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General Dermatology


Shingles

If you contracted chicken pox as a child, you can develop shingles later in your life. Caused by a reactivation of varicella-zoster virus, shingles produces a unilateral pain, burning, or blistering rash extending in a localized area. Shingles primarily occurs in people over age 50 or anyone with a compromised immune system, such as AIDS or cancer patients.

Classified as part of a group of viruses called herpes viruses, shingles is also known as herpes zoster. This virus, which causes chickenpox and shingles, is not the same virus as the ones that produce cold sores or genital herpes, a sexually transmitted disease.

After you have had chicken pox, the varicella-zoster virus lies dormant in the nerve roots near the spinal cord or base of the facial nerve. When your immune system becomes weakened, the virus can flare up and produce shingles. Stress, fatigue, or injury to the skin may contribute to a shingles outbreak.

Symptoms for shingles include:

  • Extreme pain or sensitivity in a localized area
  • Raised, red bumps and blisters in a concentrated location
  • Fever, chills, and headaches

Shingles is diagnosed based on a medical history and physical examination of the telltale rash. If you suspect you may have shingles, it is important to contact your doctor as quickly as possible. Early treatment can reduce the pain and severity of the episode. Two types of medications are prescribed to treat shingles:
  • Antiviral drugs to combat the virus, such as acyclovir, valacyclovir and famciclovir.
  • Pain medicines, from oral pain pills and antidepressants to anticonvulsants and topical preparations that contain skin-numbing agents.

You cannot catch shingles from someone with the infection; however, if you have not ever had chicken pox, you can develop chicken pox by coming in to contact with an individual who has shingles. Covering the rash from shingles decreases the chances of spreading chicken pox.

Shingles will usually run its course in several weeks, but medication can help improve healing time, ease discomfort, and reduce the likelihood of complications. Oral antiviral medications, such as Zovirax, Valtrex, and Famvir, work best when taken within 72 hours of the initial symptoms. Because of the intense pain that often accompanies this illness, your doctor may prescribe medication to make you more comfortable, like pain relievers and numbing agents.

Once you have contracted chicken pox, you have a chance of developing shingles. The best prevention is vaccination. The chicken pox vaccine, recommended for children and adults who never had the disease, decreases the likelihood of getting either virus. Zostavax, the shingles vaccine, helps prevent shingles in adults age 60 and older who had chickenpox at some point. Healthcare professionals generally recommend that anyone over age 60 receive the shingles vaccine.

The U.S. Food and Drug Administration has approved a vaccine, called Zostavax, for the prevention of adult shingles. It is approved for adults age 60 or older who have had chicken pox. Essentially, the vaccine delivers a booster dose of chicken pox. The vaccine has proven to be very effective in reducing the incidence of shingles and postherpetic neuralgia.




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