Shingles is a painful rash caused by the Varicella zostervirus (Herpes varicellae), which is the virus that causes chickenpox.

Shingles occurs in people who have had chickenpox and is a reactivation of the dormant virus. Shingles often occurs long after the initial chickenpox infection maybe years. Shingles is contagious and may itself cause chickenpox. However, contact with a person with shingles or chickenpox cannot cause shingles.

After the chickenpox virus has been contracted, it travels from the skin along the nerve paths to the roots of the nerves where it becomes inactive. The chickenpox virus then 'hibernates'. When the virus is reactivated, it travels via the nerve paths to the skin. It is not known what factors trigger a reactivation of the virus. Shingles generally affects the elderly, but occasionally occurs in children who have had chickenpox within the first year of their lives and in people with an immune deficiency.

Shingles can be a sign of immunodeficiency, caused by HIV or chemotherapy, stress, long time after sickness for example, but most people who get shingles have a normal immune system.

The first sign that a reactivation of the chickenpox virus is taking place is a burning sensation on the nerve paths along which the virus is travelling. Nerve paths typically form half-circles around the body. The pain and subsequent rash correspond to the position of the nerve paths and are almost always on one side of the body or face or limbs only, but more common in the trunk body.

The rash is typically accompanied by a fever and enlarged lymph nodes.

Two to three days after the pain has begun, a typical rash appears: small blisters on red, swollen skin. It resembles the type that is seen during an attack of chickenpox but covers a smaller area.

The rash usually reaches its peak after three to five days. Then, the blisters burst and turn into sores, which gradually scab over. The scabs fall off after two to three weeks. Sometimes the area where the rash was located becomes extremely painful after the scabs have gone and can last from a few weeks to several months. This highly unpleasant after-effect of shingles is called postherpetic neuralgia.

People with shingles are contagious to persons who have not had chickenpox.  Therefore, people who have not had chickenpox can catch chickenpox if they have close contact with the liquid from the blisters of a person who has shingles.  However, you can not catch shingles itself from someone else.  Shingles is caused by the chickenpox virus which has been dormant (staying quiet) in your body ever since you had the chickenpox.  You get shingles from your own chickenpox virus, not from someone else. Shingles usually develops when the immune system is compromised.

Shingles usually clears up in a month.  There may be severe pain that improves when the rash heals, or continues for months or years.  Persistent, on-going pain occurs in half the people over age 60 who develop shingles.  Destruction of the nerve sheath caused by shingles exposes the nerve, which continues to send painful messages from the skin to the brain.

Usually self-limiting, but can be dangerous or even fatal in the immunocompromised.

Who can get 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. Anyone who has had chicken pox can get shingles. That means almost anyone over the age of 5 could eventually get shingles. (A vaccine to prevent chicken pox became

available 5 years ago, so today's preschoolers who were vaccinated will possibly not have to worry about getting shingles.)
Shingles affects men and women and people of all races equally. Although shingles can affect adults at any age, the elderly and individuals with weakened immune systems are most susceptible to developing the condition. A woman who has active chickenpox or shingles within a few weeks of giving birth can pass the varicella zoster virus to her unborn infant. About one-third of babies who are exposed to the virus in this way go on to develop shingles before their 5th birthdays.

The varicella zoster virus that stays in the body after a case of chicken pox usually is kept inactive by the body's natural immune system. As people get older, their immune system naturally weakens to some germs, such as herpes zoster. Most people with shingles, therefore, are 65 years or older. Typically, but not always, shingles occurs in elderly people who are in some stressful situation. It is important to realize that just because a person develops shingles, the entire immune system is not necessarily having problems.

It has been estimated that at least one-half of the over-80 population will get shingles at some time. In addition to the elderly, other people with weakened immune systems who are at risk for developing shingles include people with HIV infection or AIDS, some patients with cancer (especially those receiving chemotherapy), transplant recipients, and people being treated with immunosuppressive drugs like corticosteroids.

Most people do not get shingles more than once: they develop immunity to the virus. However, about 1% to 5% of individuals will suffer a recurrence of shingles either in the original area on the body or a different area. Individuals may be most susceptible to recurrent attacks when they are run down or have a weakened immune system.

There are several effective treatments for shingles. Drugs that fight viruses (antivirals), such as acyclovir (Zovirax) or famciclovir (Famvir) can reduce the duration of the rash if started early (within 48 hours of the appearance of the rash). The addition of steroids may also limit the length of time that a patient has pain with shingles.

However, the benefit of both of these drugs is limited. In most people, shingles goes away on its own after it has run its course, and requires no treatment. However, your doctor may prescribe antiviral drugs to shorten the length of the infection, especially if you have a weakened immune system. Antiviral drugs are also used to prevent post-herpetic neuralgia, especially in people older than 50.

Most people will find pain relief with acetaminophen or other over-the-counter pain medicines, as well as cool compresses on the affected area. More severe pain may be relieved by prescription pain medications. It's important to keep your skin clean so you don't develop any other types of infections in the blistered area. Your doctor might also prescribe some type of antibacterial ointment to help prevent infection. Severe infections, such as those involving the eyes, may be treated with corticosteroids drugs as well as antiviral therapy.

