How do I know if I have shingles? The best way of how you can learn a lot about this disease is without a doubt by reading this article thoroughly.
Shingles are painful rashes along a nerve or nerve ganglion. These rashes occur as a result of the reactivation of the virus that causes chickenpox, varicella-zoster virus (VZV). Shingles most often affect the chest or face, but all parts of the body can be affected.
Sometimes the pain caused by shingles persists for months or even years after the rash is healed: this pain is called neuralgia or post-zosterian pain.
I – People at Risk and Risk Factors for Shingles
About 90% of adults in the world have had chickenpox. They are therefore carriers of varicella-zoster virus. About 20% of them will develop shingles in their lifetime.
*** People at Risk
Shingles are more common in people over 60 years of age because immunity weakens with age and the virus can multiply more easily.
– Various treatments and health problems increase the risk of shingles by weakening immunity (cancer, diabetes, corticosteroids, immunosuppressants, etc.). However, this type of risk factor is found in only 4% of people with
*** Risk Factors
No risk factor is officially recognized.
– Researchers question whether there is a possible link between shingles and chronic stress. The studies carried out so far lead to contradictory results: some suggest a link, and others do not.
– A study in North Carolina suggests that exposure to chemicals increases the risk of developing shingles. The study involved, among others, 900 participants aged 18 to 40 and living 2.5 miles from a pesticide or other chemical landfill (unused products that companies must have). These participants experienced twice as many shingles as the 742 respondents who reside at a greater distance from the site in the surrounding communities. According to the authors of the study, exposure to certain chemicals would weaken immune defenses.
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II – Evolution
In the absence of treatment, the shingles lesions last on average of 3 weeks. Most of the time, a single shingle crisis occurs. However, it happens that the virus reactivates several times. This is what happens in the case of about 1% of sufferers.
Shingles are not transmitted from person to person. However, the fluid inside the red vesicles that form during a shingles crisis contains several particles of the chickenpox virus. This fluid is very contagious: a person who touches it can get chickenpox if it never had it. To enter the body, the virus must come into contact with a mucous membrane. It can infect someone who rubs their eyes, mouth or nose, for example, with a contaminated hand.
Handwashing helps prevent transmission of the virus. It is also advisable to avoid physical contact when the liquid flows from the vesicles. People who have not had chickenpox and whose infection could have serious consequences should be extra careful: this is the case, for example, with pregnant women (the infection can be dangerous for the fetus), people with weakened immune systems and newborns.
III – Causes of Shingles
As a result of chickenpox, almost all viruses are destroyed except for a few. They remain dormant in the nerve ganglia for several years. With age or because of a disease, the immune system can lose its ability to control the virus, which can reactivate. An inflammatory reaction then develops in the ganglia and in the nerves, causing the appearance of vesicles arranged in clusters on the skin.
Infected adults who have been in contact with children with chickenpox may have increased protection against shingles. Scientists believe that second exposure to the virus stimulates the immune system and thus helps keep the virus dormant.
IV – Symptoms – How Do I Know If I Have Shingles?
– The person with shingles experiences a burning sensation, tingling, or increased sensitivity on an area of the skin along a nerve, usually on one side of the body. If it occurs on the thorax, shingles can create a more or less horizontal pattern that evokes the shape of a hemi-belt (in Latin, zona means belt).
– 1 to 3 days later, diffuse redness appears in this area of the skin.
Then, several red vesicles filled with liquid and resembling the pimples of chickenpox erupt. They cause itching, dry out in 7 to 10 days, and disappear after 2 to 3 weeks, sometimes a little more.
– Between 60% and 90% of people with shingles experience acute local pain of varying duration and intensity. It may look like burning or electric shock, or sharp twitching. Sometimes it is so strong that it can be mistaken for a heart attack, appendicitis or sciatica.
– Some people have fever and headaches.
V – Prevention of Shingles
*** Measures to Prevent Shingles
The best way to prevent it would be to not get chickenpox. This is not easy because it spreads easily in young children. It may be that varicella vaccination provides some protection against shingles. However, it will take several years to test this hypothesis, since this vaccine has only been available since 1998 in Canada and 2004 in France. Note that the varicella vaccine is also for adults who have never had chickenpox.
*** Strengthen Your Immune System
To prevent the virus from becoming active, it is best to strengthen the immune system through a healthy diet, regular physical activity and adequate rest periods. A small, controlled study of 36 people over 60 indicates that regular tai chi improves immune defenses against the chickenpox virus. Thus, tai chi would help prevent the reactivation of the chickenpox virus as zoster1. Another study of 112 healthy adults aged 59 to 86 suggests that tai chi strengthens immune defenses against varicella virus after varicella vaccination (Varivax®).
