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Shingles is a painful rash caused by the varicella-zoster virus, which is the same virus that causes chicken pox.
Shingles is a painful rash caused by the varicella-zoster virus, which is the same virus that causes chicken pox. At the moment, there are many cases of chicken pox occurring in our local grade schools. Anyone who has had chicken pox may develop shingles.
After an episode of chicken pox, the virus can remain inactive, often for decades, in cells of the nervous system. Shingles is caused by a reactivation of the virus, which can manifest as a painful rash, always on one side of the body. The rash can be found on almost any part of the body, but it is usually a band of blisters from the middle of the back to the middle of the chest. Pain often occurs several days before the rash. Less commonly, one can have just the pain and not the rash.
Most of the time, shingles occurs only once, but if it does happen again, it’s usually on another part of the body.
About 20 percent of people will develop shingles during their lifetime. Shingles can affect people of all ages, but it is more common in those older than 50 and much less common in younger individuals. It is sometimes more common in those who have conditions that weaken the immune system, such as medical treatments involving the use of cortisone, chemotherapy and radiation.
Shingles is not life-threatening. A full recovery is usually expected within a month or two, although one may rarely have a complication called postherpetic neuralgia. This condition causes the skin to remain painful and sensitive to touch for months, or even years, after the rash disappears.
Shingles cannot be passed from one person to another, but a person with shingles can pass the varicella-zoster virus to a susceptible person, causing chicken pox. Transmission usually occurs through direct skin-to-skin contact with the blisters of a shingles rash.
Several treatments are available from your health care provider:
- High doses of an antiviral drug can reduce the duration and intensity of the symptoms. Such medications include acyclovir (Zovirax), valacyclovir (Valtrex) or famciclovir (Famvir). The medicines work best when given within the first 72 hours of symptoms.
- Pain relievers can help control pain. This usually involves some form of a narcotic, such as Darvocet, Vicodin or codeine.
- Also sometimes helpful in more severe cases of shingles is the application to the rash of an ointment containing capsaicin, the compound that makes chiles spicy, or a skin patch containing the numbing drug lidocaine.
- Because shingles affects the nervous system, it may require a prescription of Neurontin for those experiencing severe pain.
Home treatment of the shingles rash involves keeping the rash clean with soap and water, applying cold, wet compresses to the blisters, and, for those not taking prescription pain medicine, doses of Tylenol or Advil as needed.
Preventatives are available in the form of vaccines. All children should be routinely vaccinated for chicken pox, as should any adult who has never had chicken pox. Although this vaccine doesn’t guarantee to prevent either chicken pox or shingles, it can reduce the intensity of the disease and reduce the chance of complications.
There is also a vaccine specifically for shingles called Zostavax. It is indicated for those 60 years and older. In studies of people who were given the vaccine, the incidence of shingles infection was reduced, and in those patients who did develop shingles, the severity and duration of infection was reduced.
The bottom line is that if you have a painful rash, it is better to seek treatment from your health care provider sooner rather than later.
Terry Hollenbeck, M.D., is an urgent-care physician at Santa Cruz Medical Foundation in Scotts Valley. A doctor with 34 years’ experience, he invites health-related questions at
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Information in this column is not intended to replace professional advice. For any medical concern, consult a qualified practitioner.
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