DEFINITIONShingles, also known as Herpes zoster, is an acute infection caused by reactivation of the varicella zoster virus (VZV). This is the same virus which causes chickenpox.
DESCRIPTIONShingles is an infection or inflammation of the nerves that lie just beneath the skin's surface. After chickenpox, the virus retreats to the nervous system (in the spinal cord and nerve cell) and appears later in the form of Shingles. It often appears when the immune system is weakened. Shingles causes severe skin irritation and inflammation of the affected area. The pain occurs as a result of damage to the nerves which then produces strong nerve impulses passed to the brain. There may be permanent nerve damage with numbness of the skin as well as scarring. If the rash from Shingles erupts near or on the eye permanent damage may result. Shingles is not contagious although a person who has not had chickenpox may catch chickenpox from a person who has Shingles.
CAUSEShingles has been associated with ageing (the vast majority of cases are reported in people over 50 years of age), a weakened immune system, trauma, excessive sun exposure or chickenpox in children who are exposed either before birth or before 18 months of age. Contact with a child who is suffering from chickenpox may also be a cause.
SIGNS AND SYMPTOMSShingles is a condition associated with extreme pain and an extended healing time. It typically appears along one nerve branch on one side of the body. This is usually along the back, on the chest or on the face. An attack of Shingles is often preceded by three or four days of chills and fever - adults. There may also be extreme pain in the affected area. The skin in this area may be unbearably sensitive to touch and may also become flushed. A rash with small skin blisters appears over the affected area. This rash may continue to appear for about one week before it shows any signs of healing. Parts of the rash may join together and appear as a chain around part of the body in the shape of a belt. The intensity of the pain in the affected area may lessen after this rash has appeared.
Even when the rash disappears, pain may still be present. This pain is called post-herpetic neuralgia or PHN. PHN occurs between four and six weeks after the disappearance of the Shingles rash. PHN may be a result of nerve root damage and it affects approximately 20% of people with Shingles. PHN can last for months or years. Older people are more susceptible to PHN and in most cases this condition does resolve with time.
TREATMENT OPTIONSAs with all conditions your Doctor should be consulted to diagnose and treat this condition. It is essential that Shingles is diagnosed and treated within three days of the rash breaking out. This greatly reduces the chances of PHN (post-herpetic neuralgia) developing. Your Doctor may prescribe an anti-viral medication. These drugs help to control the spread of the virus. Pain-controlling medications are also recommended. If severe pain is not properly managed, there is increased risk of PHN developing. Some patients find that over-the-counter pain-relievers such as Panadol are strong enough to relieve pain caused by Shingles. Other patients may require stronger medication that must be prescribed by a Doctor.
PHARMACIST'S ADVICEAsk your Pharmacist for the latest advice. 1) See your Doctor as soon as possible for treatment of Shingles. 2) Follow the Diet Hints. 3) Ask your Pharmacist if you have any queries about medications prescribed by your Doctor. 4) Your Pharmacist may suggest some pain relieving medication such as paracetamol if necessary. 5) Try applying a wet compress to lesions using sterile gauze pads from your Pharmacy soaked in cool water. Do this several times a day between 15 to 30 minutes at a time to help relieve the pain and itching. 6) If the Shingles has scarred, smear pure Vitamin E oil onto the scar (ensuring that the skin is unbroken) at least twice a day to help soften the skin and reduce the severity of scarring. 7) Ask your Pharmacist for advice about how to keep the Shingles lesions clean and free from infection. An antiseptic wash and cream may be suggested. 8) If the diet is inadequate consider some supplements. Ask your Pharmacist for advice.
DIET HINTSIt is important to have a healthy, wholesome diet. Try to include at least five servings a day of fresh fruits and vegetables.
- Legumes (peas, beans, lentils), brewer's yeast, tuna, mackerel and chicken provide B group vitamins which are important for nerve health.
- Eggs provide vitamin B12 and vitamin B1 that are important for the treatment of Shingles.
- Foods high in vitamin A and vitamin C may help skin lesions. These include yellow and orange coloured foods and citrus fruits.
- Sesame seed, avocados and green leafy vegetables provide calcium and magnesium to assist nerve function.
- Essential fatty acids are important for the nervous and immune systems. Deep sea cold water fish are good sources of essential fatty acids e.g., mackerel, salmon and fresh tuna (tinned tuna is usually drained of valuable oils).
- Try to drink plenty of water - at least 6 to 8 glasses a day.
- A diet rich in lysine is recommended for people with Shingles. Sources include fish, chicken, lamb, brewers' yeast, mung beans, eggs and oats.
- Try to avoid chocolate, peanuts, nuts, cereal grains, gelatine, carob and raisins as they are thought to promote the shingles virus.
VITAMINS/MINERALS/HERBSVitamins and minerals may only be of assistance if dietary intake is inadequate.
- Lysine is thought to have anti-viral activity, particularly the Shingles virus.
- Vitamin B12 is thought to help with healing of blisters and the pain associated with Shingles. Studies of B12 injections for Shingles have shown to be beneficial.
- Vitamin C is thought to have anti-viral activity and helps boost the immune response.
- Zinc helps protect against infection and boosts the immunity. It is thought to have preventative and therapeutic actions.
- St. John's wort is thought to have an anti-viral action and also relieve nerve pain.