Shingels (Herpes Zoster)

Herpes zoster is the medical name for shingles. It is caused by reactivation in the adult years of the chicken pox virus that occurred during childhood (the varicalla-zoster virus). The virus can be reactivated when the body's immunity to the virus breaks down. This may happen due to normal aging, or the body's immune system may become weakened due to stress from illness, physical or emotional stress, fatigue, poor nutrition, certain medications, chemotherapy, radiation therapy, or other factors.

Once reactivated, the virus travels along nerve fibers, usually settling in fairly isolated areas of skin on one side of the body. The infected area of the body usually has severe pain, itching, redness, numbness, and the development of a rash. The rash on the skin develops into small, fluid-filled blisters called vesicles. Within a few days of their appearance on the skin, the vesicles break open and form scabs. In severe cases, the rash can leave permanent scars, long standing pain, numbness, and skin discoloration.

How Does Herpes Zoster Affect The Eyes? The eyes are sometimes affected by herpes zoster. This is due to the fact that the eyes are connected to nerves that may be infected with the herpes zoster virus. The usual shingles rash can spread from an involved area of the forehead or cheek to the upper or lower eyelids. Shingles may cause redness of the conjunctiva (the mucous membrane covering the white of the eye). It can also cause small scratches or scarring of the cornea. The scratches on the cornea may increase the risk of bacterial infection in the eye. Shingles may also cause inflammation inside the eye, known as iritis or uveitis. It can also affect the optic nerve or the retina. Herpes zoster infections of the eye can lead to redness, swelling, pain, sensitivity to light, and blurred vision. Severe or repeated episodes of herpes zoster infection are associated with other eye conditions, including glaucoma, scarring inside the eye, and cataract formation.

Are Herpes Zoster Infections Contagious? Shingles caused by herpes zoster is not contagious and should not be confused with herpes simplex virus (HSV) infections. At the time the herpes zoster or varicella zoster virus first infects the body causing chickenpox, the infection is contagious. The outbreak of shingles later in life is not a new infection, but rather a reactivation of the dormant virus. For this reason, shingles is not contagious.

How Are Herpes Zoster Eye Infections Treated? Treatment of the symptoms of shingles through compresses and pain relievers is usually recommended by doctors. Lubricating eyedrops or antibiotic eye drops may aso be prescribed.

The use of antiviral medications may be recommended by your doctor. The medication most commonly prescribed is acyclovir. Occasionally, steroids may be prescribed to reduce inflammation.

By its very nature, herpes zoster infections are prone to return from time to time, especially when the immune system is weakened. Early diagnosis and treatment is important to minimize the symptoms and reduce the risk of complications that may compromise vision.

http://www.steen-hall.com/zoster.html

I. Definition: Shingles (herpes zoster) is a nerve infection caused by the chicken-pox virus. Shingles results from reactivation of the chicken-pox virus that remained in your body since you had chicken pox--perhaps many years ago.

II. Causes: Herpes zoster (shingles) is caused by the chicken-pox virus.

III. Symptoms: The rash of shingles begins as red patches that soon develop blisters, often on one side of the body. The blisters may remain small or can become large. They heal in two to four weeks. They may leave scars. Many patients mistakenly believe that "nervousness" causes shingles. this is wrong; shingles is a viral infection of a nerve and has nothing to do with being "nervous." Shingles is often painful, this is because the virus travels along the nerve to get to the skin resulting in inflammation and damage to the nerve.

III. Treatment: Acyclovir helps to control the skin eruption. It is not a cure, but helps to heal the rash, provided treatment is started early. Acyclovir is taken by mouth. Even taking acyclovir may not eliminate discomfort, burning sensations, or pain. If the discomfort is mild, take Tylenol or a similar mild painkiller. If you have too much pain, we can order a prescription painkiller to take until the pain subsides. The pain is caused by inflammation of a nerve. Cortisone taken by mouth is sometimes used in treating the nerve inflammation. The blistering rash usually clears in a few weeks. The discomfort may persist longer. Treat your rash gently. Don't open your blisters. As long as there is blistering or crusting, compresses with dilute vinegar will make you more comfortable. Compress the blisters or crusts for 10 minutes twice daily with a mixture of one-quarter cup of white vinegar and two quarts of lukewarm water. Stop the compresses when the blisters have dried up. Later, when the crusts and scabs are separating, your skin may become dry, tense, and cracked. If that happens, rub on a small amount of white petrolatum (plain Vaseline) three or four times a day.

IV. Postherpetic Neuralgia (Pain After the Rash is Gone): Shingles is often painful, this is because the virus travels along the nerve to get to the skin resulting in inflammation and damage to the nerve. The pain can last up to six months because nerves heal very slowly. The best treatment for the pain after the rash is gone is a cream called Zostrix. This cream can be bought from your pharmacy without a prescription. To use Zostrix Cream one must apply it five-six times a day. It will take two to three weeks of use before the cream will start to work. This takes tremendous patience. If you persist though, the benefit of reduced pain will pay off.

http://www.skinsite.com/info_herpes_zoster.htm

WHAT IS SHINGLES? : Shingles is a very painful disease caused by the same herpes virus that causes chicken pox (varicella zoster virus). Like other herpes viruses, the varicella-zoster virus has an initial infectious stage, (chicken pox) followed by a dormant stage. Then, with no warning, the virus becomes active again. Older people are more likely to develop shingles. Shingles is not one of the infections that leads to a diagnosis of AIDS, but people with lower T-cell counts seem to develop shingles more often than healthy people of the same age. Herpes zoster lives in nerve tissue. Outbreaks of shingles start with severe pain in a belt-like pattern on the chest, back, or in the eye and forehead. These outbreaks are almost always on just one side of the body. A day or two later, a rash appears on the skin area related to the inflamed nerve. Small blisters form, and crust over. The virus can be transmitted to other people when the blisters break open. In rare cases, shingles can spread throughout the skin or internal organs, and can cause serious complications. In most cases, the rash goes away in 10 days to two weeks, but severe pain can last for months or years.

HOW IS SHINGLES TREATED? : The standard treatment for shingles is the drug acyclovir, which can be given orally (in pill form) or intravenously in more severe cases. Recently, two new drugs have been approved for the treatment of shingles: famciclovir and valacyclovir. Both famciclovir and galaciclovir are taken three times each day, compared to five times for acyclovir. All of these drugs work best when they are started within the first three days after the shingles pain begins. Because the pain of shingles is so intense, some researchers have looked for ways to block the pain. When the herpes zoster virus inflames nerves, they pump out a chemical messenger called glutamate. Glutamate then lands on receptors on nearby cells, which transmit pain signals to the brain. Shingles triggers such a flood of glutamate that some cells stop functioning while others become hypersensitive. This probably explains why shingles patients can feel great pain even when skin is touched only lightly. There are drugs that can block the receptor sites where glutamate lands, and researchers are studying whether these drugs will help relieve shingles pain. In 1999, the FDA approved a patch form of the anesthetic lidocaine. The patch, called Lidoderm, provides pain relief for some people with shingles. Because lidoderm is applied to the skin, it has less risk of side effects than pain medications taken in pill form.

CAN SHINGLES BE PREVENTED?: Currently, there is no way to predict an outbreak of shingles, and there is no medication approved to prevent it. But researchers have shown that giving older people the chicken pox vaccine - the same vaccine used for children - boosts the type of immunity believed necessary to hold the virus in check. The researchers hope to show that this increased immunity will result in a lower risk of shingles in later life.

THE BOTTOM LINE : Shingles is an unpredictable, very painful disease. It is caused by a re-activation of the virus that causes chicken pox. Although not directly linked to HIV, shingles seems to occur more frequently in people with AIDS. Although shingles may disappear within a couple of weeks, severe pain may continue for several months. There is no known way to prevent outbreaks of shingles. The disease has been treated with acyclovir, taken five times daily, or given intravenously in severe cases. Two newer drugs, famciclovir and galaciclovir, seem to be more effective against the pain of shingles and need to be taken only three times each day.

http://aidsinfonet.org/514-shingles.html

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What is shingles? : Shingles is a localized infection due to the varicella-zoster virus, the same virus that causes chickenpox. It occurs only in people who have had chickenpox in the past and represents a reactivation of the dormant varicella virus. Why the virus reactivates in some individuals and not in others is unknown.

Who gets shingles? : The disease is primarily seen in the elderly, but occasionally occurs in younger individuals. It affects both sexes and all races with equal frequency and occurs sporadically throughout the year.

How is shingles spread? : A person must have already had chickenpox in the past to develop shingles. Contact with an infected individual does not cause another person's dormant virus to reactivate. However, the virus from a shingles patient may cause chickenpox in someone who has not had it before.

What are the symptoms of shingles? : The first sign is often a tingling feeling on the skin, itchiness or a stabbing pain. After several days, a rash appears beginning as a band or patch of raised dots on the side of the trunk or face. It then develops into small, fluid-filled blisters which begin to dry out and crust over within a few days. When the rash is at its peak, symptoms can range from mild itching to extreme and intense pain. The rash and pain usually disappear within three to five weeks.

How soon after infection do symptoms appear? : The virus lies dormant in someone who has had chickenpox in the past. It can reactivate many years later.

When and for how long is a person able to spread shingles? : A person exposed to a patient with shingles will not get shingles but may get chickenpox. The virus is present at the site of the rash and is contagious for a week after the appearance of lesions (blisters).

Does past infection make a person immune? : Yes. Most people who have shingles have only one episode with the disease in their lifetime. Those with impaired immune systems (people with AIDS, cancer or leukemia, for example) may suffer repeated attacks.

What are the complications associated with shingles? : Shingles is not usually dangerous to healthy individuals although it can cause great misery during an attack. Anyone with shingles on the upper half of their face, no matter how mild, should seek medical care at once. There is some danger that the virus could cause damage to the eye resulting in blindness. Complications are rare but may include partial facial paralysis (usually temporary), ear damage or encephalitis (inflammation of the brain).

What is the treatment for shingles? : Most cases of shingles resolve on their own without specific treatment. Two medications available for use by physicians in treating immunocompromised patients are vidarabine and acyclovir.

What can be to done prevent the spread of shingles? : Chickenpox must be prevented in order to prevent shingles. A vaccine for chickenpox is now available and it is hoped that immunized individuals will be less likely to develop shingles in later life.

http://www.netmedicine.com/pt/PTINFO/shingles.htm

I decided to add this page because my mom has shingles and before she got it I had never heard of it. So with her help I have put together what information I could find so it can be available to others. If you have any other information you would like to see added here please send it to me and I'll add it as soon as I can.

My mom has been getting shingles off and on for about 10 years now. She is only 45 years old so it's not just the old people who get it. I believe she gets it because of stress. Cuz it always pops up when I call needing something. *s* She wrote me this email last week when I asked her how it was going:

I have done great with taking the Lysine I did forget to take them for about 3 weeks then I got a few shingles. I'm back to taking it every day and have done great. I might get one or two every now and again but I'm happy with the over the counter remedy the doctors were no help at all they just want to do blood work and run the bill up with no results.

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