What Causes Shingles - Is Shingles a Painful Disease?

The disease known as shingles (Herpes zoster), a painful skin rash, is directly related to having chickenpox earlier in life. Shingles is caused by the same virus that causes chickenpox that lies dormant in the nervous system long after chickenpox has come and gone.

It is caused by the Varicella zoster virus (VZV) that belongs to the variety of herpes viruses. Because it is a virus, it never leaves the body. It positions itself along the nerve fiber routes, or dermatomes, and the rash that forms follows these routes. The rash may involve one or more dermatomes and usually occurs on one side of the body, starting out as a rash that turns into red blisters that leak a clear fluid. The blisters crust over then heal. When appearing on the face, the rash can infect the eyes, which could lead to vision loss.

The pain of shingles is due to it's involvement in the nerve fibers. As this condition may remain in the latent stage during life, the virus can reactivate due to:

• Immune system diseases


• Cancer treatment such as chemotherapy


• Excessive emotional stress

Some signs of an on coming attack of shingles include:

• Fever,


• Headache,


• Fatigue,


• Rash,


• Redness and sensitive skin,


• Sores,


• Sensations of itching, tingling, burning and pain

The pain occurs due to the Varicella zoster virus's capacity to travel along the nerves on its way to the skin's surface, resulting in damage and inflammation. In any case, damage to a nerve and inflammation can be quite painful. Thus, viral damage due to shingles causes pain that may need to be treated with pain medication to reduce the symptom of pain.

Pain associated with shingles usually last approximately three to five weeks, but can last for months after the blisters have crusted over and healed. This condition is known as postherpetic neuralgia (PHN), which can be debilitating and chronic. Since nerves heal at a very slow rate, shingles pain can exist for up to six months or more.

Herpes zoster is quite contagious to a person who has never had chickenpox. If a person never having chickenpox is exposed to the virus being shed by the one with shingles, this person who won't get shingles, but will develop chickenpox instead. They may get shingles later on down the road, however.

Herpes zoster is treated with anti-viral medications such as Acyclovir, ant-inflammatory drugs such as non-steroidal anti-inflammatory drugs (NSAIDS) that fight pain, inflammation, and fever. Topical creams and lotions such as Cortisone and Calamine lotion help to soothe the skin irritation.

A vinegar solution (vinegar in lukewarm water) can be used to help dry the blisters. Blisters resolve in two to four weeks, but may result in scarring. If the eyes become infected eye drops may be prescribed by your health care professional.

by Barb Hicks, RN/LMT