The varicella-zoster virus is the cause of both shingles and chickenpox. Once a chickenpox infection runs its course, the virus goes dormant in the body and is stored in the spinal nerves. The virus can reactivate later in life, producing the symptoms of shingles. How shingles and chickenpox present differs slightly. One crucial fact about shingles is that it can only develop in people who have had chickenpox earlier in their life. If a person who has never had chickenpox comes in contact with the shingles virus, they will likely develop the symptoms of chickenpox, not shingles.
The reactivation process of the shingles virus is not fully understood. However, research suggests that natural weakening of the immune system due to older age is a significant risk factor. For younger, healthy people, extreme stress plays a big part in weakening the immune system, which may lead to reactivation. This also means those with immune-compromising conditions such as HIV and cancer are at a higher risk of developing shingles. People on long-term steroid medication may also have increased risk of shingles.
Usually, a few days before shingles physically manifests, the infected person experiences systemic symptoms such as fever, chills, fatigue, headache, and a burning sensation at the site of the shingles rash. Numbing or itching sensations and hypersensitivity can also develop. Some people become very unwell while others do not have any symptoms at all.
The most distinct and diagnostic symptom of shingles is a skin rash. It usually affects a single area of the body because once reactivated, it spreads along the path of the nerve ganglion. The rash causes a painful burning sensation, and characteristic blisters erupt at the site. Some people develop this symptom over a small surface area, while in others it develops over a large region of the nerve path. The blisters eventually break and scab over.
Another common sign of shingles is sensitivity in the area of reactivation and rash. The sensation often begins before the rash appears and lingers after the blisters heal and is worse at the site of the blisters but often spreads out to the surrounding skin tissue. Many people describe it as feeling like a sunburn that sometimes intensifies to a mild electric shock.
Another characteristic symptom of shingles is lingering pain at the site of reactivation. Often, this pain persists for a couple of months and then subsides, but sometimes it continues for a year or more. This secondary condition is called post-herpetic neuralgia. Along with pain, people may experience continuous sensitivity with itching and numbness.
Doctors often treat shingles with pain and antiviral medications. These medications do not cure shingles but may alleviate the pain and lessen the duration of the symptoms. The pain can be severe so a doctor may prescribe numbing agents, topical creams, and nerve-blocking medications. Natural products such as oat baths, essential oils, witch hazel, and cold compresses are also helpful.
People can receive vaccinations against the shingles virus, though experts advise against one popular option until patients are about 60 years old. The vaccines offer protection for approximately five years but do not guarantee that shingles won't occur. If a vaccinated person develops shingles, however, the vaccine lessens the duration and severity of the illness. Doctors administer shingles injections as a preventative measure, not as a treatment for the active virus, and pregnant women or people who've never had chickenpox should not get the shingles vaccine.
Other conditions can mimic shingles, but they're not the same. Allergic hives may cause a burning itch, but the rash doesn't have the typical blister appearance. The rash that develops from plants like poison ivy, sumac, and oak can cause blisters, but they often develop anywhere in the body that has come in contact with the plant. Lastly, the herpes simplex virus is related to the shingles virus and often causes a similar blistering rash. However, the rash only develops on the mouth, nose, and genitals, and the pain is less severe.
One of the most significant complications of shingles occurs when the rash appears on the face, close to the eyes. This can damage the cornea, causing vision loss, and requires aggressive antiviral treatment. In some instances, neurological complications such as facial paralysis, brain swelling, and hearing or balance issues can develop. It is also possible for a mild to severe infection to occur at the site of the blisters, which will require antibiotic pills and topical ointment.
The varicella-zoster virus that manifests as chickenpox is airborne and, therefore, highly infectious. However, the reactivated virus — shingles — is not airborne and thus less contagious. A shingles infection is only contagious to people who have not had chickenpox or have not received the chickenpox vaccine. Furthermore, to be infected with the varicella-zoster virus, a person has to come into contact with the fluid from the blisters. It's vital to keep shingles blisters covered or limit contact with those who have never had chickenpox, particularly infants or immune-compromised individuals.
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