Most people are infected with this virus as children (chickenpox).  After chickenpox, the virus remains latent/dormant in the dorsal root ganglion or cranial nerve.

 

Shingles itself occurs when the varicella-zoster virus reactivates.  The virus then replicates in the nerve cell bodies and may spread from one or more ganglia.  Virions travel along nerves and infect the corresponding dermatome(s) where a red patch forms followed by a blistery rash.

 

Shingles breaks out typically around a narrow area starting at the spine and going around to the front of the chest or stomach. It can also affect the eyes, ears and mouth.  Eventually the blisters break, forming ulcers that will dry and scab.

 

The term ‘shingles’ is derived from Latin and French words meaning “belt/girdle”.  This term accurately represents the broad, belt-like distribution of the rash.  Shingles affects millions of people by the time they reach 80 years of age and is not uncommon for younger people to develop.

 

Typically the disease is a sign of a weakened/compromised immune system due to aging, immuno-suppressive drugs/therapy, psychological/environmental stress, HIV/AIDS, cancer/chemotherapy, organ transplants and other such immunity-impairing disorders.  Repeated occurrences of shingles are possible but rare.  It is extremely rare to experience more than three recurrences.

 

While still blistering, direct contact with the rash can spread the zoster virus to a person who has had no previous contact with the virus.  This person may develop chickenpox but will not immediately develop shingles.

 

An exposed pregnant woman who has not previously been infected with herpes zoster may infect the fetus causing complications in the newborn.  Chronic zoster infection and reactivation as shingles are not associated with fetal infections. Once the rash has crusted/scabbed, the person is no longer contagious.

 

Before the rash develops, you may feel one-sided mild to severe painful burning, itching, and tingling in the area where the rash will form.

 

The pain is caused by the replicating growth of the virus in the infected nerves (causing inflammation and damage).  In two to three days the virus reaches the skin and red blisters develop in the skin above the affected nerve area.  The rash usually appears on one side of the torso, arm, leg or face.

 

Depending on where the virus manifests, there may be serious complications requiring immediate treatment.  Involvement of facial nerves may lead to vertigo, loss of taste, facial nerve paralysis (bell's palsy), deafening (otic zoster), vision-loss and blindness (zoster ophthalmicus).

 

The rash and pain usually subside within three to five weeks however an average of one in five people develop a painful condition called post-herpetic neuralgia.

 

Post-herpetic neuralgia is a result of damage to the nerve fibers during the shingles outbreak and is usually difficult to treat.  PHN tends to improve over time regardless of treatment but unfortunately can last for several months to several years after.

 

Sadly, the pain generated from post-herpetic neuralgia is typically described as unbearable and excruciating (compared to burning/tearing, child birth and heart-attack)! Anything from fabric to a slight breeze can trigger the pain.

 

Because of the severity and duration of pain plus the fact that most medications offer no relief, patients may become undernourished and dehydrated, depressed and sometimes suicidal.  Very rarely, if muscle-control nerves are affected, patients may also experience muscle weakness, tremor or paralysis!

 

Post-herpetic neuralgia is rare before age 60 but around half of the patients older than 60 are affected by PHN after a shingles outbreak.  The number of people affected tends to increase more drastically with age.

 

Zoster sine herpete causes the same painful nerve damage without the traditional rash.  This is a serious condition which may affect many aspects of the nervous system.  Reported complications may include multiple cranial neuropathies, polyneuritis, myelitis (spinal inflammation), or aseptic meningitis.

 

Obviously there are some potentially serious complications that may arise from shingles. Although we tend to prefer natural treatments, a trusted and intelligent physician is your most important ally if this disease becomes serious. Please remember, I am NOT a specialist or a doctor! My role is to provide information to help you establish your own course of action.

 

-Typical Shingles Blisters & Scabbing: