Pain is severe for patients

The shingles is also known as herpes zoster. It is reactivation of the chicken pox virus, which is a type of herpes virus. The shingles can be very painful and about 20 percent of people who have had chicken pox will get the shingles. Most patients get it only once, but it can reoccur.

Zoster likes to “kick people when they are down.” It tends to arise during a time of weakened immunity when patients are sick or stressed. The chicken pox virus lies dormant in a nerve and reactivates along the nerve fibers toward the skin. This is why it is seen in one region, on one side of the body.

Patients with a very weakened immune system may have more severe cases of shingles or even disseminated zoster. HIV/Aids, cancer patients, chemo/radiation treatments, transplants all make patients more susceptible, but in general we see the shingles in patients over 50 who just happen to be sick or stressed.

Patients feel burning, itching tingling and very sensitive skin. Pain is very severe for about three days then begins to improve. It can start as a red rash but then quickly develops into blisters. The blisters then turn into scabs or crusts. A diagnosis is generally made on history and physical exam; however a viral culture or biopsy can be performed for confirmation.

Treatment for the shingles is an antiviral medication, such as acyclovir, anti-inflammatories and pain medicine may also be given.

Shingles is most common on the trunk of the body but can occur anywhere. If on the face we use extra precautions because if blisters involve the eye, it can cause permanent damage. Shingles is much less contagious than chicken pox but the virus can be transmitted through direct skin contact with the blister. Newborns and immunosuppressed patients are at the highest risk and they would get chicken pox not shingles.

Post-herpetic neuralgia is when pain from the shingles lasts long after the blisters have resolved. This pain can be managed with oral medication or nerve blocks by pain management physicians.

The vaccine for shingles (Zostavax) is FDA approved for patients age 50 and older who have not had the shingles. It helps prevent shingles. Patients may still get the still the shingles after having the vaccine, but it makes it a much less severe outbreak and minimizes the pain. Since it is a live vaccine, it should not be given in patients who are immunosuppressed or are on certain medications.

Even though most children now receive the chicken pox vaccine (Varicella vaccine) children can still get the shingles, but it is very rare. If you suspect you have the shingles or are interested in the shingles vaccine, see your doctor.

Dr. Sarah Glorioso is a partner with Dr. Josephine Futrell at Ark-La-Tex Dermatology, with clinics in Shreveport and Bossier City, and is part of the Willis-Knighton Physician Network.