Shingles, also known as herpes zoster, is a viral infection caused by the same virus that causes chickenpox – the varicella-zoster virus. Once a person has had chickenpox, the virus remains dormant in the nerve cells of the spinal cord. Many years later when the immune system weakens due to aging or from diseases such as cancer, heart disease, asthma, lung diseases or diabetes, the virus reactivates and leads to shingles. In the last few years, it has also been found that contracting COVID-19 infection increases the risk of developing shingles by up to 20%.
Shingles typically appears as a painful rash with blisters on one side of the body in a band-like fashion. It can also affect the face and eye and lead to vision problems. The rash can last for many weeks. In as many of 30% of people, the pain does not go away, and they develop postherpetic neuralgia – a chronic nerve pain condition that presents with persistent, severe pain and hypersensitivity to touch. Wearing clothes, gently touching the skin where the rash used to be can trigger extreme pain. Shingles also increases the risk for heart attack and stroke for up to 12 months.
Antiviral medications such as acyclovir, valacyclovir, etc. should be taken within 72 hours of the onset of the rash. Strong painkillers such as tramadol or even morphine may be needed as the usual painkillers are not very effective. In patients with very severe and painful rash, they will benefit from an epidural steroid injection or a nerve block procedure.
The best way to prevent shingles is to get vaccinated. The vaccine reduces the risk of developing shingles and its complications. It is recommended for adults over the age of 50 or for younger immunocompromised adults who are at risk of shingles because of chronic diseases or cancer.
Remember: Shingles is not just a rash. Rash is only one feature of the disease. It is a viral infection that damages nerves and blood vessels. This is the reason why shingles may predispose a person to stroke and heart attack.
