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Dermatology: Shingles

Dermatology: Shingles

Rebecca Fitzgerald (Dermatologist) gives expert video advice on: What are the most common symptoms of shingles?; Who are most at risk for contracting shingles?; What can I do to reduce the amount of pain caused by shingles? and more...

What is "shingles"?

Shingles is a recrudescence of an old chicken pox infection. The virus that causes chicken pox never really leaves the body. Instead, it just becomes latent in something called the dorsal root ganglion, along the side of the spine. In certain conditions, in the elderly or in someone with an underlying disease or illness, that virus can reactivate. Interestingly, because of it's position in the dorsal root ganglion, it will only reactivate on one side of the body. The shingles rash follows the distribution of the nerve on one side of the body only.

What are the most common symptoms of shingles?

The visible symptom of shingles is a very blistery rash that looks like a fever blister. This shingles symptom only occurs on one side of the body and runs in the distribution of the nerve. The distribution of the nerve isn't something that the patient would recognize; that's something that the dermatologist would recognize. What the patient could recognize as a shingles symptom, though, is that they'd get one streak of blisters down their leg or around their waist that has a sharp demarcation right in the middle.

Is shingles contagious?

The fluid from the blisters in shingles is contagious to people that have never had chicken pox. For that reason, it's recommended that anyone with shingles stay home until the blisters are crusted and dry.

Who are most at risk for contracting shingles?

Shingles can be seen in absolutely any age patient, but it's more common in people with a compromised immune system. An underlying disorder like leukemia, lymphoma, AIDS, in the elderly and in periods of great stress.

How does a dermatologist diagnose shingles?

A dermatologist can easily make a clinical diagnosis of shingles based on the unilateral distribution of the rash and the morphology of the blisters

What medications can be used to treat shingles?

There are medications that can be used: acyclovir and acyclovir-like meds that will shorten the course of the disease. Shingles will go away by itself whether it's treated with these medications or not. It'll just go away sooner if it's treated with the medications.

What can I do to reduce the amount of pain caused by shingles?

Shingles is a viral inflammation of an entire nerve. That nerve, the sort of a core of that nerve is at the dorsal root ganglion by the spinal cord. But the entire distribution of that nerve is inflamed by this viral infection. Nerves whole job and life is to feel, is to pick up sensory information. So, inflammation of a nerve can be exquisitely painful. So an acute case of shingles can be so painful that narcotic medication is needed to control the pain until some of that inflammation goes away.

What is "postherpetic neuralgia"?

Postherpetic neuralgia is a condition seen when that inflammation of those nerves goes away very, very slowly. And the pain persists until it is completely gone.

What can be done to combat postherpetic neuralgia?

There are numerous medications and there are techniques, feedback techniques that are used to help control that pain. The good news is that in the vast majority of patients, that pain does eventually resolve.