Shingles - Shingles Information, Treatment & prognosis
Shingles Information, Treatment & prognosis
Shingles is an infection caused by the varicella-zoster virus, which is the virus that causes chickenpox. Shingles occurs in people who have had chickenpox and represents a reactivation of the dormant varicella-zoster virus. The disease generally affects the elderly, although it occasionally occurs in younger and/or immunodeficient individuals. The first sign is usually a tingling feeling, itchiness, or stabbing pain on the skin. After a few days, a rash appears as a band or patch of raised dots on the side of the trunk or face. The rash develops into small, fluid-filled blisters which begin to dry out and crust over within several days. When the rash is at its peak, symptoms can range from mild itching to extreme and intense pain. Contact with a person with shingles may cause chickenpox (but not shingles) in someone who has never had chickenpox before.
Treatment for shingles includes antiviral drugs, steroids, antidepressants, anticonvulsants, and topical agents. The severity and duration of an attack of shingles can be significantly reduced by immediate treatment with the antiviral drugs acyclovir, valacyclovir or famcyclovir. These drugs may also help stave off the painful aftereffects of shingles known as postherpetic neuralgia.
Although shingles can be very painful and itchy, it is not generally dangerous to healthy individuals and it usually resolves without complications. The rash and pain usually go away within 3 to 5 weeks. Sometimes serious effects including partial facial paralysis (usually temporary), ear damage, or encephalitis (inflammation of the brain) may occur. persons with shingles on the upper half of the face should seek medical attention immediately as the virus may cause serious damage to the eyes. Most people who have shingles have only one bout with the disease in their lifetime. However, individuals with impaired immune systems, i.e., people with AIDS or cancer, may suffer repeated episodes.
The NINDS conducts and supports a program of research aimed at developing new treatments for and preventing the painful conditions of shingles.
These articles, available from a medical library, are sources of in-depth information on shingles:
Flieger, K. "Shingles -- Or Chickenpox, part Two." FDA Consumer, Food and Drug Administration, Rockville, MD (July-August 1991).
Kost, R, and Straus, S. "postherpetic Neuralgia --- pathogenesis, Treatment, and prevention." New England Journal of Medicine, 335:1; 32-42 (July 4, 1996).
Loeser, J. "Herpes Zoster and postherpetic Neuralgia." In The Management of pain, vol. 1, 2nd edition, Lea & Febiger, philadelphia, pp. 257-263 (1990).
Rockley, p, and Tyring, S. "pathophysiology and Clinical Manifestations of Varicella Zoster Virus Infections." International Journal of Dermatology, 33:4; 227-232 (April 1994).
Schultz, D. "That Spring Fever May Be Chickenpox." FDA Consumer, Food and Drug Administration, Rockville, MD, pp. 15-17 (March 1993).
"The Message is Clear: Antiherpetics Do prevent Neuralgia." Modern Medicine, 63; 8 (January 1995).
Whitley, R, et al. "Acyclovir With and Without prednisone for the Treatment of Herpes Zoster." Annals of Internal Medicine, 125:5; 376-383 (Sept. 1, 1996).
Additional information is available from the following organizations (last updated November 24, 1998):
VZV Research Foundation
40 East 72nd Street
New York, NY 10021
American Chronic pain Association
p.O. Box 850
Rocklin, CA 95677
National Chronic pain Outreach Association, Inc.
p.O. Box 274
Millboro, VA 24460