Varicella is the same virus that causes chicken pox. While the majority of people clear the virus from the body, some people are not able to get rid of the virus because it hides in the nerves. After many years, the virus is activated and cause shingles. It is not known how the virus is activated but risk factors for triggering the virus include use of steroids, HIV or presence of a cancer. It is believed that a lowered immunity may make the individual prone to infections in later life. Shingles is most common in elderly individuals past the 6th decade of life.

The diagnosis of shingles is usually made from the history and clinical presentation. In most cases there is no need for blood work. However, in some immunocompromised individuals levels of the varicella zoster IgG are measured. The levels of this immunoglobulin will indicate the immune status of the individual. The varicella zoster IGG levels are also measured in individuals who fail to respond to the Shingles vaccine. When the levels are high it means one is protected against the virus, but when the levels are low it means that one has not developed immunity to the virus.

Shingles is not a life threatening disorder but it can be agonizingly painful.

Today, doctors recommend the varicella zoster vaccine for all elderly individuals over the age of 60, whether they have had shingles or not. The shingles vaccine has been approved to help protect the body from reactivation of the chickenpox (varicella-zoster) virus. So far, the few trials on the shingles vaccine indicate that it is safe but not one hundred protective against virus activation. However, even when the virus fails to prevent reactivation, it helps reduce the severity and duration of shingles. Although the shingles vaccine is useful for prevention of shingles, it is not effective in preventing the pain of post herpetic neuralgia.

The varicella zoster vaccine is a live vaccine and administered as a single injection in the upper arm. The vaccine has a few side effects that include pain, redness and mild pain at the injection site. Some people do develop headaches and general malaise for a few dayss. These symptoms can be lessened by taking a tylenol every 4-6 hours for 24 hours.

The shingles vaccine is not recommended for individuals who:

- Are allergic to gelatin or any other component of the vaccine
- Have a weakened or suppressed immune system such as HIV or leukemia
- Are receiving drugs like corticosteroids, anti cancer drugs or radiation therapy
- Have active infection like tuberculosis
- Are pregnant or trying to get pregnant

The cost of the shingles vaccine is not always covered by all insurance plans or Medicare. Besides elderly individuals over age 60, the shingles vaccine can be administered to children and adults who have not yet had varicella zoster virus infection previously.

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There are many Proteolytic enzymes obtained from a variety of natural foods and fruits like the papaya, kiwi and pineapple which are reported to help soothe the pain in shingles. Some of the Proteolytic enzymes are derived from animal pancreas and similar analogs are also used to treat patients with chronic pancreatitis. All such Proteolytic enzymes are available without a prescription and can be bought from any natural health food store. Side effects of Proteolytic enzymes include allergies, gastric upset, and diarrhea. One should understand that Proteolytic enzymes rarely work when they are taken by mouth as they immediately get broken down by acidity in the stomach. Proteolytic enzymes can also interfere with absorption of many prescription drugs and vitamins. Thus, one should discuss the use of these supplements with a physician prior to usage.

Tai Chi is widely hyped up as an effective treatment for zoster virus. In one uncontrolled study, elderly people who participated in tai chi reported decreased pain. However, the study was of short duration and only involved 36 patients. Moreover, criteria for assessing pain were very subjective.

Capsaicin Cream is made from special chili powder obtained from Eastern Europe. Capsaicin has been around for a few decades and used to treat neuropathic pain. A few studies have shown that topical application of capsaicin as treatment for zoster virus works but there are just as many studies which have shown no effect. The problem with capsaicin is that there are many formulations and the product quality and quantity does vary from store to store. Capsaicin is applied on to the skin 2-4 times day and takes a few weeks to work. If it fails to reduce pain after the first 5-7 days, it is unlikely to work at all. Thus, consumers should initially not buy dozens of bottles. The cream does cause a stinging or a burning sensation when first applied. The majority of people who have shingles do not find relief from capsaicin.

