Symptoms of Shingles

Shingles (also known as Herpes Zoster) is an infection with the varicella-zoster virus
that produces a severely painful skin eruption of fluid filled blisters. Chickenpox and
shingles are caused by the varicella –zoster virus. Chickenpox is the initial
infection. During this infection the virus spreads to and infects the nerve fibers of
the spinal and cranial nerves and lies dormant for a number of years. The
reemergence of the virus years later causes the shingles infection. During the
shingles infection, the virus travels back down the nerve fibers to the skin, where it
creates painful sores. Shingles infections are common after the age of 50.
Immunosuppressed individuals, example those with AIDS or cancer, are highly at
risk.

Symptoms

The early symptoms of shingles include headache, fever, nausea, diarrhea, malaise
and difficulties with urination in the 3 or 4 days before shingles develop. These
symptoms are usually followed by hyperesthesia, itching in an area of the skin and
sensations of pain often described as burning, stinging, tingling, throbbing and
numbing.

The initial phase is followed by the appearance of clusters of small, fluid-filled

blisters surrounded by a small red area. The blisters occupy only the limited area of
skin served by the infected nerves. The blisters usually occur in the thoracic or
lumbar region but may spread to other parts of the body. These blisters are
typically unilateral, meaning they affect only one side of the body. The involved
area of the body is usually very sensitive to any stimulus, including light touch, and
may be severely painful.

The blisters begin to dry and scab about 5 days after they appear. Until scabbing
occurs, the blisters contain varicella-zoster virus and can cause chickenpox if
transmitted to susceptible people. One attack of shingles gives a lifelong immunity
to the infection. Scarring may be extensive, but most people recover without any
lasting effects. More commonly, older people may continue to have chronic pain in
the affected area. Involvement of the facial nerve leading to the eyes can be very
serious, and if not treated properly may cause visual impairment.

Diagnosis

The doctor may have problems in diagnosing shingles before the blisters appear,
but the location of the initial pain in a vague band on one side of the body can be
useful clue. However, once the blisters appear in the typical pattern following a
nerve root, the diagnosis if usually clear.

Treatment
Treatment includes several antiviral drugs such as famciclover, valacyclovir and
acyclovir. These antiviral drugs are indicated particularly for older people and those
with impaired immune system. Pain-relieving drugs are often required to relieve
the pain that the patient.