What is Shingles?
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These are similar answers as to what shingles are, based on several definitions from separate health organizations. Please forgive me if there are any repetitions.
Shingles are a viral infection that causes a painful rash. Although shingles can occur anywhere on your body, they most often appear as a single stripe of blisters that wrap around either the left or the right side of your torso.
Shingles are caused by the varicella-zoster virus — the same virus that causes chickenpox. After you’ve had chickenpox, the virus lies inactive in nerve tissue near your spinal cord and brain. Years later, the virus may reactivate as shingles.
While it isn’t a life-threatening condition, shingles can be very painful. Vaccines can help reduce the risk of shingles, while early treatment can help shorten a shingles infection and lessen the chance of complications.
Shingles are the name commonly used for herpes zoster, an infection that shows up as a painful skin rash with blisters, usually on part of one side of the body (left or right), often in a strip. Shingles are caused by the varicella-zoster virus.
Shingles is a viral infection that results from the varicella-zoster virus (VZV), the same virus that causes chickenpox. It typically affects a single sensory nerve ganglion and the skin surface that the nerve supplies.
Anyone who has had chickenpox can later develop shingles.
In fact, according to the Centers for Disease Control and Prevention (CDC), an estimated 1 in 3 people in the United States develop shingles during their lifetime.
However, a person can only develop shingles if they have had chickenpox or exposure to the virus that causes it. This virus can lie dormant for years.
Most adults with the dormant virus never develop shingles, but for some, the virus reactivates several times.
Shingles are most common after the age of 50 years, but they can appear at any age if a person has previously had chickenpox.
In this article, learn more about shingles, including symptoms, complications, and treatments.
Shingles usually affect one side of the body. This is most often the waist, chest, abdomen, or back. Symptoms can also appear on the face and in the eyes, mouth, and ears. The virus can also affect some internal organs.
Shingles typically affect a single sensory nerve ganglion near the spinal cord, called a dorsal root ganglion. This is why the symptoms occur in specific areas of the body, rather than all over it. The pain results from nerve involvement, rather than the rash itself.
In fact, some people have pain but no rash. Others, meanwhile, may have a rash with pain that is accompanied by other symptoms, such as fever, chills, or headache.
Symptoms can vary in nature, depending on where on the body they appear.
Some of the most common symptoms of shingles include:
- a constant dull, burning, or gnawing pain, or sharp, stabbing pain that comes and goes
- a skin rash that resembles a chickenpox rash but only affects certain areas
- fluid-filled blisters that develop as part of the rash
Symptoms on the body
A blistering skin rash may appear in one or more distinct bands with sensory nerves of the skin, called dermatomes.
Common locations for this include:
- the chest
- the abdomen
- the back
- around the waist
It usually occurs only on one side of the body. The location of the symptoms will depend on which dermatome distribution the virus affects.
The rash affects the face, symptoms usually appear on one side only — usually around one eye and the forehead.
They can include:
- pain over the affected dermatome
- a rash
- muscle weakness
The virus affects an ophthalmic nerve, which means that a person has herpes zoster ophthalmicus.
This can cause pain, redness, and swelling in and around the eye, as well as temporary or permanent loss of vision.
Shingles can also occur in or around the ear, leading to problems with balance and hearing, as well as muscle weakness on the affected side of the face.
These changes can be long-term or even permanent. A person who develops symptoms in or around the ears and eyes should seek immediate medical attention to reduce the risk of complications.
shingles affect the mouth, a person may experience:
- facial tenderness
- pain in the mouth
- lesions in hard and soft palate tissues
The pain and discomfort of these symptoms can make it difficult to eat or drink.
Shingles can also affect internal organs. There will not be a rash, but other problems can arise.
For example, researchers have found evidence of shingles in the digestive system, which can lead to gastrointestinal dysfunction, and in the arteries in the brain, which may increase the risk of stroke and dementia.
There may also be other symptoms, including:
Symptoms typically progress as follows:
- Pain, tingling, numbness, and itching start to affect a specific part of the skin.
