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The varicella–zoster virus (VZV) can cause two diseases: chickenpox (varicella) and shingles (herpes zoster). Before a vaccine was developed in 1994, chickenpox was a common contagious childhood disease that produced itchy blisters but rarely caused serious problems. However, if adults who did not have the disease as children contract it, it could cause more serious complications.
Shingles is caused by the same virus that causes chickenpox. Once you have had chickenpox, the varicella-zoster virus lies dormant in your nerves and can re-emerge as shingles. Shingles, which is characterized by a rash of blisters, can be very painful but is not life-threatening. Some people who develop shingles also develop a condition caused postherpetic neuralgia, which causes the skin to remain painful even after the rash is gone. Shingles is most common in people over age 60 or in those with a weak immune system. There is a vaccine that reduces your risk of getting shingles.
Signs and Symptoms
The typical rash of chickenpox is made up of groups of small, itchy blisters surrounded by inflamed skin. The rash usually starts on the face, scalp, or chest, quickly spreading throughout the body. It usually appears a few days after you have been exposed. Over 4 days, each blister tends to dry out and form a scab, which then falls off 9 - 13 days later.
The rash is usually preceded or accompanied by:
The typical shingles rash starts as redness followed by blisters that usually cover only one side of your body. The rash follows the path of the nerve where the virus has lain dormant. About 50 - 60% of people with shingles have the rash on their trunk. The next most common site is one side of the face, which may even include the tongue, eye, or ear.
Before the rash appears, you will have warning symptoms of pain -- usually a sharp, aching, piercing, tearing, or burning sensation -- on the part of your body where the rash appears 1 - 5 days later. That area may also feel itchy, numb, and unbearably sensitive to touch, even just from your clothes touching your skin.
Other symptoms may include:
Both chickenpox and shingles are caused by the varicella-zoster virus (VZV), a type of herpes virus. The virus is spread when you come in contact with the rash or by sneezing, coughing, and breathing -- in other words, when someone with chickenpox sneezes or coughs, there are droplets with the VZV virus in the air. The person is contagious from 2 days before the rash appears until all of the blisters have crusted over.
While shingles is caused by the same virus that leads to chickenpox, the way you develop this painful skin condition is different. After you have had chickenpox, the virus lives in a dormant state, as if it is hibernating, in nerve cells along your spine. Later in life, when it "wakes up" -- usually from a weakened immune system, aging, or other risk factor -- the virus travels down the path of the particular nerve where it was "hibernating," causing pain followed by the rash. Anyone who has had chickenpox can get shingles, although a vaccine can reduce your risk.
Your doctor can usually diagnose chickenpox easily because of its characteristic rash. If there is any doubt, however, the doctor may view a scraping from one of the blisters under the microscope.
If you have shingles, your doctor can usually make a diagnosis from the history of pain and other symptoms and the rash itself. He or she may take a scraping from one of the blisters for a laboratory test.
Both chickenpox and shingles generally get better by themselves, unless you are at high risk for complications. The goal of treatment is to reduce pain and itching.
You can reduce symptoms of chickenpox and shingles with some simple steps:
Antiviral drugs -- Most effective when started within 72 hours of the first sign of a rash, these drugs are often given to people who are at risk of postherpetic neuralgia. They include:
Corticosteroids -- used with Zovirax to reduce inflammation
Pain relievers -- For pain associated with shingles, an over-the-counter pain reliever such as acetaminophen (Tylenol) or ibuprofen (Advil, Motrin) may be effective. For severe pain or pain associated with postherpetic neuralgia, your doctor may prescribe a narcotic (opioid) pain reliever.
For postherpetic neuralgia
Capsaicin -- contains a pain reliever derived from chili peppers that produces a burning sensation when applied to the skin. It is available as an ointment (Zostrix) or a patch. A 2003 study reported that the patch reduced pain by 33% in about half of people with postherpetic neuralgia.
Lidocaine patch (Lidoderm) -- applied to the skin to reduce pain.
Tricyclic antidepressants -- Low doses of tricyclics, especially nortiptyline (Pamelor), may help reduce pain.
Gabapentin (Neurontin) -- an anticonvulsant (antiseizure) medication that may also help reduce pain
Nutrition and Dietary Supplements
Because supplements may have side effects or interact with medications, you should take them only under the supervision of a knowledgeable health care provider.
The use of herbs is a time honored approach to strengthening the body and treating disease. Herbs, however, can trigger side effects and can interact with other herbs, supplements, or medications. For these reasons, you should take herbs should be taken with care, under the supervision of a health care practitioner.
Although the results of scientific studies have been somewhat mixed, acupuncture may help relieve the nerve pain associated with shingles, especially when combined with traditional medications. Acupuncturists treat people based on an individualized assessment of the excesses and deficiencies of qi located in various meridians. In the case of shingles, a qi deficiency is usually detected in the liver meridian and an excess in the gallbladder meridian. Acupuncturists will often provide needle or moxibustion treatment (a technique in which the herb mugwort is burned over specific acupuncture points) around painful areas.
Although very few studies have examined the effectiveness of specific homeopathic therapies, professional homeopaths may consider the following remedies for the treatment of chickenpox and shingles based on their knowledge and experience. Before prescribing a remedy, homeopaths take into account a person's constitutional type. A constitutional type is defined as a person's physical, emotional, and psychological makeup. An experienced homeopath assesses all of these factors when determining the most appropriate treatment for each individual.
The following relaxation techniques may help reduce the pain and stress associated with shingles and postherpetic neuralgia:
People with post-herpetic neuralgia have reported some relief from using hypnosis.
If you get chickenpox when you are pregnant, the infection may spread to the baby.
If your immune system is weakened, shingles blisters may spread to other parts of your body and it will likely take longer for the symptoms to heal, maybe lasting for months. Conditions that weaken your immune function include:
Warnings and Precautions
Prognosis and Complications
While chickenpox usually goes away on its own, severe and sometimes fatal infections may occur, particularly in newborn infants, adults, and people whose immune systems are weakened (see Special Populations). Such potential infections include:
Shingles usually clears up in 2 - 3 weeks. Your chance of getting another bout of shingles is only 1% - 5% if you have a healthy immune system. If you have a weakened immune system (see Special Populations), your risk for recurrence is higher.
Potential complications from shingles include:
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Review Date: 10/10/2011
Reviewed By: Steven D. Ehrlich, NMD, Solutions Acupuncture, a private practice specializing in complementary and alternative medicine, Phoenix, AZ. Review provided by VeriMed Healthcare Network.
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