Other zoster treatment include acupuncture, peppermint oil, geranium oil, and aloe vera. Only anecdotal reports exist about the efficacy of these treatments. In any case, one should try to keep the skin area clean, dry and avoid hot showers. Cool wet compresses and calamine lotion can help reduce the itch and pain. Drink ample fluid and get lots of rest.

Unfortunately, shingles is a difficult disorder to treat and there is no ideal treatment. All alternative zoster treatments work to some degree but none is 100% effective.

-Burning pain, numbness, tingling which may vary in intensity from mild to severe.
-Shingles pictures usually reveal a red rash that is always begins several later after the pain.
-The rash has fluid filled blisters that eventually become crusted. Itching also tends to occur at some point during the infection.

Other shingles symptoms include fever, chills, general fatigue, headache and inability to sleep.
The degree of pain is variable but in most cases, it is intense. Many times the pain around the chest is mistaken for a heart attack, pneumonia or bone pain. In some people, the rash occurs round the eye and is very dramatic in appearance.

Individuals who develop shingles can only pass the varicella zoster virus to individuals who have not had chicken pox. The transmission usually occurs via direct contact with the open skin sores. Once the virus has been transmitted, the individual will develop chickenpox and not shingles.
Shingles complications include:

-Post herpetic neuralgia which is ongoing pain after the rash has cleared. Sometimes the pain is unresponsive to the usual pain medications.
-Shingles pictures may also reveal an infection around the eye. This can result in vision loss if not treated in time. -Others may develop an infection of the brain; have hearing problems or facial paralysis.

Most cases of shingles resolve spontaneously 10-21 days. Contagious shingles treatment can sometimes help decrease pain, speed healing and reduce the risk of complications.
The typical drugs used for contagious shingles treatment include acyclovir, valacyclovir and famicyclovir. For those individuals with intense pain the treatment may include potent narcotics, anti depressants and a variety of numbing medications.

Home measures to relieve pain for shingles include taking a cool bath or using cool compresses. One may need to take an anti histamine to relieve the itch and apply some calamine lotion. To avoid stress, one may need to relax.
Today, there is the shingles vaccine that can help prevent shingles in older people who have had chicken pox. The shingles vaccine unfortunately does not guarantee that you will not get shingles. However, this live vaccine can decrease the intensity and course of post herpetic neuralgia. The shingles vaccine is only used for prevention and does not help individuals who have the acute rash.
The shingles and zoster virus vaccine is not recommended for individuals, who have a weak immune system, are on steroids or using chemotherapeutic drugs.

Symptoms of the shingles virus are obvious. The pain and rash typically occur on side of the body. Pain is the universal symptom and is generally pretty intense; it feels like burning hot pain. Associated with pain may be areas of numbness and tingling. The pain can be so severe that one cannot sleep nor do any type of work.
Soon after the pain, some individuals develop a red rash. The red rash usually becomes more prominent 24-48 hours after the onset of pain. Also visible are vesicles or small blisters that contain fluid. These blisters appear in a linear fashion and are quite tender to touch. With time, the fluid filled blisters break open and become dry or crusted.
Itching is quite common when the blisters appear. The itch is often intense at night and can result in scratch marks.
Almost everyone with symptoms of the shingles virus will feel ill. Some individuals will also develop fevers and chills. These symptoms usually last for a day or two. Other general symptoms of shingles include fatigue and tiredness. Other minor symptoms include a constant headache and loss of appetite.
The majority of individuals with symptoms of shingles visit a doctor because of pain, which can be intense. Often the pain is mistaken for a heart attack or a problem with the lung. Some people with shingles and symptoms may not have any evidence of a rash and the diagnosis can be difficult. In some elderly individuals, shingles can occur around the eye and can be obvious. The individuals usually have trouble with vision, excessive tearing and the face on one side is usually reddened.
Moreover, shingles can easily be transmitted to other individuals in the family who have a weakened immune system, or those who are using steroids or have HIV. When the shingles virus is acquired by these individuals, it causes chicken pox and not shingles.
Shingles symptoms can be managed at home but sometimes the rash many occur around the eye and affect vision; if this is left untreated permanent eye damage can occur.

