Shingles (also known as herpes Zoster) is a very common condition. It is reported by the CDC that up to one million people in the United States will be affected by shingles each year so it is more important than ever that we know more and attempt to understand this condition. All herpes viruses share some common reactions, behaviors and patterns. This includes a pattern of active symptoms that are usually followed by periods of latency (inactivity of the virus). Periods of latency can differ from person to person. There is a family of seven herpes viruses that affect humans and most of us have been exposed to and dealt with a few of these by the time we are full-grown.
Herpes Simples Virus – the most common
Viracella–Zoster Virus – causes chicken pox
Cytomegalovirus
Epstein-Barr Virus – causes mononucleosis
Human Herpes Virus Type 6 – causes roseola
Human Herpes Virus Type 7
Human Herpes Virus Type 8 – research is still being conducted on HHV-6, 7 & 8 but these are newly discovered and still young in terms of research.
This is why it is important to realize that chicken pox and shingles come from the same herpes family tree but are two different branches! After the viracella virus causes chicken pox and then lays latent or “hides” from the body going undetected from the immune system for years it can re-emerge as the herpes-zoster virus spreading through the patient using the nerve paths connected to the sacral ganglia.
The pain will most likely be at the site where the reactivated herpes zoster virus will re-emerge. This pain has been described from shingles patients as burning, aching, piercing or a feeling of having been shocked electrically. The skin in that same area will itch, it may feel numb. Most patients report that these areas are sensitive to the point of being unbearable. Some herpes zoster patients experience additional flu-like symptoms of muscle ache, headache, and general malaise.
Fevers have been reported but it is not the norm. The prodrome stage for shingles lasts from one to five days before the eruption of the skin rash and blisters appear. The pain can last longer, weeks or even months have been reported and some people can’t even wear clothing on the affected areas. Between 50 to 60% of herpes zoster outbreaks are seen on the trunk of the body and it is no wonder clothing is optional at this point with the rash that begins as small, red, clear spots then developing into small fluid filled blisters. The blisters grow and become puss filled. Within seven days to two weeks the blisters form crusts and heal. It may take months for the skin to heal completely and healing takes even longer in people who are immuno compromised.
The second most common place for herpes zoster is on the head – usually on one side of the face. When the face itself is affected great care must be taken in order that the herpes zoster not spread to the eyes or the mouth. Be aware that if the rash begins to travel up the side of the nose then the eyes are in danger. Shingles may also appear on the neck and on the lower back.
Those who are over the age of 85 years old have a reported 50% of getting shingles and are at the greatest risk of acquiring Post Herpetic Neuralgic (PHN) which is a complication of shingles. Post Herpetic Neuropathy is persistent pain in the area of the shingles because the nerve path is terribly aggravated by the virus and reacts with pain.
PHN is the most feared complication of herpes zoster, especially in the elderly population. People who are immuno suppressed from illness have a much higher opportunity for the herpes zoster virus to reactivate because their immune systems are impaired and people who have cancers are certainly at risk to get shingles. Those with Hodgkin’s disease are at the greatest risk followed by patients with lymphomas and other types of cancers.
Chemotherapy increases the risk of activating herpes zoster and many cancer patients must have chemotherapy to complete treatment of certain cancers. Stress is also a trigger for reactivation of the herpes zoster virus and that is something most us of cannot escape.
The public interest in many sensitive conditions affecting us all has increased, as has the need for continued education. Such a painful and debilitating condition as Shingles has come out of the closet and is now focused on and discussed openly via the Internet and many public awareness groups such as AARP and NIH. There is much sharing of information and the days of suffering silently are thankfully gone.