- After up to 2 weeks, a rash appears.
- Red blotches and itchy, fluid-filled blisters develop and continue to do so for 3-5 days.
- The blisters may merge, forming a solid red band that looks similar to a severe burn. The gentlest touch may be painful.
- Inflammation may affect the soft tissue under and around the rash.
- After 7–10 days, the blisters gradually dry up and form scabs or crusts. As the blisters disappear, they may leave minor scarring.
Shingles usually last around 2–4 weeks. It is contagious until the blisters dry up and crust over.
Most people will only have an episode of shingles once, but it can recur in some people.
Rarely, complications can arise — especially in people with an impaired immune system.
Possible complications of shingles include:
- Postherpetic neuralgia (PHN)
- inflammation of the brain or spinal cord, increasing the risk of stroke, encephalitis, and meningitis
- eye and vision problems
- problems with balance and hearing
- damage to blood vessels, which could lead to stroke
According to the CDC, around 10–18% of people who have shingles will develop PHN, a long-term complication wherein the pain of a shingles rash lasts long beyond the rash itself.
It is more likely to occur if a person develops shingles after the age of 40 years, and the risk continues to increase with age.
In people with weak immune systems
People with a weakened immune system will have a higher risk of developing shingles and experiencing severe symptoms and complications.
This includes people who:
- have cancer, especially leukemia or lymphoma
- have HIV
- have undergone an organ transplant
- are taking medications to suppress the immune system, including chemotherapy drugs
These people should seek medical attention as soon as possible if they have concerns about shingles-related symptoms.
Are shingles contagious?
It is not possible to directly transmit shingles to another person. However, a person who has never had chickenpox can contract VZV by coming into direct contact with the fluid in the blisters of a person who currently has shingles.
If this happens and the person has not received vaccination against chickenpox, they would develop chickenpox first, not shingles.
Shingles do not spread through coughing or sneezing. Only direct contact with fluid from the blisters can spread the virus. Therefore, covering the blisters reduces the risk of contagion.
It is important to note that the virus is only active from when the blisters first appear to when they dry up and crust over. Transmission is not possible before the blisters develop and after the crusts form. If a person does not develop blisters, the virus cannot spread in the traditional sense.
Taking the following precautions can help prevent the transmission of the virus:
- Cover the rash.
- Wash your hands often.
- Avoid touching or scratching the rash.
It is also important to avoid contact with:
- Infants who are preterm or have a low birth weight
- pregnant women who have never had chickenpox or the vaccine for it
- Those with a weakened immune system
A doctor may prescribe antiviral drugs to stop the virus from multiplying.
Antiviral treatment can help:
- reduce the severity and duration of symptoms
- prevent complications from developing
- lower the risk of the rash coming back
Tips for managing symptoms include:
- using pain relief medication
- reducing stress as much as possible
- eating regular, nutritious meals
- Getting some gentle exercise
- Wearing loose-fitting clothes, for comfort
To relieve itching, the CDC recommends:
- applying calamine lotion
- taking a lukewarm, oatmeal bath
- placing a cool, damp washcloth on the blisters
Most people will recover with home treatment, but a person should seek medical help if other symptoms appear, such as a fever. Around 1–4% of people will need to spend time in the hospital due to complications.
Undergoing vaccination can offer protection from both chickenpox and shingles.
For children: Chickenpox vaccine:
Experts recommend routine immunization with the varicella vaccine (chickenpox vaccine) during childhood.
With two doses of the vaccine, there is at least a 90% chance of preventing chickenpox. Preventing chickenpox will also prevent shingles.
Children should receive the first dose at 12–15 months. The second dose is at 4–6 years.
Tests have shown the vaccine to be safe, though some children may experience:
- pain at the injection site
- a fever and a mild rash
- temporary joint pain and stiffness
Since vaccination started in children, the number of shingles cases has dropped.
For older adults: Shingles vaccine:
A different vaccine, the herpes zoster vaccine, is available for people aged 50 and older who have had chickenpox and therefore carry VZV. Experts also recommend this vaccine for those who have not had chickenpox or shingles.
