Shingles: The Pain and the Misery

shinglesShingles is currently on the rise especially among those aged 60 and over, it is in essence a “reawakening” of the chickenpox virus. Never fully discharged from the body, this virus lies inactive for years and reactivates when immunity is weakened, traveling through the nerve pathways to your skin and producing shingles.

The first symptoms appear usually on either the left or right side of the torso, starting with a burning pain, tingling and then erupting in a red rash in the painful area At first, the rash appears similar to hives but the patches then develop into fluid-filled blisters that break open and crust over. Unlike other allergic rashes that cause itching, the patient will feel pain, which might be extreme in the affected dermatome, with sensations that are often described as stinging, tingling, aching, numbing or throbbing, and interspersed with quick stabs of agonizing pain. Blisters then begin crusting over, falling off in two to three weeks. However, pain may remain in and around the affected area even if all the blisters clear.

The rash may also involve the face, eyes, mouth, and ears, which is more serious as it can cause eye pain, bacterial super-infections, keratitis and vision loss or damage to the ear including Ramsay Hunt syndrome and hearing loss. Other serious complications include pneumonia and encephalitis.

In the elderly, the pain, which is known as post herpetic neuralgia (PHN) and occurs when the nerves have been damaged after an outbreak of shingles, can last more than a year and seriously affect the individual’s emotions as well as his/her ability to be independent. Early prescription of antivirals such as Acyclovir will help skin lesions and reduce severity and complications. Such treatment must be started within 72 hours to be effective.

Professor Somsak Lolekha, president of the Medical Council of Thailand, says PNH and other complications remain the main concern in shingles patients, with these occurring in 50 per cent of patients over 50 years of age, and in more than 70 per cent of patient over 70 years of age.

08/04/2015

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