Shingles Treatment Summary

    Shingles are caused by the reactivation of a virus. It can manifest as red, painful rash with small blisters on your skin. Very often, this may not be obvious in the first few days when shingles infection first appears. Shingles treatment with anti-viral medication is effective, and reduces suffering and complications from the viral infection. 

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    DermNetNZ.org

    About Shingles

    The lifetime incidence of shingles is about 10-20%, and this rises with advancing age, with more than 60% of patients affected by the disease being more than 50 years of age.

    After one recovers from chickenpox, the virus never goes away but stays resident in the nerve roots. Shingles develop because of the reactivation of the varicella-zoster virus in your nerve roots. The exact reason of the reactivation of the virus is not precisely known but may be associated with stress, infections, or re-exposure to the virus.

    Shingles often starts with a painful rash that progress to the appearance of groups of small blisters (vesicles) on the background of red skin, following, which the vesicles will rupture and crust over during the healing phase. Shingles can affect any part of the body, but common areas include the trunk, limbs and face. Symptoms last about 2 weeks, and healing may take up to a month.

    Shingles Treatment

    It is important to treat Shingles early to reduce suffering and complications from the disease.  Shingles treatment, in the form of a course of prescription anti-viral medication is the mainstay to reduce the burden of the disease. Recently, a varicella-zoster vaccine has been approved to reduce the incidence of Shingles to those above the age of 50.

    Complications of Shingles

    Complications for shingles are fortunately uncommon. They mostly occur in the elderly, above 60 years of age.

    The most common complication is Post-Herpetic Neuralgia (PHN). PHN may occur shortly after the acute attack of shingles, or develop weeks to months following the shingles attack. It causes chronic pain that can persists over months to years.

    Shingles that occurs over the facial and eye region, have an increased risk of causing eyesight problems such inflammation, ulcers and blindness. Shingles may also causes weakness in facial muscles and deafness in some cases.

    Shingles may be more severe in individuals with a weakened immune system. Examples include having diabetes, advanced age, and immune system deficiency disorders. Hospitalisation for treatment and observation are recommended in these cases. 

     

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    References:

    1. Dworkin RH, Johnson RW, Breuer J, Gnann JW, et al. Recommendations for the management of herpes zoster. Clin Infect Dis. 2007 Jan 1. 44 Suppl 1:S1-26.
    2. Sanford M, Keating GM. Zoster vaccine (Zostavax): a review of its use in preventing herpes zoster and postherpetic neuralgia in older adults. Drugs Aging. 2010 Feb 1. 27(2):159-76.