Shingles! What’s Shingles?

by Ellen S. Mullen M.D.

Shingles is another name for the condition called “herpes zoster.”  Shingles may often begin as a painful area located in one area of the skin.  Initially there may only be pain but a blistering rash soon follows.  This rash is located in an area of the skin called a dermatome.  A dermatome is an area of skin that is innervated by a particular nerve.  Therefore the rash will only extend to the areas that are innervated by this nerve.  Shingles never goes across the midline of the body, so a person will never have a shingles rash on both sides of his or her body.  The rash is painful and one can only get shingles if you have had the chickenpox or the chickenpox vaccine in the past.

br

After a person has the chickenpox the virus stays in your body in nerve cells.  Usually a person’s immune system keeps the chicken pox in these nerve cells.  However if a person’s immune system weakens secondary to illness, age, increased stress or certain medications the virus may escape and cause the herpes rash.  The rash usually lasts about 7-10 days and can leave your skin discolored in some cases.  In some instances even though the rash goes away the pain may persist.  This is called post herpetic neuralgia and occurs in about 1 in 5 people who have shingles. There are several topical and oral medications that are used to help decrease the pain.

br

Shingles can also affect the eyes and lead to blindness.  Shingles noted on the face or close to or in the eyes should be evaluated by an eye doctor right away.  There are oral medications to treat shingles.  These medications are Zovirax, Valtrex or Famvir and work best if started within 72 hours of getting the rash.  There are also topical medications that can be used to decrease the pain.  

br

Shingles is not contagious but chickenpox can be transmitted to others if they have not had chickenpox before or been vaccinated for chicken pox.  The chicken pox virus lives in the herpes blisters and can be spread until the blisters are completely healed.   If you have shingles you should avoid pregnant women and babies less than 1 year old.  Another preventative treatment to help avoid shingles is the Zostavax vaccine.  It is indicated in persons over the age of 60 to receive a single vaccination.