jildi Marz Jis Say Kamar Kay Qareeb Chittay Par Jatay Hain Aur Soozish Hoti Hai/ ایک جلدی مرض جس سے کمر کے قریب چتے پڑ جاتے ہیں اور سوزش ہوتی ہے)  is a viral infection caused by the Varicella-zoster virus (VZV) (the same virus causing chickenpox). It targets the sensory nerve ganglion and nerve supplies to the skin surfaces and causes painful rash anywhere in the body.

Varicella-zoster virus (VZV) causes the two serious illnesses that are given below: 

  • Chickenpox forms itchy blisters on the back, chest, and face area where it spreads to other parts of the body.
  • Shingle is a painful rash that appears on the lateral side of the body. As it starts to expand, turns into red fluid-filled blisters. These red blisters typically dry out and make a crust over 7 to 10 days.

Shingles cause infection in the body when VZV remains dormant around groups of nerve cells. The underlying VZV can reactivate after many years or decades later as shingles.

Shingles Prevalence

Shingles are one of the leading viral diseases that may produce once in a lifetime or in more than one episode. Almost 1 out of 3 people suffer from shingles in the world's population.

Most commonly, the associated complication of shingles is postherpetic neuralgia (PHN). About 10 to 18% of people suffer from PHN  along with shingles. The risk of PHN may increase with age. Children are also prone to shingles, but it is rare.

 

Doctors Treating Shingles

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Signs and Symptoms of Shingles

People with shingles feel pain, itching, or tingling in the affected area before the rash appears for several days. 

Most commonly, the rash forms one side of the body laterally either the left or right side of body. It can affect other areas of the body like the face, eyes and spread to the body. The rash due to shingles is similar to chickenpox.

Other symptoms of shingles include:

Types of Shingles

Causes of Shingles

Shingles are primarily caused by the Varicella-zoster virus (the same virus causing chickenpox). A person who has chickenpox may also have a risk of causing shingles. After recovery from chickenpox, the virus can enter the nervous system and reside there in a dormant state for even years. Once the virus reactivates and radiates along the nerve pathways to the skin it may produce shingles, but not every person who has experienced chickenpox will be infected with shingles too.

Is it contagious?

A person with shingles can transmit the Varicella-zoster virus through direct contact with open blisters of the shingles rash. But it mainly transmits to those who are not immune to chickenpox or may have weakened immunity such as pregnant women, newborns, children, or older people, etc. 

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Risk Factors of Shingles

Here are some of the important risk factors for shingles: 

  • If you are older than 50 years of age, you can suffer from shingles.
  • Suffering from certain medical conditions can increase your risk of suffering from shingles.
  • Consuming certain medications can be a risk factor for shingles (steroids or other medications that weaken your immune system).
  • Certain treatments you go through also increase your risk of shingles (chemotherapy, radiation therapy).

Health Complications

Several health complications are associated with shingles. 

  • Postherpetic Neuralgia: In this condition, the damaged nerve fibers send aggravated signals of pain from the skin to the brain is called postherpetic neuralgia. That's why pain remains for a prolonged period even after the blisters have been removed.
  • Vision Loss: If shingles affect in or around an eye may cause painful eye infections that lead to vision loss.
  • Neurological Problems: Shingles also affect the brain nerves which ultimately cause inflammation of the brain (encephalitis), facial paralysis, or hearing or balance problems.
  • Skin Infections: It is possible when shingles blisters do not treat properly then have a risk of bacterial skin infections.

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Prevention

In order to prevent this contagious disease, following immunization of people are mandatory

Chickenpox Vaccine

The varicella vaccine (Varivax) has been given to immunizing people since childhood on daily routines. The vaccine may also recommend to adults especially those who never had chickenpox. Although the vaccine does not treat chickenpox permanently it helps to reduce the risk of complications and the intensity of the disease.

Shingles Vaccine

People suffering from shingles are being vaccinated with two major vaccines: 

  • Zostavax
  • Shingrix

Zostavax, an FDA-approved vaccine in 2006, has been used as an effective vaccine to protect thousands of people against shingles for almost five years. It is a live virus vaccine and is administered to the patients as a single injection, which usually inserts in the upper arm. 

Shingrix is also an FDA-approved vaccine in 2017 and is the preferred choice of Zostavax. It contains a non-living virus composition that is given in two doses for at least 2 to 6 months.

A doctor recommends shingrix for people over the age of 50 and older or can be those people who have already received Zostavax. Zostavax is better to recommend until age 60.

The most possible side effects at the site of injection of shingle vaccine are: 

  • Redness
  • Pain
  • Tenderness
  • Swelling 
  • Itching 
  • Headaches

The shingles vaccine acts as a preventive strategy that's why it doesn't intend to treat people completely. But only reduce the course and severity of the disease.

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Diagnosis

Shingles diagnosis depends on the sign and symptoms of infection and the severity of pain that it causes on one side of the body. A doctor may scrape the tissue or culture of the blisters from the affected region and deliver them to the lab for laboratory examination.

Treatment of Shingles | When to Consult a Doctor

Initially, shingles symptoms can be reduced by home remedies to heal the itchiness and pain by applying these natural products on the affected skin.

  • Essential oils such as Chamomile oil, Eucalyptus oil, or Tea tree oil, act as an anti-inflammatory and anti-microbial effect and reduce the blisters on the skin.
  • Cold compresses cloth is used to relieve itchiness
  • Take cold baths on daily basis, with minimal scrubbing
  • Oat baths are also preferable to reduce inflammation
  • Eat orange, red and green fruits and vegetables such as watermelon, carrot, pumpkin, apricot, spinach, etc
  • Take vitamin supplements containing vitamin C, vitamin D, zinc, or selenium to boost immunity

If the individuals don’t treat by home remedies then a doctor prescribes antiviral drugs to prompt the healing and reduce the risk of complications. Below are the effective antiviral drugs:

  • Acyclovir (Zovirax)
  • Valacyclovir (Valtrex)

A dermatologist may recommend different kinds of drugs to the patients for reducing severe pain that is:

  • Capsaicin topical patch (Qutenza)
  • Anticonvulsants, such as gabapentin (Neurontin)
  • Tricyclic antidepressants, such as amitriptyline
  • Numbing agents, such as lidocaine, are delivered via a cream, gel, spray, or skin patch
  • Medications that contain narcotics, such as codeine
  • An injection including corticosteroids and local anesthetics

The shingles remain on the body for at least two and six weeks. Most people suffer from shingles at least once in a lifetime but some people can experience more than one time.

In case you exhibit any concerning signs and symptoms of shingles, consult a medical professional as soon as possible.