Herpes zoster or shingles is a localised, blistering and painful rash caused by reactivation of varicella-zoster virus (VZV). Herpes zoster is characterised by dermatomal distribution, that is the blisters are confined to the cutaneous distribution of one or two adjacent sensory nerves. Anyone that has previously had varicella (chickenpox) may subsequently develop zoster. Zoster can occur in childhood but is much more common in adults, especially older people. Those who have a depressed immune system have an increased risk of developing zoster and rarely it is even possible to get another shingles outbreak after having had an outbreak.
The first symptom of shingles is usually a painful rash on one side of the face or body. Blisters then form on the rash, which begin to scab over in 7-10 days and then fall off in 2-3 weeks. A person can also have itching, tingling or pain in the area before a visible rash develops. Other symptoms of shingles include a fever, chills, abdominal pain, joint pain, swollen glands or headaches. Shingles can also affect the eyes and ears; if this is not treated, it can cause vision or hearing loss. If shingles is affecting a nerve in your face, it can cause drooping eyelids, loss of eye motion, vision problems, taste problems and difficulty moving muscles in the face.
Health care providers can usually diagnose shingles with a simple examination of the skin area. Tests or skin samples are rarely needed. Prescription antiviral drugs are used to treat shingles, which shorten the lifespan of the disease and prevent complications, along with reducing pain. These antivirals should be started within 72 hours of the initial pain or burning, or appearance of a rash, and hopefully before blisters appear.
Although these drugs are usually given in pill form, in severe cases they may be given intravenously. Analgesic pain medication may also be used for pain relief. To relieve itching, some treatments include wet compresses, calamine lotion and colloidal oatmeal baths. A vaccine exists for shingles and may be recommended by your primary care physician. The vaccine is generally given to the elderly or those at higher risk of shingles.