Shingle is a nonprofessional term used for Herpes Zoster infection in medicine. The Centre for Disease Control and Prevention reports an overall of one million cases of shingles in the US alone each year.
Shingle is a viral disease that pronounces itself as a rash. The rash is quite painful, appearing in a small area of one side of the face or another body part, taking the shape of a band or strips or may take an irregular shape.
The cause of Shingles
The cause of shingles is Varicella Zoster virus that takes advantage of a weakened immune system in an individual, characterized by the breakout of rash. Being one of the eight herpes viruses, the Varicella Zoster virus is specific to humans. It is the same virus that causes chickenpox in children, teens, and young adults. Shingles usually affect the elderly, almost rarely appearing in children.
The site attacked by Varicella virus
Varicella zoster attacks the lung tissues causing the signs and symptoms of pneumonia and bronchitis and in some cases, inflammation of the brain. The actual site of infection is a single nerve and the tissue supplied by it with the rash appearing on the skin.
The resolution of chicken pox is followed by the occupation of the nerve roots by the Varicella virus that remains dormant until the body encounters any state of compromised immunity. The virus becomes active but this reactivation does not result in chicken pox rather as the painful rash, we know as shingles.
That is why one encounters shingles mostly in middle age or the old age, both of which are risk band for low immunity. The infection appears in individuals previously exposed to the chicken pox virus and once you get infected, you might have a recurrence at different intervals but with decreasing frequency.
The signs and symptoms of Shingles
Shingles appear in different stages and individuals experience the signs and symptoms of the disease in varying degrees but a typical case of shingles begins with
- A constant dull pain or stabs of sharp pain that comes and goes
- A few days after the pain, rash typical of shingles appear on the skin of the affected site. Usually, it is one side of the body or face.
- The rash develops into red blotches that soon become filled with fluid and are very scratchy.
- After about 7-10 days, the rash dries up forming scabs or crusts.
- The skin lesion gradually fades in weeks to follow and in some cases, a scar may be left behind.
- Some other associated symptoms are fatigue, headache, fever and chills, nausea and malaise, joint pain and muscle aches, and an occasional upset stomach
Complications of Shingles
Though Shingles have a good prognosis, if not treated promptly it can lead to certain complications
- Postherpetic neuralgia
It is a condition when the pain of shingles continues long after the skin lesions are recovered and are the most prevalent of all complications. The damaged nerve endings continue to send exaggerated pain signals to the brain.
- Neurological problems
Other neurological problems as hearing loss, balance troubles, facial paralysis can occur and in severe cases, inflammation of brain can cause death.
- Vision loss
The rash if spreads to the nose or the eye area may cause infection of the eyes and thereby vision loss.
- Skin lesions
If not treated properly, shingles can lead to superadded bacterial skin infections.
Are Shingles contagious?
Shingles is not a contagious disease generally but when the infection is in a fluid-filled blister stage, it can be transferred to people who are at a risk of developing the disease. Once the scab or crust is formed over the blisters, the chances of this conveyance are null.
Individuals at risk of developing the infection
At the blister stage, the infection can be transferred to people
- Who have never had chicken pox
- Who are not vaccinated against the virus
- Pregnant women
- Elderly people above the age of 50
- People with lowered immunity as in the cases of certain drugs, chemotherapy, HIV and others
The extreme of ages (newborn and elderly) are vulnerable because of lowered immunity and so are the pregnant women.
Diagnosis of Shingles
The pain of shingles is often excruciating enough for anyone to consult a physician. The typical rash on one side of the body and the blisters are trademarks of shingles.
The final diagnosis is made by culturing the tissue fluid of the blisters.
Treatment of Shingles
Shingles have no cure because the virus stays in the nerve ganglion and there is no way to get it out of there. The only treatment for shingles is symptomatic. Many anti-viral medications are available and getting a prompt treatment is key to fine prognosis. The anti-viral medication includes
To alleviate the pain, oral painkillers and topical preparations help like
- Capsaicin cream
- Local anesthetic cream, gel, spray or skin patch
- Injections containing anesthetic or corticosteroids may also be prescribed
The pain of Shingles can be managed with the help of cold compress on the blisters. Scratching will not help the condition so avoid it. Calamine lotion helps to reduce the itch after cold compress. To accelerate the drying of blisters, cornstarch or baking soda can be applied. Proper cleansing of the sores and the skin surrounding it would protect against bacterial infection.
Alternate line of therapy
Some other therapies may help in long-term pain alleviation in cases of postherpetic neuralgia. These include
- TENS therapy
- Biofeedback method
- Stress management and behavioral therapy
Prevention of Shingles
Shingles are preventable via vaccination against the Varicella Zoster virus. Two vaccines for this purpose are
- Chicken pox vaccine
- Shingles vaccine
Both the vaccines are not a guarantee that you won’t contract shingles but these vaccines lower the risk of shingles as well as reduce the severity in case of the infection. These vaccines also lessen the possibility of developing complications of herpes zoster infection.
The Centre for Disease Control and Prevention recommends the vaccines for anyone above the age of 60 years.
However, there are some contraindications to being vaccinated against herpes zoster virus, which may be listed as
- A co-existing weakened immune system
- With past history of bone marrow cancer or cancer of lymphatic system
- Ongoing chemotherapy or radiation therapy
- In cases of untreated and active tuberculosis
- Allergy to any component of the shingles vaccine
- In cases of pregnancy
Diet to aid prevention of Shingles
Though vaccine plays an important role in the prevention of shingles, some foods can help reduce the chances of activating the shingles virus in our body.
According to a case-controlled study published in the “International Journal of Epidemiology”, people who consume nutrient dense foods as fruits, vegetables and include micronutrients as iron, zinc, folate, and vitamin A, C, E and B6 as supplements have fewer chances of developing shingles.
Anti-inflammatory foods, with less sugar and more of fruits, vegetables, nuts, fish, and whole grains, build up the immunity. Some herbs like ginger, garlic, turmeric and basil as well as some spices boost the body’s natural mechanisms to fight inflammation.
A lysine-rich food help counteracts the effects of its counterpart, arginine that accelerate the replication of herpes zoster virus and is thus a vital component to fighting the specific infection. Some of the lysine-rich foods are fish as tuna, salmon, trout and mackerel, low-fat dairy cheese, yogurt and most of the poultry.
A healthy lifestyle with good eating habits and proper vaccination ensures a reduced risk of developing shingles. If infected, early and prompt treatment would lead to a superior prospect.