Could It Be Shingles?
It happens without warning. You begin to notice that you have an outbreak of red bumps on one side of your body that rapidly turn into what appear to be blisters on top of a red rash. Over the next few days, the blisters and rash may spread and finally they erupt and start to dry into crusts. You have noticed that the area is itchy, and sometimes sore. You wonder, could this be shingles?
Shingles, or Herpes Zoster (HZ) as it is known medically, is the diagnosis of a rash that fits this description. It is caused by the same virus that is responsible for chickenpox (varicella). Most people are infected with chickenpox during childhood. After the infection subsides, the virus becomes inactive and remains in our nervous system. In some people, the virus is reactivated in the future and manifests itself in the rash known as shingles.
For most people, shingles tends to occur later in life and some may experience more than one episode in a lifetime. Increasing age, being on immunosuppressive medications, fatigue, emotional stress, and radiation therapy have all been thought to be implications for re-activation of the virus.
Patients may experience headaches, sensitivity to light, or a general feeling of being tired prior to the eruption of the rash. Some people experience a swelling of the lymph nodes, pain, itching, or a burning sensation in a certain area of the skin. The virus generally follows a linear pattern down a single spinal nerve. This explains why the rash usually only affects one side of the body. The vesicles may begin as clear but become cloudy or filled with yellow pus by the third to fourth day. They may rupture and form crusts that fall off within two to three weeks.
A complication of shingles may be post herpetic neuralgia, the residual pain that can last more than thirty days since the onset of the rash. The incidence of this usually increases with age, with most cases occurring after age thirty. If shingles occurs around or over the eyes, it is a more serious concern and patients must see an ophthalmologist for a consultation to check to make sure there are no complications within the eye such as swelling or inflammation that could affect the vision.
Depending on the severity, we can treat shingles with cool wet dressings, oral steroids, and/or oral antiviral medications. The oral antiviral therapy is the most common form of treatment and works best if it is initiated within the first forty eight hours of the onset of the symptoms. Pain management varies depending on the severity of the symptoms.
If you suspect you have shingles, it is important to make an appointment for evaluation so that treatment may be initiated if appropriate.