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Shingles/PHN

Shingles is a viral infection that causes a painful rash. It usually appears as a single stripe of blisters that wraps around either the left or the right side of your torso, although shingles can occur anywhere on your body.

Cause

Shingles is 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. For unknown reasons the virus may reactivate as shingles.

Shingles isn’t life-threatening condition, but is very painful. Vaccines can help reduce the risk of shingles, and early treatment can help shorten a shingles infection and reduce the chance of complications.

Symptoms

The symptoms of shingles usually affect only a small section of one side of your body and may include:

  • A red rash that begins a few days after the pain
  • Fluid-filled blisters that break open and crust over
  • Itching
  • Pain, burning, numbness or tingling
  • Sensitivity to touch

Some people also experience:

  • Fever
  • Fatigue
  • Headache
  • Sensitivity to light

Pain is usually the first symptom of shingles and it can be severe. Depending on the location of the pain, it can be mistaken for a symptom of diseases affecting the heart, lungs or kidneys. Occasionally, some people experience shingles pain without ever developing the rash.

The shingles rash usually develops as a stripe of blisters that wraps around either the left or right side of your torso. Occasionally the shingles rash occurs around one eye or on one side of the neck or face.

Treatment

There’s no cure for shingles, but prompt treatment with prescription antiviral drugs can speed healing and reduce your risk of complications. These medications include:

  • Acyclovir (Zovirax)
  • Valacyclovir (Valtrex)
  • Famciclovir (Famvir)

Shingles can cause severe pain, so your doctor also may prescribe:

  • Capsaicin cream
  • Anticonvulsants, such as gabapentin (Neurontin)
  • Tricyclic antidepressants, such as amitriptyline
  • Numbing agents, such as lidocaine, delivered via a cream, gel, spray or skin patch
  • Medications that contain narcotics, such as codeine
  • An injection including corticosteroids and local anesthetics

Shingles usually lasts between two and six weeks. Most people get shingles only once, but it is possible to get it two or more times.

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