In the U.S., 99.5% of people born before 1980 already have this virus. The herpes zoster vaccine can help prevent shingles in people who already have it.
The options available are Zostavax and a newer vaccine called Shingrix.
After two doses of Shingrix, a person will have over 90% protection against shingles, falling to just above 85% after 4 years, according to the CDC.
Who should not have the vaccine?
People who should not have the shingles vaccine without first discussing it with their doctor include those who:
- have an allergy to any component of the shingles vaccine
- have a weakened immune system
- are or might be pregnant
Shingles result from VZV, the same virus that causes chickenpox. After recovering from chickenpox, the virus remains in the body. It lies dormant in the dorsal root ganglion of the peripheral nervous system.
VZV belongs to a group of viruses called herpes viruses. This is why shingles also have the name “herpes zoster.”
All herpes viruses can hide in the nervous system, where they can remain indefinitely in a latent state.
Under the right conditions, the herpes zoster virus can “reactivate,” similar to waking up from hibernation, and travel down nerve fibers to cause a new active infection.
What triggers this is not usually clear, but it may happen when something weakens the immune system, prompting the virus to reactivate.
Risk factors and triggers:
Possible risk factors and triggers include:
- older age
- certain cancers or cancer treatment options
- treatments that suppress the immune system
- stress or trauma
Anyone who has had chickenpox can develop shingles.
Most people make a full recovery from shingles within 3–5 weeks, but some experience severe complications. Those most at risk are people with a weakened immune system.
Getting the varicella vaccination during childhood can prevent both chickenpox and shingles. For those who did not have the vaccination in childhood, other inoculations are available.
People aged 50 and older should talk to their doctor about vaccination.
Is it possible to have the virus without ever having symptoms of chickenpox?
The virus that causes chickenpox and shingles spreads as a result of exposure to the infected fluid in the blisters that develop as a symptom of these conditions.
Those who receive the live vaccination for chickenpox will receive an injection of a weaker form of the virus. This should cause the body to make antibodies that can fight against the virus. Because of this, 90% of those who have the vaccination will not get chickenpox.
If a person comes into contact with blister fluid from someone with chickenpox or shingles, if they were vaccinated and have formed immunity against the virus, they should not develop chickenpox symptoms. Nor should they be able to catch any infection that they can spread to others, even if they have exposure to the virus when someone near them has chickenpox or shingles.
Alternative Treatments For Shingles:
Please Always Consult With A Medical Practitioner First.
1. Cold Water
Cold water can help control the pain from blisters. It can also help ease itching and irritation.
- Soak a towel in cold water, wring out the excess water, and gently place it on the blisters. Leave it on for 20 minutes and then remove it. Repeat until the pain decreases.
- Also, you can take a cool bath to help ease the pain. Soak in cool water for several minutes, and then pat dry your skin completely.
Note: Do not use ice packs or water that is too cold. Also, make sure to wash any used towels to prevent the spread of the virus.
The anti-irritating and soothing properties of oatmeal can give you much relief from the irritation, pain, and constant itchiness associated with shingles.
- Add two cups of finely powdered oatmeal to a bathtub filled with lukewarm water. Soak in this bathwater for 10 to 15 minutes. You can take this soothing bath two or three times daily until there is an improvement in your condition.
- You can also make a paste of one tablespoon of coarsely powdered oatmeal and water. Apply the paste on the affected area, allow it to dry on its own, and then wash it off with warm water. Repeat several times a day for at least one week.
Apple cider vinegar is another very effective remedy for shingles. It will help dry out the sores and stop the itching. Being a natural disinfectant and antiviral, it will also speed up the recovery process.
- Mix together equal amounts of apple cider vinegar and water. Soak a cotton cloth in the solution and place it on the affected areas. Leave it on until it dries on its own. Repeat several times daily until the shingles heal completely.
- Also, you can add one teaspoon each of apple cider vinegar and honey to a glass of warm water. Drink this solution three times daily with meals for one or two weeks.
4. Aloe Vera
Due to its soothing and cooling properties, aloe vera is also considered an excellent home remedy for shingles. It can soothe the affected skin, reduce pain and itching, and speed up the healing process.
- Apply freshly extracted aloe vera gel to the affected area, rubbing gently in a circular motion.
- Leave it on for about 30 minutes, and then wash it off with cold water. You can also take a cold bath.
- Follow this remedy two or three times daily for about a week.
Licorice contains several antiviral and immune-boosting compounds that help in the treatment of shingles.
- Add a little water to one teaspoon of licorice powder to make a paste. Apply this paste on the affected area, allow it to dry on its own, and then rinse it off with warm water. Follow this remedy for two or three times a day for one or two weeks.
- You can also brew a strong tea from licorice, allow it to cool, and then dab it on the blisters using cotton balls. Do this three or four times daily until you see improvement.
Garlic is one of the strongest antiviral foods available and a great home treatment for shingles.
- Make a paste of five garlic cloves and apply it to the affected area. Leave it on for five minutes, and then wash it off with warm water. Do this a few times daily for one or two weeks.
- You can also eat three to four cloves of raw garlic daily, or take two 1000 mg garlic capsules twice a day, for one week.
Honey is a good remedy to treat the blisters associated with shingles. The healing and skin-reviving properties of honey will help clear up the blisters as well as relieve pain and irritation.
- Apply honey on a bandage and put it on the affected area. Use as many bandages as needed to cover the area. Replace with fresh honey every few hours. Continue until your condition improves.
- Also, eat one tablespoon of honey daily to boost your immune system for faster recovery.
8. Virgin Coconut Oil
Pure virgin coconut oil has anti-inflammatory as well as antiviral properties that help treat shingles.
- Lightly warm some virgin coconut oil. Apply this oil to the affected skin and cover the area with gauze. Change every few hours. Continue the remedy until you notice an improvement in your condition.
- Also, try to include two or three tablespoons of coconut oil in your daily diet. You can start by taking one tablespoon a day and gradually increase the amount. This is a great way to help your body heal quickly.
9. Lemon Balm
Lemon balm has polyphenols that give this herb its antiviral properties. Lemon balm can help get rid of the pain and discomfort from blisters and rashes.
- Make lemon balm tea by steeping two to four teaspoons of this herb in one cup of boiling water for five to 10 minutes.
- Allow the tea to cool.
- Soak a cotton ball in the tea, apply the solution to the affected area, and leave it on until it dries completely.
- Repeat the process at least four times daily until you get relief.
10. Sea Salt
Sea salt has antiseptic properties, and hence it will help treat shingles naturally. Sea salt will help dry up the blisters quickly for faster recovery.
- Mix one tablespoon of sea salt in one-half cup of water. Use a cotton ball to apply the mixture to the affected area. Do this three or four times a day for one week to help heal the blisters.
- You can also add one-half to one cup of sea salt to your bath water and soak in it for 30 minutes daily.
Along with these remedies, you need to follow certain precautionary measures, including:
- Keep the inflamed skin clean and dry.
- Do not pick at the blisters.
- Keep the blisters exposed to air as much as possible.
- You can apply calamine lotion or capsaicin cream to the affected area.
- Do not share any clothes, towels, or flannels with others.
More on Home Treatments:
Dab Calendula Oil To Ease Itching And Promote Healing
Calendula or marigold is known for its healing properties. Homeopathy recommends the use of calendula oil or gel to relieve itching and encourage the healing of blisters caused by chickenpox and shingles. Calendula has anti-inflammatory properties and has been found to quicken wound healing as well as improve the texture of the skin. Flavonoids present in this herb are thought to be responsible for this effect.
Apply Capsaicin Ointment For Pain Relief
Capsaicin, a component found in red pepper, can ease the pain caused by shingles. This compound depletes a neurotransmitter called substance P. which helps transmit pain signals to your brain.