A vaccine against shingles is now available in Canada and France for the indication “Prevention of shingles and post-herpetic pain in persons over 65 years of age on a one-shot schedule”. Zostavax® is a new vaccine that helps prevent shingles. It is intended for people aged 60 and over (65 years old in France) who have already had chickenpox. It is obtained by prescription and has some contraindications. This vaccine is different from that intended to protect against chickenpox. It does not protect shingles but halves the risk of getting it, on average. In addition, it decreases the severity of symptoms of shingles, as well as the risk of post-shingal neuralgia (two-thirds). These data come from a study conducted by the manufacturer of 38,500 men and women aged 60 and over. The vaccine is more effective in people 60 to 69 years old than 70 years and older.
In August 2008, Health Canada approved Zostavax®. Since September 2009, Canadians who wish can be vaccinated (a single dose is required at a cost of $ 150). This vaccine has been marketed since 2006 in the United States, some European Union countries and Australia. In France, it is reimbursed at 30% by Social Security in respect of its indication.
*** Measures to Prevent Post-Zona Neuralgia
It is important to consult a doctor as soon as symptoms of shingles appear. He will prescribe antiviral treatments. When these are taken early, they probably help to limit the occurrence of post-shingular neuralgia. If neuralgia occurs, antivirals taken early may reduce its duration.
To avoid complications to the eyes, it is also important to see an ophthalmologist as soon as shingles touch the upper part of the face.
VI – Medical Treatments for Shingles
Important. If you are asking yourself, “How do I know if I have shingles?” consulting a doctor is the surest way to know. The earlier the treatment, the better its effectiveness. Ideally, an antiviral drug should be taken within 3 days of the appearance of a lesion.
Antivirals (drugs that fight viruses), as in France aciclovir (Zovirax®) and valaciclovir (Zelitrex®), which are the two antivirals with Marketing Authorization, but also in Canada the famciclovir ( Famvir®) and valaciclovir (Valtrex®) may be prescribed. They are taken orally. They are well tolerated and have few side effects. Antivirals accelerate healing, reduce acute pain, and probably limit the onset of post-zoster neuralgia if taken within 3 days of rash.
Pain relievers can help relieve mild or moderate pain, in addition to antivirals, such as paracetamol (also known as acetaminophen) (Tylenol®, Panadol®, Paracetamol® in Canada, Doliprane®, Daffalgan®, Efferalgan® in France, etc.). ). Narcotic analgesics, also known as opiates, may be prescribed as needed: for example, tramadol or codeine, or even morphine (in small doses).
Note. Nonsteroidal anti-inflammatory drugs, such as ibuprofen (Advil® in France, Motrin® in Canada, etc.) are not indicated in shingles.
Corticosteroids (such as cortisone) may also be prescribed, but more rarely. In combination with antivirals, they can help reduce (modestly) the duration and intensity of symptoms of shingles. However, they do not help prevent post-zoster neuralgia. These medications are usually reserved for people with very uncomfortable symptoms, given their side effects.
Post-shingular neuralgia may require, in addition to the use of conventional analgesics, a tricyclic antidepressant, antiepileptic, or narcotic analgesic treatments, depending on the intensity of the pain. In France, there is also anesthetic plaster (Versatis 5% ®) to be applied to the pain area once a day, for a maximum of 12 hours per 24 hours.
*** Practical Advice
– Whenever possible, keep the skin area clean and dry.
– To relieve pain and dry lesions, apply fresh, moist compresses to the blisters. The compresses can be moistened with water and a few drops of vinegar. Calamine lotion can also be used.
– Take a bath in fresh water with a little baking soda or oatmeal (psn) colloidal.
– Do not scratch the vesicles and do not attempt to pierce them.
– Wear light clothing to avoid rubbing of vesicles.
– To help the body fight infection, rest well.
– In case of severe pain, anything that helps the body to relax can have a soothing effect: reading, listening to music, hobbies, meditation, tai chi, etc.
*** By Way of Conclusion: The Opinion of Dr. Dominic Larose
As part of its quality approach, Passeportsanté.net invites you to discover the opinion of a health professional. Dr. Dominic Larose, emergency physician, gives you his opinion on shingles:
At the beginning of my practice, in the 1980s, it was not easy to tell an elderly person that she had shingles. Everyone had heard of post-zona pain and lesions that never healed. I am impressed by the effectiveness of current antiviral treatments. Now my patients are getting better and have much less pain and sequelae than before.