Shingles, whose technical term is herpes zoster, is a viral infection. Its main symptoms are burning pain and rash in the form of vesicles. The responsible virus Varicella Zoster Virus (VZV) has already been present in the body at the onset of the disease. Shingles occurs only in patients who have already had chickenpox, as the virus is the trigger and cause of both diseases.
What is shingles?
Shingles usually occurs in older people. Occasionally, however, it also occurs in younger people with a weak immune system. Shingles, which is also known as herpes zoster or zoster, is an infectious skin disease. It is triggered by the Varicella Zoster Virus (VZV), which belongs to the herpes viruses. It is also the causative agent for chickenpox. Shingles can only be contracted by people who have already had chickenpox. This infection is therefore also called a secondary infection. The name shingles is derived from the typical skin rash, in which swollen and reddish blisters appear that wrap around the body at the spine. Since chickenpox mostly occurred in the childhood of the affected person, shingles mostly affects adults and older people (between the ages of 60 and 70). At the same time, the disease is hardly contagious.
Causes
As mentioned earlier, the varicella zoster virus (VZV) is responsible for both chickenpox and shingles. In this context, shingles can only occur if the patient has previously had chickenpox. Therefore, the disease usually occurs only in older people (often after the age of 45). The shingles virus prepares itself on the nerve fibers towards the nerve nodes (spinal ganglia), which are present on the spinal column. In this process, the varicella zoster virus nests in the nerve cells. After that, there may be no abnormalities for years. Only in old age is the virus reactivated and develops into the well-known shingles. Why the virus is reactivated only after a long time is still unknown. Frequently, people with an immune deficiency or susceptibility to infections are affected by shingles. Hereditary or genetic causes within a family can also play a role. Stress and psychosomatic problems can also be considered as triggers of shingles. In rare cases, the pathogen is also transmitted directly without the affected person having already contracted chickenpox. In this case, however, he must have had direct contact with the blisters of a shingles patient. Then, however, the latter first falls ill with chickenpox and not with shingles itself.
Symptoms, complaints and signs
In shingles, a painful rash forms, usually starting from the spine and spreading around the body like a belt. Since the rash is usually confined to this region. The skin is moderately to severely reddened and nodular lesions appear, grouping into foci. After some time in the course of the disease, jocular blisters the size of a pinhead to the size of a pea form from the nodules. Often these blisters are filled with a bloody or watery fluid. Later in the course of the disease, the blisters may fuse and later break open. Before the typical rash of shingles appears, there is often a general feeling of illness in the affected person beforehand, which is also accompanied by fatigue or a slight fever. This feeling of illness increases significantly during the first days of the disease. There is severe, burning pain in the region of the body that is later affected by the rash. Many sufferers experience paresthesia. These are sensory disturbances in the affected body regions, which can manifest themselves as a sensation of cold or warmth, tingling, itching or numbness. In rare cases, paralysis may occur in the course of shingles.
Course
The course of shingles usually occurs without complications. Although treatment by a physician appears to be advisable, about 60 percent of all cases heal on their own within two to four weeks. In most cases, only pigmented skin areas remain, which appear either paler or more tanned. Nevertheless, severe pain can also occur during the course of shingles. If the burning pain is too severe, pain therapy by a medical professional should be considered.
Complications
Complications of shingles occur in about 20 percent of all cases, making them relatively common. These are particularly severe in immunocompromised patients, but late-onset treatment also increases the risk of secondary disease. If shingles spreads to the head and face, viruses can settle on the auditory or optic nerve and, in the worst case, lead to loss of hearing or vision. If viruses invade the brain, life-threatening meningitis may result. If the immune system is severely weakened, the zoster viruses occasionally settle throughout the body and also infect internal organs. A very painful and not uncommon complication of shingles is the so-called postzosteric neuralgia, in which the typical pain is felt long after the rash has healed due to nerve damage – in some cases it even lasts a lifetime. The risk of this long-term persistence of zoster pain increases with age, but can be reduced by early treatment. Even a less dramatic course of shingles often results in bacterial infections, pigmentation disorders or scarring, as well as paralysis and sensory disturbances in the area of the pre-damaged skin.
When should you see a doctor?
If shingles is suspected, then the doctor should be seen immediately. Patients can contact their primary care physician. No time should be lost outside of office hours, for example, on weekends or over holidays. Patients can contact the emergency room of the regional hospital or an emergency practice during these times. The earlier treatment of shingles begins, the better its course can be mitigated and a quick recovery promoted. Hoping that shingles will go away on its own makes absolutely no sense from a medical point of view. In any case, shingles requires professional treatment and monitoring, and during its occurrence regular check-ups with a doctor are important for the healing process. In severe cases, patients may be admitted to hospital as inpatients. The family doctor or dermatologist can make a recommendation here and arrange for referral. Shingles announces itself by reddened, sensitive skin areas, on which very soon very itchy and burning blisters form. If the patient can observe these signs, he should not hesitate and immediately consult a doctor. Even if the suspicion is unclear, it is very useful to have the diagnosis clarified. The own treatment of shingles with supposedly helpful home remedies, on the other hand, is not useful.