Ointments with capsaicin are available in the market. You can also mix a pinch of powdered red pepper with plain skin ointment to make one at home. However, do keep in mind that it’s not a good idea to use capsaicin ointments on broken skin. Also, the application of the ointment can cause burning and itching the first few times. Do a patch test before using it to ensure your skin doesn’t react adversely to it.
Apply A Baking Soda Solution To Relieve Irritated Skin
Another common remedy for itching that’s easily available at home is baking soda. Add a little baking soda to a glass of water and apply the solution to relieve irritated skin. You can also try adding some baking soda to your bathwater. Although it’s not clear how exactly baking soda works, its alkaline nature is supposed to be at work here.
Have A Chamomile Bath To Ease Itching
Chamomile and calamine lotion are time-tested remedies that help relieve itching. You can add anti-inflammatory chamomile to your bath water to soothe your skin. Dabbing a little calamine lotion on affected areas and letting it dry on your skin can also tackle that maddening itch.
10. Apply A Licorice Gel Or Tea For Pain And Inflammation
Licorice has traditionally been used topically to treat shingles and ease the pain that lasts even after the blisters disappear. So how does licorice work? Glycyrrhizin, an active component found in this herb, has been found to stop varicella-zoster from replicating. You can apply licorice gel a couple of times a day for relief. You can also boil the herb in water to make a strong tea and apply that to the blisters.
People have used essential oils as herbal remedies for many years, often for skin conditions.
Some essential oils have properties that may help with skin irritation and healing These oils include:
- Chamomile oil has anti-inflammatory and antimicrobial properties and can improve ulcers and pressure sores by aiding skin-cell regeneration.
- Eucalyptus oil has anti-inflammatory properties and can increase the speed at which cancer patients’ sores heal.
- Tea tree oil has anti-inflammatory and antimicrobial properties and can promote wound healing.
In some cases, pure essential oils can cause allergic reactions. Therefore, people should always do a patch test before trying them.
It is best to dilute oils with a carrier oil or to visit a pharmacy to purchase them premixed as a safe topical ointment.
The FDA has not approved many essential oils for use, so it is important to talk to a pharmacist or doctor before using any of them.
2. Cold compresses
Holding cool clothes or compresses against the rash site may assist in relieving itchiness and reducing inflammation.
People can lightly soak a natural cotton cloth or towel with cool water and wring it out before placing it on sore, itchy areas. They can then repeat this as necessary.
It is also best not to expose the skin to extreme temperatures, so people should avoid using ice baths or very hot water. Hot water will increase blood flow and potentially slow down the healing of sores, whereas ice will increase skin sensitivity.
3. Witch hazel
Researchers believe that witch hazel is more effective than chamomile in reducing inflammation and itchiness in some individuals.
People can apply witch hazel topically to areas of irritation and inflammation to achieve relief.
4. Cool baths
Taking cool baths or showers every day, with minimal scrubbing, will help to keep sores and blisters clean and reduce the risk of infection.
Cool water should also relieve sore and itchy spots, helping to prevent scratching, which could cause scarring.
6. Gentiana scabra
Researchers have found that Gentiana scabra, a blue or purple flower occurring throughout North America, has a positive effect on pain relief in shingles and decreases the likelihood of postherpetic neuralgia.
By reducing inflammation in the skin, Gentiana scabra minimizes pain and promotes healing. A reputable Chinese medicine practitioner can prepare the herbal formula by boiling the plant in water. People can then take the remedy orally.
A healthy diet is vital for preventing and fighting illness.
The Dietary Guidelines for Americans recommend eating a varied diet comprising many vegetables, fruits, and whole grains as well as legumes, nuts, and lean meats.
People should aim to include orange, red, and green foods that contain the carotenoids lycopene, lutein, zeaxanthin, and pro-vitamin A in their diet. Carotenoids are very important for immune function, and occur in the following foods:
- orange foods: carrot, pumpkin, and apricot
- Red foods: watermelon, red pepper, grapefruit, and cherry
- green foods: kale, parsley, spinach, melon, lettuce, and endive
Limiting trans and saturated fats, and avoiding added sugar and salt where possible can also reduce inflammation and improve immune function.
