Shingles - Symptoms, Causes, and Treatment

Shingles, also known as herpes zoster, is an infection caused by the varicella-zoster virus, which is the same virus that causes chickenpox. Even after you have recovered from chickenpox, the virus can remain dormant in the nervous system for many years before reactivating and causing shingles.

What is shingles (herpes zoster)?

Symptoms of shingles
Causes of shingles
Risk factors for shingles
Complications of shingles
Treatment methods for shingles
Lifestyle recommendations for shingles patients
- Is shingles contagious?
- What foods should shingles patients avoid?
Precautions to prevent infection and ways to avoid shingles

Shingles is characterized by a red rash that is painful and itchy. The condition usually manifests as a band of blisters on one side of the body, often on the torso, neck, or face.

After a person has chickenpox or is infected with the varicella-zoster virus (VZV), the virus lies dormant within the spinal and cranial nerve roots. Later on, the virus can reactivate (triggered by changes in the immune system, which may weaken or strengthen when the body is under stress), leading to the development of shingles (herpes zoster).

Patients with shingles can transmit the virus to others through direct contact. The blisters can contain the virus and infect others. However, those who contract the virus will develop chickenpox, not shingles. Therefore, individuals with shingles should avoid close contact with others. Once the rashes have healed completely, the risk of transmission diminishes.

This condition is not life-threatening but can be painful. Vaccines can help reduce the risk of developing shingles, and early treatment may shorten the duration of the infection and decrease the risk of complications.

Symptoms of shingles

The most common and notable symptoms of shingles are pain and burning.

The first and most notable symptoms of shingles are usually pain and burning sensations. The pain typically occurs on one side of the body and appears in small patches, followed by a red rash.

Rash manifestations include:

Red patches.
Fluid-filled blisters that are prone to bursting.
Localized rash extending from the spine to the torso.
Rash on the face and ears.
Itching.

Some individuals may experience signs and symptoms beyond pain and rash. These symptoms may include:

Fever.
Chills.
Headache.
Fatigue.
Muscle weakness.

Some rare and severe complications include:

Pain or rash involving the eyes, which requires treatment to prevent permanent eye damage.
Hearing loss or severe ear pain, dizziness, or loss of taste, which may be symptoms of Ramsay Hunt syndrome;
Secondary bacterial infections, which can occur if the affected skin becomes red, swollen, and warm to the touch.

Causes of shingles

Shingles is caused by the varicella-zoster virus, which also causes chickenpox. Anyone who has had chickenpox can develop shingles. After recovering from chickenpox, the virus can enter the nervous system and remain dormant for many years. Eventually, it may reactivate and travel along the nerves to the skin, resulting in blisters.

So far, scientists do not fully understand why the virus reactivates; it may be due to a decline in the immune response to infections as you age. Varicella-zoster is part of a group of viruses known as herpes viruses, which include those that cause cold sores and genital herpes. Therefore, shingles is also referred to as herpes zoster.

However, the viruses that cause chickenpox and shingles are not the same as those that cause cold sores or genital herpes, which is a sexually transmitted infection.

Most cases of shingles resolve within 2-3 weeks.

Risk factors for shingles

Most cases of shingles resolve on their own within 2-3 weeks. Shingles rarely occurs more than once in a person, but about 1 in 3 people will experience shingles at some point in their lives. Shingles is more common in older adults and those with weakened immune systems.

Some typical factors that may increase the risk of developing shingles include:

Age over 50. Shingles is most common in individuals over 50 years old, and the risk increases with age. Some experts estimate that half of those aged 80 and older will develop shingles;
Certain medical conditions. Conditions that weaken the immune system, such as HIV/AIDS and cancer, can increase the risk of shingles;
Cancer treatments. Radiation therapy or chemotherapy can reduce resistance to infections and may trigger shingles;
Medications. Long-term use of medications that prevent transplant rejection, such as the steroid prednisone, may increase the risk of shingles.

Complications of shingles

Shingles is not fatal but can lead to serious consequences. Here are some common complications:

Postherpetic neuralgia: After the blisters have healed and the skin returns to normal, patients may still experience pain, burning, or tingling in the area affected by shingles.

This occurs because the nerves in that area become inflamed, leading to long-term damage. Patients may require long-term treatment with pain relievers, physical therapy, and management of other related chronic conditions (such as diabetes).

Eye complications: This is a complex complication when shingles affects the optic nerve and occurs in the facial area, near the eyes. Patients may experience eye pain along with a rash. A specialist should be consulted if there are any eye-related signs.

