Dr. MJ Bazos MD,
What is shingles, and who can get
Shingles is another name for a condition called
"herpes zoster." It causes a painful rash. You can only get shingles if you had
chickenpox in the past.
After you have chickenpox (usually as a child),
the virus that causes it stays in your body in certain nerve cells. Most of the
time your immune system keeps the chickenpox virus in these cells. As you get
older, or if your immune system gets weak, the chickenpox virus may escape from
the nerve cells and cause shingles.
Most people who get shingles are more than 50
years old or have a weak immune system. For example, you might get shingles if
you have cancer, take medicines that weaken your immune system or have the virus
that causes AIDS (acquired immunodeficiency syndrome).
What are the symptoms of shingles?
Shingles causes a painful, blistering rash.
Sometimes the pain starts a few days before the rash appears.
The rash begins with reddish bumps. In a few
days, these bumps turn into blisters. You might feel a stinging or burning pain.
The rash may wrap around your back and chest, or it may be on one side of your
The blisters usually crust over and fall off
after 7 to 10 days. You may see changes in the color of your skin when the scabs
fall off. In bad cases of shingles, these color changes last forever.
Even though the rash gets better or goes away in
a few weeks, the pain may last longer. In most people, the pain goes away in 1
to 3 months.
Shingles can also affect your eyes, causing
swollen eyelids, redness and pain. Shingles of the eye can cause scars that
affect your vision. It can also lead to glaucoma later in life. Glaucoma is an
eye disease that can cause blindness. People who have shingles of the eye should
see an eye doctor right away.
How is shingles treated?
Shingles is often treated with acyclovir (brand
name: Zovirax), famciclovir (brand name: Famvir) or valacyclovir (brand name:
Valtrex). Your doctor will decide which of these medicines might work for you.
These medicines work better if you start taking them in the first 3 days
after you get the rash.
Your doctor might also have you take a steroid
medicine to reduce your pain and swelling.
Shingles of the eye is treated with antiviral
medicines and steroids.
What can I do about the pain?
To help with the pain of shingles, your doctor
might have you take an over-the-counter pain medicine like acetaminophen (one
brand name: Tylenol) or ibuprofen (one brand name: Motrin). Aspirin is not
recommended because using it might cause a liver problem called Reye's
Putting a medicated lotion (two brand names:
Benadryl, Caladryl) on the blisters might reduce the pain and itching. Putting
cool compresses soaked in an astringent liquid (two brand names: Bluboro,
Domeboro) on the blisters and sores might make them hurt or itch less.
If shingles causes severe pain, your doctor
might have you take a prescription pain medicine.
What is postherpetic neuralgia?
"Postherpetic neuralgia" is the name used when
the pain of shingles lasts for a long time after the rash is gone. About 1 in 5
people with shingles will get postherpetic neuralgia.
Like shingles, postherpetic neuralgia causes a
stinging or burning pain. Your skin might become very sensitive to temperature
changes or a light touch, such as from a bedsheet or moving air.
Most people with postherpetic neuralgia get
better with time. Almost all of them are free of pain within 1 year. A few
people have chronic pain (pain that doesn't go away).
How is postherpetic neuralgia
Postherpetic neuralgia is often treated with
over-the-counter pain medicines and capsaicin cream (two brand names: Capsin,
Zostrix). If these medicines don't help enough, your doctor might try some other
treatments, such as a patch that contains lidocaine (brand name: Lidoderm).
Some medicines that are used to treat depression
and seizures can also help the nerve pain of postherpetic neuralgia. These
medicines don't work very fast, though. It might be several weeks before they
help your pain.