20070412

Shingles "My Experience with Shingles"



Shingles -Causes and Risk Factors

Shingles is caused by a germ called varicella-zoster virus -- the one that gave you chickenpox when you were a child. As you recovered from chickenpox, the sores healed and the other symptoms went away, but the virus remained. It is with you for life.

The virus hides out in nerve cells, usually in the spine. But it can reactivate. Somehow, the virus gets a signal that your immunity has become weakened. This triggers the reactivation.

In the reactivation, the virus follows a nerve path called a dermatome. The nerve path begins at specific points in the spine, continues around one side of the body, and surfaces at the nerve endings in the skin. The pattern of the rash reflects the location of that nerve path.

The leading risk factor for shingles is a history of having had chickenpox. One out of every five people who have had chickenpox is likely to get shingles.

Another risk factor is aging. As we age, our natural immunity gradually loses its ability to protect against infection. The shingles virus can take advantage of this and reactivate.

Conditions that weaken immunity can also put people at risk for shingles. Shingles is especially dangerous for anyone who has had cancer, radiation treatments for cancer, HIV infection, or a transplant operation.

Most cases of shingles occur in adults. Only about 5 percent of cases occur in children. With children, immune deficiency is the primary risk factor, but children who had chickenpox before they were one year old may also get shingles before they become adults.

There have been studies of adults who had chickenpox as children and were later exposed to children who had chickenpox. Interestingly, that exposure apparently boosted the adult's immunity, which actually helped them avoid getting shingles later in life.

Stress is another factor that may contribute to outbreaks. While stress alone does not cause the outbreaks, shingles often occurs in people who have recently had a stressful event in their lives.

Symptoms and Diagnosis

An outbreak of shingles usually begins with a burning, itching, or tingling sensation on the back, chest, or around the rib cage or waist. It is also common for the face or eye area to be affected.

Some people report feeling feverish and weak during the early stages. Usually within 48 to 72 hours, a red, blotchy rash develops on the affected area. The rash erupts into small blisters that look like chickenpox. The blisters seem to arrive in waves over a period of three to five days.

The blisters tend to be clustered in one specific area, rather than being scattered all over the body like chickenpox. The torso or face are the parts most likely to be affected, but on occasion, shingles breaks out in the lower body. The burning sensation in the rash area is often accompanied by shooting pains.

After the blisters erupt, the open sores take a week or two to crust over. The sores are usually gone within another two weeks. The pain may diminish somewhat, but it often continues for months -- and can go on for years.

Shingles can be quite painful. Many shingles patients say that it was the intense pain that ultimately sent them to the doctor. They often report that the sensation of anything brushing across the inflamed nerve endings on the skin is almost unbearable.

A typical shingles case is easy to diagnose. The doctor might suspect shingles if

the rash is only on one side of the body

the rash erupts along one of the many nerve paths, called dermatomes, that stem from the spine

The doctor usually confirms a diagnosis of shingles if the person also

reports a sharp, burning pain

has had chickenpox

has blisters that look like chickenpox

is elderly.

Some people go to the doctor because of burning, painful, itchy sensations on one area of skin, but they don't get a rash. If there is no rash, the symptoms can be difficult to diagnose because they can be mistaken for numerous other diseases.

In cases where there is no rash or the diagnosis is questionable, doctors can do a blood test. If there is a rash, but it does not resemble the usual shingles outbreak, skin scrapings from the sores can also be used.


The information provided should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies.

Copyright Information: Public domain information with acknowledgement given to the U.S. National Library of Medicine.

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