Treatment and therapy
Shingles is treated with antivirals. Usually, the disease is harmless and can be easily treated. However, patients with a weakened immune system (mostly elderly people) may experience complications, especially with severe pain. Nevertheless, a visit to the doctor is always advisable. The aim of medical therapy is then to alleviate the symptoms and shorten the time of the disease. The above-mentioned medications can be used to treat and control reddening of the skin and pain. The affected person himself can support the treatment of his shingles by resting the body. Likewise, he should take good care of the rash. Special creams and powders prescribed by the doctor are suitable for this purpose.
Outlook and prognosis
If shingles is diagnosed by a specialist and treated as soon as possible, a good prognosis can be given. If the prescribed medication is taken regularly, relief of symptoms occurs within a short time. If stressful situations are also avoided, the disease will have subsided after a few weeks. The affected person does not have to expect any permanent damage. If the disease is detected during pregnancy and treated immediately, there is also no danger to the unborn child. The causative agent of shingles is herpes zoster. However, since this pathogen remains in the body, affected persons should ensure that they have a strong immune system in order to avoid a recurrence of the disease. This is the only way to ensure a permanently good prognosis. If shingles is not detected, permanent damage is to be expected. The same applies if the disease is protracted. A promising prognosis cannot be made in this case either.Since considerable pain is associated with this condition, there is a risk that this pain will become chronic. A considerable impairment of the quality of life is therefore to be expected. In addition, sensory disturbances or signs of paralysis in the affected region of the body must be expected. If these are not treated, the entire organism can be affected. Furthermore, it must be expected that scarring that has occurred will remain and permanent impairments will result.
Prevention
Shingles, unlike chickenpox, is not very contagious. Recently, a vaccine has become available that can reduce the risk of shingles by about 50%. This vaccine can also protect against the painful disease post zoster neuralgia, which can be a possible secondary disease of shingles. In this case, the vaccination reduces the risk by more than 66%. However, many people also have shingles discussed. However, this alternative healing method is controversial in conventional medicine.
Follow-up
The aftercare measures after a treated shingles are mainly of a caring nature. For example, the skin is severely attacked by the herpes zoster infection. After the crusts that remain after many shingles rashes fall off, the skin underneath is very thin and sensitive. Mild creams and a nutrient-rich diet promote skin healing. It is recommended to drink enough and pay attention to vitamins. If wounds are present, they should be kept appropriately clean. Occasionally, pus-filled pimples also occur. These should be treated antiseptically without irritating them too much. Aftercare for skin health can take some time after shingles. In addition, some sufferers experience post-zoster neuralgia. Older patients are more likely to be affected. This can sometimes be very painful and requires administration of pain medication for some time. In addition, these neuralgias can have a very negative impact on the quality of life of the affected person. Accordingly, the aftercare can be extended to other therapies (psychotherapy, exercise therapy). If the infection with the varicella-zoster viruses has also spread to other parts of the body (nerves, eyes, ears, etc.), follow-up examinations are appropriate. Damage should be found quickly so that medical measures can still be initiated if necessary.
What you can do yourself
Patients with shingles can take some self-help measures to help the healing process. Within the first few weeks after infection, contact with other people, especially young children, sick people, and pregnant women, should be avoided. In the long term, a healthy lifestyle with a balanced diet, sufficient sleep and exercise in the fresh air is recommended. With regard to diet, the following applies: avoid foods that are difficult to digest and eat more spicy foods. Alcohol and other stimulants should be avoided completely. It is also important to take it easy so as not to put further strain on the immune system. Further bacterial infections should be avoided by sufficient body hygiene and prudent handling of the shingles. Therefore: Do not open blisters and remove crusts only under medical supervision. At most, bark may be gently loosened with moist compresses and compresses. In addition to over-the-counter medications, Vaseline and natural creams can also be used to relieve pain and itching. Remedies from herbal medicine and homeopathy, such as tea tree oil, healing mud packs or Schüßler salts, have proved particularly effective. An alternative is cold milk, which is applied to the affected skin area with a washcloth. For pain, gentle cooling helps, as do applications with lemon balm or Epsom salts. To avoid complications, the above-mentioned measures should only be applied after consultation with the doctor.
