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What You Need To Know About Shingles: A Complete Guide

What You Need To Know About Shingles: A Complete Guide

Shingles are a viral disease that can cause an excruciating rash to appear on the body. The rash usually occurs in one part of the body, and the same virus causes it as chickenpox.

Shingles, also named (herpes zoster), is an infection that results from the reactivation of a dormant varicella-zoster virus. It affects people who have previously had chickenpox or been infected with herpes zoster and causes painful, blistering skin eruptions across one side of the face, trunk, arms, and legs.

Scientists say that approximately 1 in 3 people will develop shingles during their lifetime. Anyone of any age can get shingles. However, it is more prevalent in people over the age of 50.

The rash of shingles typically lasts for 1-2 weeks. However, some people may experience lingering pain or ongoing discomfort even after the rash has cleared up. But there are vaccines to prevent this disease and treatments that reduce the risk of complications.

What Are The Symptoms Of Shingles?

Shingles symptoms typically develop on one side of the body or face and appear in a limited area rather than all over. 

Between the initial symptoms and the full blown-out rash, the symptoms include:

  • pruritus (itchy skin)
  • dysesthesia (painful burning, prickling, or aching feeling)
  • pain in the affected skin area

The pain can be felt by several days before the rash and can be misinterpreted and misdiagnosed by doctors as: 

  • myocardial infarction 
  • biliary or renal colic
  • pleurisy
  • dental pain 
  • glaucoma
  • duodenal ulcer 
  • appendicitis

This type of misdiagnosis can lead to lead to potential mistreatment.

Shingles begin as red patches or skin lesions, and within 7 to 10 days, they turn to tiny fluid-filled sacs and then scabs.

10% to 20% of shingles infections can affect the entire eye, causing keratitis, scarring, and vision loss. An early warning sign is a fluid-filled sac on the tip, side, or root of the nose.

The infection can damage the brain and cause:

  • acute or chronic encephalitis
  • myelitis 
  • aseptic meningitis
  • polyradiculitis 
  • retinitis
  • autonomic dysfunction 
  • motor neuropathies
  • Guillain-Barré syndrome
  • hemiparesis
  • cranial or peripheral nerve palsies

Shingles can kill a person, but it is rare. In people with a fragile immune system due to some disease or medications, the mortality rate is between 5% and 15%.

What Causes Shingles?

Shingles On Different Parts Of The Body

As an initial matter, according to the National Institute of Health, you cannot get shingles unless you suffered from chickenpox at an earlier time in your life.

The virus that causes shingles is the varicella-zoster virus, which also causes chickenpox. After a person has had a case of chickenpox, the virus hides inactive in the nervous system and can “reactivate” later in life in the form of shingles.

In other words, shingles are the second bout of chickenpox but in the form of shingles.

Scientists have reported that the reactivation of the varicella-zoster virus happens because of advanced age and/or a weakened immune system. The natural body defenses weaken, thus causing the virus to reemerge in the form of shingles.

The researchers further conveyed that the virus can reawaken and cause numerous neurological (brain) and ocular (eye or vision) disorders without any traces of shingles.

Is Shingles Contagious?

Is Shingles Contagious?

Shingles is contagious, but it’s a little complicated. If a person is infected with shingles, he can infect you with the virus (varicella-zoster virus) that caused his shingles. 

However, if you get infected, you will not get shingles, but you will get chickenpox first. Once you suffer from chickenpox, you may get shingles later in life if the virus reactivates in your body for some reason.

As stated earlier in this article, no one can get shingles unless they had chickenpox first.

The bottom line is that although shingles themselves are not contagious, the varicella-zoster virus could be transmitted through contact with an individual who has shingles, causing you to get chickenpox and then possibly shingles later in life.

More importantly, if you received a shingles vaccine, you more than likely not get infected with the varicella-zoster virus if you contacted someone with shingles. More on vaccines later in the article.

How To Treat Shingles

There’s no cure for the shingles, but there are antiviral medications available that may reduce the duration and severity of the disease. 

For example, a study published on August 5, 2021, explained a new and potent antiviral medication that works wonders against shingles.

It is an approved medication called Amenamevir (Amenalief®), labeled as a next-generation drug against shingles. Amenamevir has successfully treated over a million shingles patients in Japan alone at the study’s publication. (Please speak to your doctor about this new medication)

It has also been approved for use in the USA by the Food and Drug Administration.

Postherpetic Neuralgia (PHN): An After-Effect to Shingles?

According to a 2022 study, about 9–34% of people who get shingles develop a complication called postherpetic neuralgia (PHN). And for those over 60-years-old, PHN affects between 65–73%.

PHN is a chronic pain condition in which the patient has severe, sometimes prolonged, and excruciating, pain in the area where they had shingles due to damaged nerve fibers that can last for months and even years after recovering from shingles.

For those afflicted with PHN, 30–50% suffer for more than one year, while others suffer from pain that lasts more than ten years. PHN is a severe complication associated with shingles.