Long-term nerve damage: Patients may experience loss of sensation in the skin, balance, or hearing.

Skin infections: This complication occurs when the skin becomes ulcerated, which may worsen with chronic conditions such as eczema or psoriasis.

Treatment methods for shingles

Most cases of shingles can be diagnosed through clinical examination. Therefore, if a doctor suspects you have this condition, they will examine the rash and blisters. They may request some tests in certain cases and ask about your medical history.

In rare cases, a doctor may request a sample of skin or fluid from the blisters. A sterile swab will be used to collect a tissue or fluid sample, which is then sent to a medical laboratory to confirm the presence of the virus.

It’s important to note that there is currently no cure for shingles; however, timely treatment with prescription antiviral medications can speed up recovery and reduce the risk of complications. These medications include:

Acyclovir (Zovirax®);
Valacyclovir (Valtrex®);
Famciclovir (Famvir®).

Shingles can cause severe pain, so doctors may prescribe:

Capsaicin cream;

Anticonvulsants, such as gabapentin (Neurontin®).
Tricyclic antidepressants, such as amitriptyline.
Local anesthetics like lidocaine in cream, gel, spray, or patch form.
Medications containing opioids, such as codeine.
Injections including corticosteroids and local anesthetics.

Lifestyle recommendations for shingles patients

Remember to take cool baths or use cool, wet compresses on the blisters to relieve itching and pain. Additionally, if possible, try to reduce stress in your life.

Is shingles contagious?

Many people wonder whether shingles is contagious. As mentioned earlier, shingles is an infectious disease, so it can be transmitted from person to person through common contact, such as sharing towels or washcloths. However, a person who is infected may not develop shingles but will get chickenpox instead. Those who have had chickenpox will not catch shingles from someone else, but if they have had shingles, they may develop the condition again in the future.

Individuals with shingles should limit foods high in fat.

What foods should shingles patients avoid?

Individuals with shingles should avoid the following foods:

Fats: Foods high in fat can worsen inflammation and prolong healing time.
Alcoholic beverages such as wine and beer: Alcohol can hinder the immune system, allowing illness-causing viruses to spread more rapidly.
Nuts, soybean products, chocolate, oats, wheat germ, coconut, white flour, and gelatin.
Refined grains: These types of foods can raise blood sugar levels, increase the risk of infection, and delay wound healing.

Foods beneficial for individuals with shingles that you should include daily:

Nutrient-rich foods, especially those high in zinc and vitamins A, B12, C, and E, can help support the immune system. Consuming lysine may also help inhibit the virus.

Lysine

Lysine is an amino acid believed to inhibit the growth of certain viruses, including the virus that causes shingles.

Foods rich in zinc and vitamins A, B12, C, E

A balanced diet can help prevent nutrient deficiencies that may weaken the immune system. The following nutrients are particularly important for maintaining a healthy immune system:

Zinc (red meat, bean sprouts, green beans, eggs, oysters).
Vitamin A (egg yolks, beef liver, salmon, sweet potatoes, carrots).
Vitamin B12 (clams, sardines, beef, fortified cereals, milk or fortified non-dairy milk).
Vitamin C (guava, parsley, kale, kiwi, lemons).
Vitamin E (sunflower seeds, almonds, salmon, trout, avocados).

Complex carbohydrates

Shifting from simple carbohydrates to complex carbohydrates may help reduce inflammation and improve overall health. Complex carbohydrates are higher in fiber and whole grains provide more nutritional value.

Some forms of complex carbohydrates include whole grain bread, brown rice, barley, sweet potatoes, whole wheat pasta, and whole grain cereals.

Precautions to Prevent Infection and Ways to Avoid the Illness

To prevent spreading the illness to others and to minimize complications, patients should pay attention to the following:

Do not rub or expose the blistered skin to dirty water, as this can cause the blisters to burst and lead to infection.
Wash the affected skin area with diluted saline or a specialized wash as prescribed by a doctor.
Wash your hands frequently and properly, especially after caring for the affected area. Additionally, wear loose, comfortable clothing.
Limit or avoid contact with individuals who have not been vaccinated against chickenpox, particularly children and pregnant women.

The best way to prevent the disease is through chickenpox vaccination, which involves introducing an inactivated virus into the body. This vaccine helps reduce the risk of developing shingles and boosts resistance against the virus.

Vaccination against chickenpox is the best way to prevent the disease

While shingles is not a dangerous illness, it can cause significant pain and discomfort for those affected. Therefore, it is advisable to seek treatment as soon as possible to avoid unwanted complications. Additionally, preventing the spread of the illness to those around you is very important.