Post-herpetic neuralgia is treated with tranquilizers, sedatives, or antidepressants that are taken at night. During an outbreak of shingles, as with any illness, it's important to get plenty of rest, follow a health diet, and reduce stress levels. Some people believe it's beneficial to boost the immune system with additional supplements of vitamins B12 and B complex, and C, as well as calcium. It's important to follow your doctor's recommendations for safe levels of vitamin supplements.

Pain medications can also offer relief. For mild to moderate pain, acetaminophen (Tylenol) or over-the-counter non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Motrin, Advil), naproxen (Aleve), and ketoprofen (Orudis KT) can be effective. For moderate to severe pain, more powerful pain killers may be needed, such as prescription NSAIDs or narcotic analgesics. Corticosteroids (for example, prednisone, methylprednisolone, cortisone, and hydrocortisone) are also sometimes prescribed to reduce the pain, discomfort, inflammation, redness, and itching associated with the rash and blisters.

For postherpetic neuralgia (PHN), medications for nerve pain may be needed. These include anti-seizure drugs such as gabapentin (Neurontin), carbamazepine (Tegretol), and phenytoin (Dilantin); antidepressants such as amitriptyline (Elavil), nortriptyline (Pamelor), desipramine (Norpramine), and doxepin (Adapine); a lidocaine patch 5% (Lidoderm); or capsaicin cream (Dolorac, Trixaicin, Zostrix, Zostrix-HP).

In addition to antiviral medication, pain medications may be needed for symptom control. The affected area should be kept covered and dry. However, bathing is permitted and the area can be cleansed with soap and water. An aluminum acetate solution (Burows or Domeboro's solution, available at your pharmacy) can be used to help dry up the blisters and oozing.

Post-herpetic neuralgia may be difficult to treat successfully. It may respond to tricyclic antidepressant medications such as amitriptyline or anti-epileptic medication such as carbamazepine or sodium valproate. For ophthalmic herpes zoster, antivirals are used to fight the varicella zoster virus and prevent it from spreading to a larger area of the face and the eye.

Other treatments include pain medicines, corticosteroids, and cool compresses. If you think you might have ophthalmic shingles, it is extremely important that you consult your primary doctor or an ophthalmologist immediately for treatment and advice to prevent permanent eye damage.

Shingles can be a very nasty infection to have to deal with. Not only does it cause extremely painful nerve and muscle pain, but it can also reappear several times throughout your life. Many shingles sufferers develop a condition known as Postherpetic Neuralgia, which causes ongoing muscle and nerve pain. This condition occurs when the shingles virus has permanently damaged nerves in the body.

Complementary and Alternative Treatments for Shingles

Herbal Medicine for Shingles

Several herbs and herbal combinations are useful in the treatment of shingles. We have the special formulars for these naughty shingles.

You can e-mail to us your full medical history and blood test report and then we can send by courier service to you.

How do I know if it is shingles?

Once the virus has been reactivated, it multiplies, spreads and causes pain along the path of the nerve that is infected. The rash that follows is painful and usually forms a band, eg, running across the body or down a leg, often on just one side. 'Zoster' comes from the Greek word for 'belt', which describes the pattern of the rash. The area of the rash depends on which nerve supply the virus has been 'hiding out' in.

What will I feel?

Shingles typically begins with pain and itching. The cause of this usually becomes obvious within two to three days when red patches start to form on the skin in the painful area, and the pain may worsen or become a deep aching or burning. You may have headache and fever.

If you are under 50 years of age, shingles pain is often not too severe, but if you are older it can be extremely painful. The rash then develops into a crop of small blisters, which tend to join and crust over in about seven to ten days. Untreated, the rash usually lasts two to five weeks, and it may leave some scarring. You remain infectious until all of the rash has scabbed over.

How can my doctor help?

If your doctors cannot stop the shingles pain, then its best to order for your shingles herbs or come over to our centre for your shingles intensive treatment.

Pain lasting beyond a month from the start of the rash, and when the rash has healed, is called neuralgia - the most common complication of shingles. It happens because the infection has inflamed and possibly damaged the nerve as well as the skin.

This causes your pain senses to become disorganised and overexcitable while the nerves are repaired. The pain improves with time usually, but it is difficult to treat while it lasts. If you are under 50 years neuralgia is very uncommon but about 50% of those aged over 60 will have pain at one month, and 25% after three months. It can last much longer in a few people. It is also more likely if the pain during shingles was severe or if an eye was affected.

Muscle weakness

About 5% of people with shingles have muscle weakness that follows days or weeks after the pain and rash begin (this is usually in the elderly). It happens because the nerve supplying the muscle has also been inflamed by the virus. It occurs more often on the face than on the body, but most people with muscle weakness recover completely or near completely.

Scarring

Scarring - usually white areas with lost pigment - can occur, depending on how bad the shingles was. The scarred skin may feel like it has lost its feeling. Scarring is also more common in the elderly.

How can I help myself?

• take medications as prescribed - this reduces the severity of shingles and the risk of lasting problems
• call your doctor if the pain becomes too great or if your face becomes affected
• if you cannot sleep, try constructing a support to keep the weight of your bedding off of your body
• keep the rash dry (you can still bathe or shower)
• stay at home until your rash has healed
• after the shingles, avoid exposing the area to sunlight
• if you have lasting pain, wear loose-fitting clothes made of natural fibres and seek help from your doctor early on.

Fortunately, 95% of people who get shingles will never have it again.