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Everything You Need To Know About Shingles

Shingles is a viral infection that causes a painful skin rash. It affects more than one million Americans every year. Here’s everything you need to know about this common medical condition.

1) Shingles is Baused by the Same Virus that Causes Chicken Pox.

Both chicken pox and shingles are caused by the Varicella-Zoster Virus (VZV). The initial infection presents as chicken pox, with small blisters (called vesicles) that usually appear all over the body. When chicken pox resolves, VZV goes dormant, lying along one nerve pathway (called a dermatome). Later, VZV re-activates as shingles, causing vesicles that only appear on one side of the body, along one nerve pathway.

2) There Are Several Risk Factors that Increase Your Risk of Shingles.

While anyone who’s had chicken pox could get shingles, there are several risk factors that make the virus more likely to re-activate. The biggest risk factor for shingles is age. Patients who are age 50 and up have a much higher incidence of shingles than their younger counterparts. Patients who have HIV, autoimmune disorders or an underactive immune system are also more likely to contract shingles.

3) There are Several Signs and Symptoms to Look For.

Pain is the most common symptom of shingles. It usually starts as a burning sensation along the affected dermatome, and often becomes a deeper nerve pain once the rash appears. The rash begins as small red bumps that develop into vesicles and take up to two weeks to disappear.

Less than 20% of patients with shingles will also experience systemic symptoms, including fever, body aches and malaise.

4) There are Several Ways to Diagnose Shingles.

Most of the time, a healthcare provider can diagnose shingles based on your symptoms and exam findings. However, if the diagnosis is unclear, a viral culture can be obtained to look for microscopic evidence of VZV.

5) Shingles is Treatable.

Antiviral medications are the first line treatment for shingles. These medications not only shorten the course of the infection; they also decrease the likelihood of a patient developing postherpetic neuralgia, which happens when the rash resolves, but the nerve pain persists. Antiviral medications are most effective when they’re started within 72 hours of the onset of shingles.

6) Shingles Can Be Prevented with a Vaccine.

The first shingles vaccine was Zostavax, which was approved for use in 2006. In 2017, the Shingrix vaccine became available, and is now the preferred vaccine for preventing shingles. It’s recommended that adults ages 50 years and up receive two doses of the Shingrix vaccine, which lowers the rates of shingles and postherpetic neuralgia by 90%.

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Sources:

https://www.uptodate.com/contents/epidemiology-clinical-manifestations-and-diagnosis-of-herpes-zoster

https://www.cdc.gov/vaccines/vpd/shingles/public/shingrix/index.html

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