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Am Fam Physician. 2000 Apr 15;61(8):2447-2448.
See related article on shingles.
What is shingles, and who can get it?
Shingles is another name for a condition called “herpes zoster.” It causes a painful rash. You can only get shingles if you had chickenpox in the past.
After you have chickenpox (usually as a child), the virus that causes it stays in your body, in certain nerve cells. Most of the time your immune system keeps the chickenpox virus in these cells. As you get older or if your immune system gets weak, the chickenpox virus may escape from the nerve cells and cause shingles.
Most people who get shingles are more than 50 years old or have a weak immune system. For example, you might get shingles if you have cancer, take medicines that weaken your immune system or have the virus that causes AIDS (acquired immunodeficiency syndrome).
What are the symptoms of shingles?
Shingles causes a painful, blistering rash. Sometimes the pain starts a few days before the rash appears.
The rash begins with raised reddish bumps. In a few days, these bumps turn into blisters. You might feel a stinging or burning pain. The rash may wrap around your back and chest, or it may be on one side of your face.
The blisters crust over and fall off after 7 to 10 days. You may see changes in the color of your skin when the scabs fall off. In bad cases, the color changes last forever.
Even though the rash gets better or goes away in a few weeks, the pain may last longer. In most people, the pain goes away in 1 to 3 months.
Shingles can also affect your eyes, causing swollen eyelids, redness and pain. Shingles of the eye can cause scars that affect your vision. It can also lead to glaucoma later in life. Glaucoma is an eye disease that can cause blindness.
How is shingles treated?
Shingles is often treated with acyclovir (brand name: Zovirax), famciclovir (brand name: Famvir) or valacyclovir (brand name: Valtrex). Your doctor can help you decide which of these medicines might work for you. These medicines work better if you start taking them in the first three days after you get the rash.
Your doctor might also have you take a steroid medicine for about three weeks.
Shingles of the eye is treated with antiviral medicines and steroids.
What can I do about the pain?
To help with the pain of shingles, your doctor might have you take an over-the-counter pain medicine like acetaminophen (brand name: Tylenol) or ibuprofen (brand names: Advil, Motrin). Aspirin is not recommended because you might also get Reye's syndrome, a liver problem.
Putting a medicated lotion (brand name: Caladryl) on the blisters might help the pain and itching. Putting cool compresses soaked in an astringent liquid (brand name: Domeboro) on the blisters and sores also might make them hurt or itch less.
If shingles causes severe pain, your doctor might have you take a prescription pain medicine.
What is postherpetic neuralgia?
“Postherpetic neuralgia” is the name used when the pain of shingles lasts for a long time after the rash is gone. About 1 in 5 people with shingles gets postherpetic neuralgia.
Like shingles, postherpetic neuralgia causes a stinging or burning pain. Your skin might become very sensitive to a light touch, such as from a bedsheet or moving air.
Most people with postherpetic neuralgia get better with time. Almost all of them are free of pain within 1 year. A few people have chronic pain (pain that doesn't go away).
How is postherpetic neuralgia treated?
Postherpetic neuralgia is often treated with over-the-counter pain medicines and capsaicin cream (brand name: Zostrix). If these medicines don't help enough, your doctor might try some other treatments.
Some medicines that are also used to treat depression and seizures can help the nerve pain of postherpetic neuralgia. These medicines don't work very fast. It might be several weeks before they help your pain.
This handout is provided to you by your family doctor and the American Academy of Family Physicians. Other health-related information is available from the AAFP online at http://familydoctor.org.
This information provides a general overview and may not apply to everyone. Talk to your family doctor to find out if this information applies to you and to get more information on this subject.
Copyright © 2000 by the American Academy of Family Physicians.
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