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Johns Hopkins Symptoms and Remedies

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Shingles Herpes Zoster

The lines mark the areas of skin served by individual brain or spinal nerves. The rash from shingles typically follows one of these bands.

What is it?

Shingles, also known as herpes zoster, is a disorder caused by varicella zoster, the same virus that causes chicken pox. After an attack of chicken pox, usually a childhood disease, the virus does not die but rather lies dormant in the nerve cells that extend from the spinal cord or the brain. Years later, the virus may be reactivated and migrate along the path of a nerve to the surface of the skin, where it causes a rash of painful blisters.While it is generally not a dangerous condition, shingles can be extremely painful and often causes lingering nerve pain (postherpetic neuralgia) for months or even years after the rash is gone. This disorder only affects those who have previously had chicken pox and usually strikes after the age of 50. Usually only one attack occurs, lasting for two or three weeks.Outlook is good unless the virus spreads to the brain or spinal cord.

What Causes It?

  • How or why shingles occurs is uncertain. It is believed that the virus reactivates when the immune system—owing to age, illness, stress, or the use of immunosuppressant drugs—becomes too weak to keep the virus in a state of dormancy. Immunosuppressed patients are at increased risk for shingles.

Prevention

  • There is no known way to prevent shingles.

Diagnosis

  • Shingles is suspected based on typical skin lesions and a history of chicken pox or shingles.
  • A direct microscopic examination or culture of the skin lesions may be taken to confirm the diagnosis.

How to Treat It

  • Apply cool, wet compresses or ice packs.
  • Use over-the-counter pain relievers.
  • Calamine lotion and oatmeal or cornstarch baths can help relieve itching.
  • During the early stages, antiviral drugs, such as acylclovir, may be combined with a potent corticosteroid drug (such as prednisone), which speeds healing and lessens the duration of severe pain.
  • Medications that impede nerve impulses, such as carbamazepine, gabapentin, and amitriptyline,may be used for more serious cases of postherpetic neuralgia.
  • Narcotics may be prescribed to control severe pain.
  • In the most severe or persistent cases, injections of blocking agents directly into nerves may be used to prevent pain signals from reaching the brain.

When to Call a Doctor

  • Call a doctor if you develop symptoms of shingles.
  • See a doctor or ophthalmologist immediately if shingles occurs around the eye or affects vision.