Shingles is a very painful rash cause by the herpes zoster virus. This same virus causes chicken pox. The majority of people only get one episode of shingles and that will suffice for a lifetime. The rash and pain are not easily forgotten as the pain is excruciating. Most people have no idea if they have shingles and thus it is important to know what the rash looks like so that they can seek early treatment. Vivid pictures of shingles rash can be seen at www.nlm.nih.gov/…/ency/imagepages/19687.htm.

In most individuals, the rash appears just below the breast and is tender to touch. Another example of the shingles rash can be seen at http://www.prestonhunt.com/hd/pics/87%20Shingles.jpg.

Shingles always presents with a vague pain followed by a skin rash in the next 48 hours, the rash is also characterized by a number of fluid filled blisters called vesicles. Other pictures of shingles can be seen at http://www.lib.uiowa.edu/hardin/md/pictures22/dermnet/herpes_zoster_shingles_trunk06.jpg. The blisters tend to break down and eventually crust over. It is during this period of time that shingles is most contagious.

Shingles is only contagious to people who have never had chicken pox previously and some type of skin contact is required. For this reason, doctors recommend that all affected individual cover the shingle blisters with a dry dressing. However, even the lightest touch of any fabric can induce pain. An example of shingles on the back can be seen at http://www.pyroenergen.com/articles08/images/herpes-zoster-shingles2.jpg.

The available drugs only work when started within 24 hours of the rash.

While the shingle virus tends to occur along the nerves in the chest or abdomen in some cases, it may also occur on the face. Herpes zoster can be very dramatic when it occurs on the face and usually affects on eye. The individual will feel intense pain, tearing of the eyes, blurred vision and feel ill. Immediate medical attention is recommended because permanent damage to the eye can occur if treatment is not initiated. An example of herpes zoster of the eye can be seen at http://www.seniorark.com/Health%20Articles/shingles.jpg. The majority of people who have herpes zoster of the eye are the elderly and the episode usually last anywhere from 2-4 weeks.

Shingles is also quite common on the back. Unlike the front of the body, shingles on the back is often quite widespread because of the density of nerves. Shingles pictures can be seen on most dermatology or infectious disease websites.

Herpes zoster and shingles can occur at any age, but is most common in elderly individuals. Individuals who had chicken pox before the age of one and those who have a weak immune system (eg HIV, use of steroids or those with cancer.

Shingles is only contagious for individual who have not previously had chicken pox as a child or the chicken pox vaccine. Individuals who do acquire herpes zoster, the individuals develop chicken pox and not shingles.

The initial symptom is pain and is usually on one side of the body. The pain is often described as knife like or burning. The pain may be associated with tingling and numbness. A few days later, a red linear rash appears. Soon this is followed by small blisters on the rash in a linear fashion. The blisters are often itchy. Over the next several day, th fluid filled blisters do break open and crust over. Scarring from the blisters is very rare.

In most people, the rash may occur on the side of the chest, face, eyes or mouth. Other symptoms include headaches, chills, fever, paralysis of facial muscles, muscle and joint pain, severe fatigue, loss of taste and vision
The diagnosis of herpes zoster and shingles is made by a clinical exam.
Shingles usually resolves on its own without any medical treatment. The majority of people only require medications to ease the pain. The typical medications used to treat shingles include acyclovir, famicyclovir and valacyclovir.

The medications only work when they are administered within 24 hours of the symptoms. The drugs do not cure herpes zoster but only reduce the intensity of pain. In some individuals the duration of illness may be shortened by a few days. while most people can take the medications by mouth, some people may benefit from intravenous medications.

Sometimes anti-inflammatory medications like corticosteroids are used to reduce swelling and pain. However, these drugs do not always work.

Other medications that may be used include antihistamines, pain medications and zostrix. Cool wet compresses, soothing baths, lotions , starch baths, calamine lotion and colloidal oatmeal baths may help reduce pain and itch.

The skin should be kept clean at all times using warm water and dry dressings. Herpes zoster vaccine may help elderly individual who develop post herpetic neuralgia. However, herpes zoster vaccine is only helpful in 50-60 percent of individuals.

