What Are Shingles
VZV or the varicella-zoster virus essentially causes shingles. It generally manifests two distinct ways: chickenpox in children or herpes zoster (also known as simply zoster) as a secondary condition later in life. The primary infection in children presents as a classic case of chickenpox. This generally includes a fever, spreading rash as well as maculopapular lesions. These lesions, over time, develop into vesicles that typically spread to the extremities. The condition is usually benign, but once the body develops an immunity to the virus, the latent virus persists within the dorsal root of the spinal cord.
This latent virus is where things may get complicated down the line. Herpes zoster is caused by that latent virus reactivating in the dorsal column and migrating along sensory dermatomes, causing pain and a rash. Herpes Zoster follows a similar progression as chickenpox, starting as maculopapular lesions, which then develop into vesicles which scab. These scabs can take up to one month to fully heal. The reactivation of the virus is usually prevented or abated by the immune system, so immunocompromised individuals or elderly individuals are generally at higher risk of developing herpes zoster.
What Are The Symptoms
Symptoms of shingles are relatively easy to spot, especially if you know what to look for. Since the virus uses the dorsal column as a pathway to various dermatomes, the presentation of the symptoms will generally follow a dermatomal pattern, isolated to specific regions and usually present unilaterally. The specific symptoms you should look out for include the following:
- Persistent pain, burning, or tingling in a localized area
- Sensitivity to touch
- A red rash developing a few days after the pain
- Blisters filled with fluid that scab over after rupturing
While these are the most common symptoms, there are other symptoms that may present as a result of herpes zoster which aren’t hallmark traits of the virus. These include:
- Light Sensitivity
The blisters and rash will generally develop along several adjacent dermatomes, following the sensory tracts of the dorsal column to their dermatomal distribution. This means that the rash and blisters will usually be in a localized area, such as the upper chest, inner thigh, dorsum of the foot, across the shoulder, etc., and will specifically present themselves on one side of the body.
The pain will almost always be the first symptom, and the pain can vary from mild to intense. Depending on the location of the pain, it may also be misdiagnosed as referred pain from potential visceral issues like heart problems, liver issues, lung problems, or even kidney stones. In some cases, a rash doesn’t even develop.
While herpes zoster generally resolves on its own, there are some instances you may want to contact a doctor:
- If the rash occurs near the eye, as it may lead to permanent damage
- If you are over age 60
- If you are immunocompromised
- If the rash is widespread
These instances have a higher risk of complications, so having a professional diagnosis and treatment plan can go a long way to reducing the risk of permanent damage. For more routine cases of herpes zoster, there are various ways you can help treat and alleviate the symptoms.
Since the root cause of the symptoms originates in the dorsal root of the spinal cord, shingles cream and creams that are good for shingles will have little effect on actually curing the virus. Still, they work wonders for helping to alleviate the symptoms and make things at least somewhat more tolerable. There are various shingles cream brands that can help alleviate symptoms; some bring prescription-strength while others are generic over-the-counter brands. Based on the severity of the symptoms, you may want to ask your doctor for recommendations on creams that are good for shingles and which cream would be best suited for your case.
If you are looking to help speed up the recovery process, various antiviral treatments may help eradicate or reduce the activity of the virus at its source. Most require a prescription of some form, so discuss antiviral options with your doctor to see if antiviral medications are a good fit for you.
Lastly, there are preventative VZV vaccines that can help prevent the reactivation of the virus. These vaccines are generally recommended for those over the age of 60 and are at higher risk for complications.
What To Do If You Develop Symptoms
If you develop symptoms that fit any of the criteria that make you a risk for complications (rash near the eyes, immunocompromised, widespread inflammation, etc.) you must see a doctor as soon as you can to prevent any serious complications and find a treatment plan that works best around your medical circumstances. Even if you are not at high risk for complications, it is recommended to make an appointment with your doctor early since the anti-viral medications are more effective the sooner you start your treatment regimen.