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Coping with shingles

When the pain continues

Shingles can damage nerve fibers in such a way that their ability to send messages from your skin becomes exaggerated and confused. The resulting pain can last long after the shingles rash is gone. This condition is called postherpetic neuralgia (PHN). Treatment is highly individual and may include one or more of several medications and creams that have been shown to help reduce pain in people who have PHN. A relatively new prescription skin patch containing lidocaine has also proven effective, delivering continuous pain relief directly where it’s needed, without causing major side effects.

To most adults, chicken pox is a long-forgotten illness. Unfortunately, to put a new twist on an old saying: forgotten but not gone. When a child’s body battles the chicken pox virus, called varicella zoster, his or her immune system may not destroy all of it. What’s left of the virus can hibernate inside nerve cells only to be reactivated many years later by such factors as age, illness, medications and stress.

When the varicella zoster virus is reactivated, the resulting illness is called herpes zoster, commonly referred to as shingles. Shingles causes a localized, blistery rash. The rash may occur on the chest, trunk or back. Less commonly, it can appear on the face, in the mouth or down an arm or a leg. The shingles rash always appears on just one side of the body. Some people notice a burning, tingling or itching feeling even before the rash forms.

Shingles is treated with antiviral drugs, which can reduce the severity of the infection if taken within three days of developing the rash. Anti-inflammatory drugs may be prescribed to reduce swelling. Shingles is painful because the reactivated virus travels along nerve fibers that extend to your skin. For that reason, prescription pain relievers are part of the treatment.

About one in five adults will experience shingles, which is most common in people older than age 50. Early treatment is important to reduce the length and severity of symptoms. In addition, prompt treatment helps to reduce the length and severity of postherpetic neuralgia (post-her-PET-ic noo-RAL-jah), the most common complication of shingles, should it occur. Shingles itself usually heals within a month.

Although people who had chicken pox as children may develop shingles themselves, they will not “catch” shingles from someone else. Their immune systems protect them from a new invasion by the varicella-zoster virus. However, anyone who did not have chicken pox as a child may develop shingles by coming into contact with someone who has the illness.

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