A small nuisance to a major health problem.

What is Shingles?

Shingles is a blistering rash that affects a single area of the body and is caused by reactivation of the chickenpox virus. After causing chickenpox, the varicella virus lies dormant in the dorsal root ganglia at the back of the spinal cord. Re-activation of the virus occurs at one or two levels of the spinal cord and can occur many decades later. The virus spreads up the nervous system from that level in the spinal chord to the skin. The rash is therefore found on one or two segments of the skin, these segments being called dermatomes. The distribution of the rash is easiest to describe on the chest where the rash will go horizontally across the chest wall – at one level, and on one side.

The rash of acute shingles is often itchy. The pain of acute shingles may may be described as burning, stabbing, or itchy. People often feel tired – called malaise – and may experienced headaches.

Shingles can occur in all age groups. The condition is more common in females and in people who are immunosuppressed. Shingles is more common with increasing age,

What is Postherpetic Neuralgia?

Persistent pain, called postherpetic neuralgia (PHP), is the main issue with shingles.

The pain may be burning or tingling, and the skin may be very sensitive – or painful – to even light touch. There may be reduced sensation to touch or frank numbness.

These are risk factors for developing PHP:

  • Increasing age
  • The rash is severe
  • Acute shingesl pain that is severe
  • Symptoms occurring before the rash has started (“prodromal symptoms” like pain or headaches)
  • Eye involvement
  • Being on immunsuppressant medication

What strikes doctors who see people with shingles is just how much it can knock people about.

What does Shingles look like?

The rash occurs in a segment of the body on either the left or right side but not both, and does not cross the midline.

The rash is made up of individual lesions that may number just a few to over a hundred. Just as with chickenpox, each lesion evolves through 4 stages: red spot, blister,  pustule, and finally crusting. The rash starts to settle down after around 2 weeks and goes by around 3-4 weeks.

Skin HSV (cold sores) may appear similar to shingles. A viral swab will confirm which it is.