In some unfortunate people, herpes zoster virus may cause brain or eye damage resulting in visual loss.

The question everyone wants answered is, “Are shingles contagious?” The answer is yes. However, the shingles virus is only contagious to people who have never had chicken pox. Thus, all individuals who have never had chicken pox can very easily catch the shingles virus if they have close contact with the person. The individuals who catch the virus do not develop shingles but in fact develop chicken pox. There is no way one can ever catch shingles from any infected individual.

It is recommended that individuals who have shingles lesions keep them well covered. If this is done, then one is not able to have direct contact with the blisters and the chances of acquiring herpes zoster are less.

There are at least 5-10 percent of individuals who develop shingles and do not develop a rash of blisters. Shingles is only contagious if the rash has blisters that break open. If there is no rash then there is no chance of spreading the virus. Moreover, shingles is only contagious during the time when blisters break open. The fluid filled blisters contain the virus and contact with this fluid is necessary for transmission. As long as the blisters are intact, the chance of transmission is small.

In general, shingles initially presents with pain followed by a rash on day 2-4. This is soon followed by blisters which last anywhere from 5-15 days.
How long are shingles contagious? The shingles contagious period lasts anywhere from day 3 to day 14 of the infection cycle. The best protection against shingles is not to be near an individual who has active blisters. Moreover, the individual with shingles can cover the blisters with a dry dressing and this will limit the chance of spread.

Individuals at highest risk of being infected from shingles are the following:

-Those who are on steroids and have become immunocompromised
-Those with cancer
-Individuals who are on a variety of anti cancer drugs
-Individuals with depressed immunity like HIV or AIDs
-Individuals who have never had chicken pox
-Elderly individuals over the age of 60
-Pregnant women or those who are planning to conceive
-Children less than 1 year of age

Healthy people who have had chicken pox can never develop chicken pox or shingles after coming into contact with individuals who have shingles.

For individuals who have shingles, a few words of advice:
Shingle disease contagious period occurs during the phase when the blisters break open until they crust. So in order to decrease the shingles contagious period, cover the lesion. Avoid exposure to strong sunlight and stay in a cool environment to limit the pain and itching. Finally avoid scratching the rash of contagious shingles so that the blisters do not break open.

Shingles tends to occur in elderly individuals and current data indicate that close to a million people get this disorder each year.

Just prior to the rash, one may feel a burning or knife like pain usually on the chest wall. The area of skin becomes hypertensive to touch and there may be episodic tingling. Soon this is followed by a red rash which has blisters. The blisters are filled with fluid and eventually rupture. Over the next few days, the blister dry out and become crusted. Shingles occurs on one side of the body and the entire episode may last 10-21 days. The pain can be variable and is often confused with a skin infection, heart attack or bone pain.

Shingles is contagious but only for people who have never had chicken pox as children. Shingles is most contagious during the time blisters are forming and crusting over. However, some individuals develop pain but never have the rash or blisters.

The diagnosis of shingles is not difficult. A physician can look at the rash and determine the cause. There is no need for fancy radiological tests or blood work. Once the condition is diagnosed, the majority of cases of shingles resolve on their own. However, most people seek treatment for pain, which can be excruciating. Unfortunately, all the available treatments are not very effective and in order to work must be started within 24 hours after onset of symptoms. The drugs do not work when used after 48-72 hours. There are both topical and oral medications to treat shingles pain. Topical creams (like zostrix) and lotions are a waste of money and not recommended. The pills have to be taken 3-5 times a day for 7 days and are very costly. If medications are taken within the first 24 hours, they can help reduce the intensity of pain and duration of the rash. Unfortunately, less than 10% of patients see any benefit from drugs like acyclovir or valacyclovir. Topical local anesthetic creams are available but in most cases only provide pain relief for a very shor time.

The area of infection should be kept cleaned and one can bath or shower. However, the skin site can be exquisitely sensitive to hot water. Cool compresses and calamine lotion do help relieve the itch. There are a variety of alternative health care treatments being offered for zoster virus infection but the efficacy of such treatments remains questionable.

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