Herpes zoster, colloquially known as shingles, is the reactivation of varicella zoster virus, or VZV. The virus, one of the Herpesviridae group, leads to a group of painful blisters over the area of a dermatome.As you get older, or if your immune system gets weak, the chickenpox virus may escape from the nerve cells and cause shingles. In most cases, however, a cause for the reactivation of the virus is never found. The herpes virus that causes shingles and chicken pox is not the same as the herpes virus that causes genital herpes (which can be transmitted) and herpes mouth sores. Shingles is medically termed Herpes zoster. Early signs of shingles include burning or shooting pain and tingling or itching, usually on one side of the body or face. The pain can be mild to severe. Blisters then form and last from one to 14 days. If shingles appears on your face, it may affect your vision or hearingThe most common location for shingles is a band, called a dermatome, spanning one side of the trunk around the waistline. Anyone who has had chickenpox is at risk for shingles. Scientists think that in the original battle with the varicella-zoster virus, some of the virus particles leave the skin blisters and move into the nervous system. When the varicella-zoster virus reactivates, the virus moves back down the long nerve fibers that extend from the sensory cell bodies to the skin. The viruses multiply, the tell-tale rash erupts, and the person now has shingles.Shingles is another name for a condition called “herpes zoster.” Shingles, also known as herpes zoster, is a disease that affects an estimated 2 in every 10 people in their lifetime. This year, more than 500,000 people will develop shingles. It is correctly known as herpes zoster. Chickenpox or varicella is the primary infection with the virus, Herpes zoster , also called ‘varicella-zoster’. During this widespread infection, which usually occurs in childhood, virus is seeded to nerve cells in the spinal cord, usually of nerves that supply sensation to the skin. The virus remains in a resting phase in these nerve cells for years before it is reactivated and grows down the nerves to the skin to produce shingles (zoster). This can occur in childhood but is much more common in adults, especially the elderly. Shingles patients are infectious both from virus in the lesions and in some instances the nose and throat.Causes of ShinglesVaricella zoster virus, the same virus that causes chicken pox, causes shingles. This virus is in the herpes family. After a person has had chickenpox the virus remains in their body, lying dormant or hidden in part of the nervous system. For some reason, often many years later, the virus travels back down one of the nerves to the skin, where it causes a rash in the area of skin supplied by that nerve. It’s not clear what triggers reactivation of the chickenpox virus but it may be linked to changes in the immune system. Ensuring your immune system is not weakened may help to prevent this occurring.Signs and Symptoms of ShinglesBefore a rash is visible, the patient may notice several days to a week of burning pain and sensitive skin. Shingles start as small blisters on a red base, with new blisters continuing to form for 3-5 days. The blisters follow the path of individual nerves that comes out of the spinal cord (called dermatomal pattern). The entire path of the nerve may be involved or there may be areas with blisters and areas without blistersWhat is the prognosis?For most healthy people, the lesions heal, the pain subsides within 3 to 5 weeks, and the blisters leave no scars. However, shingles is a serious threat in immunosuppressed individuals for example, those with HIV infection or who are receiving cancer treatments that can weaken their immune systems. People who receive organ transplants are also vulnerable to shingles because they are given drugs that suppress the immune system. Treatment for ShinglesShingles is often treated with acyclovir (brand name: Zovirax), famciclovir (brand name: Famvir) or valacyclovir (brand name: Valtrex). Acyclovir is available in a generic form, but the pills must be taken five times a day, whereas valacyclovir and famcyclovir pills are taken three times a day. It is important not to miss any doses and not to stop taking the medication early. Antiviral drugs can reduce by about half the risk of being left with postherpetic neuralgia which is chronic pain that can last for months or years after the shingles rash clears. Doctors recommend starting antiviral drugs at the first sign of the shingles rash, or even if the telltale symptoms indicate that a rash is about to erupt. Even if a patient is not seen by a doctor at the beginning of the illness, it may still be useful to start antiviral medications if new lesions are still forming.Alternative Treatment may include:# Cold compresses: Apply towels or washcloths wrung out in cold water (and stored in the freezer if you want them colder) to the lesions.# Lysine cream, available in health food stores, can be applied topically daily or as directed on package label.# Make an ointment of two mashed aspirins mixed with two tablespoons of chloroform (or Vaseline intensive Care). Apply to the lesions and let dry, Calamine lotion can be applied to the lesions.Tai ChiThere is preliminary evidence suggesting that tai chi may improve immune function and health in older adults at risk for shingles.In one study, 36 men and women, aged 60 and over, took a 15 week program of Tai Chi Chih (three 45 minute classes per week) or a wait list control. After 15 weeks, there was an increase in varicella zoster virus-specific immunity and health functioning in people taking Tai Chi Chih. Tai Chi Chih is just one form of the Chinese martial art.
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