The severity of shingles depends on various factors
The severity of shingles depends on various factors, such as age, overall health, and part of the body where shingles develops

The severity of shingles depends on various factors, such as age of the patient, general health condition of the patient, and the part of the body where shingles develops. For some people, the symptoms are mild with mild pain and itching. Whereas other patients may present with intense pain, itching, and complications. 

What is shingles?

Shingles is also called herpes zoster. It is caused by varicella zoster virus, the same virus that causes chickenpox. Sometimes, in patients who have a history of chickenpox, the virus can be present in the nervous system for years in a dormant stage. It reactivates as shingles.

What causes shingles?

The reactivation of the chickenpox virus as shingles occurs more commonly in the following cases:

  • Periods of extreme physical or emotional stress
  • Weakened immune system due to HIV (human immunodeficiency virus)
  • Cancer patients
  • Patients who have had a transplant
  • Age above 50 years
  • Patients with diabetes
  • Patients taking medications such as steroids or immunosuppressant medications
  • Poor nutrition and health
  • Major physical injury

What are the signs and symptoms of shingles?

Shingles typically occurs over one side of the face or body. The common signs and symptoms may include:

  • Pain is usually the first symptom in shingles and can vary in intensity
  • Burning sensation, numbness or tingling and itching
  • Raised red rash which usually appears a few days after the pain
  • Multiple blisters which appear in a stripe pattern
  • The blisters contain fluid and they break open with crusting
  • Fever, chills, fatigue, and body ache
  • Headache
  • Photophobia (sensitivity to light) in case the rash involves the forehead
  • Fatigue

QUESTION

Shingles is a painful rash caused by the same virus that causes chickenpox. See Answer

How does shingles rash appear?

Shingles is a reactivation of the dormant herpes zoster virus, the same virus that causes chickenpox. Shingles is often triggered by severe stress, trauma or an illness.
The typical red shingles rash and blisters follow pain, itching and tingling

The typical red shingles rash and blisters follow pain, itching and tingling. The rash is usually limited to one side of the face and body. 

Shingles on the face, scalp, mouth and ear

  • Rash and shingles blisters appear on one side of the face, extending to the scalp and ear.
  • If the rash involves the ear, it can lead to hearing loss, imbalance and weakness of the facial muscles.
  • Shingles rash on the scalp causes pain while combing and bald patches. 
  • Shingles can occur in the mouth, which is usually very painful, causing pain while eating and change in taste.

Shingles of the eye and forehead

  • Rash and blisters appear around the eye, over the eyelids, once side of the forehead, extending to the tip of the nose. 
  • Patients complain of burning or throbbing in the eye, with watering of eyes, swelling and blurred vision.
  • The pain may be present after the rash disappears due to nerve damage, but improves eventually. Without treatment, shingles of the eye and forehead can lead to corneal damage and vision loss.

Shingles on the waist and back

  • Rashes and blistering appear over one side of the waist and the back in a stripe pattern, extending up to the lower back. 

Shingles on the buttocks

  • Shingles rash and blisters over the buttocks, usually on one side. 

What are complications of shingles?

Shingles can have complications that last long after the rash has disappeared. Complications can also occur if the infection has not been treated appropriately:

  • Inflammation of the brain (encephalitis)
  • Facial nerve paralysis 
  • Inflammation of the eye
  • Loss of vision (due to cornea infection)
  • Postherpetic neuralgia (pain that lasts long after the infection resolves)
  • Loss of hearing and balance problems 
  • Loss of taste
  • Superinfection with bacteria causing increased swelling, redness, warmth, pain, tenderness and pus formation 

How is shingles treated?

Treatment is most effective when initiated within 72 hours of the appearance of the rash. Antiviral drugs (acyclovir, valacyclovir, etc.) can help recover faster and reduce the risk of complications. 

Shingles rash and blisters can cause severe pain and may not reduce with over-the-counter pain medication. Treatment of pain includes:

  • Antiseizure medicines (e.g., gabapentin)
  • Antidepressants 
  • Cool compresses
  • Medicated lotions to reduce pain and itching
  • Numbing creams (e.g., lidocaine gel)
  • Over-the-counter pain killers such as paracetamol or ibuprofen 
  • Prescription painkillers such as codeine for intense pain

Can shingles be prevented?

Shingles can be prevented. Vaccine is available against varicella zoster virus to prevent chickenpox and shingles. According to the CDC (Centers for Disease Control and Prevention), children are routinely recommended to take two doses of the vaccine, the first dose at the age of 12-15 months and the second between 4-6 years.

Two doses of the vaccine are recommended in children and adults who have never had chickenpox. One dose of the vaccine prevents 95% of moderate disease and 100% of severe disease. Two doses of the vaccine are more effective. It is not known how long the vaccine is effective, but studies have shown that the vaccine provides protection against the varicella zoster virus for 10-20 years following vaccination. 

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Medically Reviewed on 3/4/2022
References
https://www.webmd.com/skin-problems-and-treatments/guide/understanding-shingles-basics

https://www.webmd.com/skin-problems-and-treatments/shingles/shingles-skin#1

https://www.cdc.gov/shingles/index.html

https://emedicine.medscape.com/article/1132465-overview

https://www.cdc.gov/chickenpox/vaccination.html