There is a link between vitamin D and immune function. Many older people are at risk of low vitamin D levels, so they must ensure that they get sufficient sun exposure or take supplements to protect their immunity.
Taking vitamin C, zinc, and selenium supplements can also improve immunity in older adults.
However, taking high doses of vitamins and minerals can do more harm than good. Multivitamins, which contain lower and safer levels of many vitamins and minerals, are usually a better option.
9. Quit smoking
Smoking offers no health benefits and is always harmful. It is vital to quit smoking as it increases the risk of many cancers and diseases.
Smoking lowers immunity against infection, especially in older people, and can delay recovery and healing.
10. Reduce stress
Using meditation to relax and trying to rest when possible may help to reduce the symptoms of stress.
Natural and Herbal Therapies for Shingles
You may choose to pair the following natural remedies with your prescription antiviral to enhance the effect or you may choose to use these as stand-alone care for your shingles outbreak. The benefit of the following natural and herbal remedies is the nerve protection and restoration that is available through these herbs that are not offered in conventional antiviral medication.
Vitamin C has been shown in several studies to ease an episode of shingles by inhibiting the replication of the virus. Vitamin C also reduces the postherpetic pain experienced after the initial outbreak which can often be worse than the original nerve pain prior to the rash. The average recommended dosage is 1,000mg three times a day during a herpes zoster episode.
L-lysine is an amino acid. Just like vitamin C, it inhibits the replication of the herpes zoster virus. The suggested daily dose is 1,000 mg three times a day during the episode and once daily as a maintenance/preventive dose.
St. John’s Wort (Hypericum perforatum) is a herb used for nerve pain and shingles. The active constituents are hypericin and hyperforin and they contribute to the herb’s antiviral, anti-inflammatory, nerve protective, and nerve restorative properties. St. John’s wort greatly eases the pain and duration of the herpes zoster virus. Suggested daily doses would be 900mg of powdered herb capsule or 2-3ml of herb tincture three to four times a day.
Licorice root (Glycyrrhiza glabra) has glucocorticoid effects that modulate the function of the immune system. It is antiviral for the herpes zoster virus, anti-inflammatory, and soothing to the affected nerve tissue. The main constituent in licorice root is glycyrrhizic acid, also known as glycyrrhizin or glycyrrhetinic acid. Suggested daily doses would be 900mg of powdered herb capsule or 2-3ml of herb tincture three to four times a day.
Topical herbal remedies can also be applied to the rash and are very soothing to the pain and itching. Some herbs that work well in a compress, poultice, or salve are calendula (Calendula officinalis), arnica (Arnica montana), St. John’s wort (Hypericum perforatum), chaparral (Larrea tridentata), and comfrey (Symphytum officinale). These dried herbs can be purchased in a herbal apothecary and a herbalist will be able to guide you in how to make these topical remedies at home. You can infuse these herbs into an oil to use a soothing topical application and you can find a herbal oil recipe.
Incidence (annual) of Shingles: 500,000 cases (NIAID)
Incidence extrapolations for the USA for Shingles: 499,999 per year, 41,666 per month, 9,615 per week, 1,369 per day, 57 per hour, 0 per minute, 0 per second. Note: This extrapolation calculation uses the incidence statistic: 500,000 cases (NIAID)
The lifetime risk for Shingles: 2 in 10 lifetimes (NIAID)
Prevalence of Shingles: This year, more than 500,000 people will develop shingles.
Shingles is a serious condition that can cause severe symptoms in some people, especially those with weakened immune systems. In some cases, shingles can also lead to serious complications such as nerve damage and loss of vision. It may be more serious for older adults.
Unfortunately, it is not possible to cure shingles. However, as with other viruses, resting and eating a healthy diet will help with recovery.
Using treatments to alleviate symptoms will increase comfort and mental well-being, and may also reduce the risk of postherpetic neuralgia.
Always check with your doctor.
Thank you for reading.
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