Symptoms include:

  • burning or stabbing sensations
  • itching
  • tingling or numbness 
  • angina-like aching or squeezing feelings 
  • deep aching or pulled muscle sensations 

Postherpetic neuralgia may interfere with a patient’s quality of life. It is a severe issue as it can affect the patient in so many ways, such as:

Physical Effects

  • Fatigue
  • Anorexia
  • Weight loss
  • Reduced mobility
  • Physical inactivity
  • Insomnia

Psychological Effects

Social Effects

  • Withdrawal
  • Isolation
  • Attendance at fewer social gatherings
  • Loss of independence
  • Change in social role

Functional Effects

  • Dressing, bathing, eating, mobility
  • Travelling, cooking, housework, shopping

In a recently released exhaustive study dated January 7, 2022, researchers confirmed how shingles and PHN could have a debilitating effect on a person’s quality of life. The people used in the study were impacted as follows:

  • 97% – impacted their emotional functioning
  • 97% – impacted their daily activities
  • 91% – affected their sleep quality
  • 78% – affected their physical functioning
  • 66% – could not pursue their hobbies
  • 63% – impacted their social functioning
  • 38% – impacted their jobs and careers
  • 28% – affected their cognitive functioning

How To Treat Postherpetic Neuralgia (PHN)

Amenamevir (Amenalief®)

The good news is that Amenamevir (Amenalief®) is effective against complications associated with herpes zoster (shingles), especially PHN. After a thorough investigation by scientists, they stated the following in their 2020 research paper:

  • …our findings indicate that AMNV (Amenamevir) could be useful for treating AHP and PHN in patients with herpes zoster.

What You Need To Know About Shingles: A Complete Guide 1

Vitamin B-12

scientific review that investigated numerous studies on shingles patients showed that Vitamin B-12 therapy could help in the quality of life for PHN patients, including the pain associated with it.

Ultrasound And Shockwave Therapy (New For 2022)

new study published on January 7, 2022, revealed promising and effective PHN treatments. Although further research is needed, there is compelling evidence that they work.

One is called “ultrasound-guided stellate ganglion block.” The other is “extracorporeal shock wave therapy.” These therapies work best if used together, according to the study.

Ultrasound-Guided Stellate Ganglion Block

According to the study, ultrasound-guided stellate ganglion block is a minimally invasive treatment procedure. Some of the ways it works are through blocking the pain response associated with PHN by:

  • relaxing the nerves and muscles 
  • regulating the autonomous nervous system (body’s unconscious actions including heart rate, blood pressure, respiration, digestion, etc.
  • regulating the endocrine system (glands and organs)
  • modulating the immune system
  • removing the inflammatory response that causes pain by relieving spasms
  • enhancing T-cell activity
  • reducing nerve inflammation
  • promoting nerve repair
Extracorporeal Shock Wave Therapy

Shock wave therapy has a powerful effect on the treatment of chronic pain. Researchers believe it primarily produces pain relief (analgesia).

It appears to work by interfering with the transmission (messages from neuron to neuron) of pain information and increasing the body’s ability to withstand more pain, thereby soothing pain. 

Are There Vaccines To Prevent Shingles?

Are There Vaccines To Prevent Shingles?

There are or were two approved vaccines to prevent shingles.

Zostavax

The first is Zostavax. This vaccine was created by Merck and received FDA approval for use in people over 60-years-old in 2006. 

In 2011, it was approved for use in adults between 50 – 59.

According to the CDC, this vaccine lessened your chances of getting shingles by 51% and PHN by 67%. More interestingly, the CDC stated in its report that everyone should take the Zostavax vaccine because,

  • Studies show that more than 99% of Americans aged 40 and older have had chickenpox, even if they don’t remember getting the disease.

It isn’t easy to believe that 99% of people over 40 had chickenpox. However, and with a warning, this vaccine was taken off the market on November 18, 2020. It is no longer available.

In 2015, the first reports began surfacing, claiming that there were problems with Zostavax. In 2016, many lawsuits were filed alleging that Zostavax caused severe injury.

Zostavax was a “live virus vaccine.” The vaccine was intended to inject a weakened form of the varicella-zoster virus into your body, keep the virus at bay and prevent a shingles infection. Its objective was to stop shingles eruptions before symptoms began by preparing the body for an impending fight with no risk of exposure.

However, according to allegations in many lawsuits, Zostavax caused:

  • cardiovascular injury 
  • joint and muscle pain
  • rashes 
  • pneumonia 
  • vision and hearing loss 
  • cellulitis 
  • lymph node disease 
  • actinic keratosis 
  • severe cutaneous disease 
  • postherpetic neuralgia (PHN) weakness
  • numbness, facial paralysis 
  • brain inflammation (encephalitis)
  • death

These are some serious allegations. The first lawsuit trial will begin on January 18, 2022.

Shingrix Vaccine

Glaxo Smith Klein developed the Shingrix vaccine for shingles. The FDA approved it in October 2017 to help prevent shingles in people over 50.

Shingrix is given in two separate doses. The second is administered two to six months after the first. Research shows that it is superior to the Zostavax vaccine.

According to the CDC, this vaccine is “more than 90% effective at preventing shingles and PHN.” Another report from April 2021 stated that its overall effectiveness is estimated to be 85.5%. The vaccine appears to be potent against shingles.

Shingrix is not a “live virus vaccine” like Zostavax was. It is constructed from a single protein called “glycoprotein E” taken from the varicella-zoster virus’s outer shell.

The vaccine also contains an adjuvant (a compound that improves or regulates the immune response to a vaccine). The adjuvant is an extract from the Quillaja Saponaria tree.

It is the only shingles vaccine to unite a “non-live” antigen with a specifically designed adjuvant.

Summary

Shingles is a serious health problem. And it will likely get worse as the people live longer since it primarily affects older adults.

Common complications of shingles include postherpetic neuralgia (PHN), which is more common in older adults and people with weakened immune systems. PHN can ruin someone’s life for many years.

Vaccines effectively shield you from the severe pain and complications associated with shingles. There is one vaccine available, Shingrix, which effectively prevents these complications.

Anyone with a history of chickenpox should seriously consider taking the Shingrix vaccine as a safety precaution. Speak to your health care provider about everything in this article if you are at risk.