Shingle Overview

Anyone who has had chickenpox infection is at risk of acquiring Shingles. After having chicken pox, the virus will stay dormant in the body. Shingles is the latent reoccurrence of varicella zoster virus infection. The re-infection with the same virus will result to shingles.

Shingles and its Complications – Management and Treatment

Post herpetic neuralgia is the most common complication following herpes zoster infection. This is defined as the presence of significant pain. This condition occurs when damaged nerve fibers that cause changes within the components of the nervous system due to the presence of the virus in the peripheral blood send confused messages of pain to the brain which is sometimes exaggerated. This may last upto three months or longer after shingles infection. The goal of post herpetic neuralgia treatment is directed towards reduction of pain.

 Pharmacologic management

Antiviral Medicines

These medicines will not totally treat the disease shingles per se but it aims to shorten the period and the severity of the infection (i.e., new vesicle formation), thus lessens the number of days of acute discomfort. It is proven effective if the medicine is initiated as soon as the rashes appear usually within seventy two hours of eruption of rashes. Prodromal symptoms commonly associated with shingles are pain, itching (burning or shooting) and body malaise. Therefore, people who suspect they might have the infection should visit a healthcare professional and seek for treatment options. Antiviral agents inhibit the herpes zoster virus from replication and shedding by exerting directly on the virus. It also promotes healing of the lesions and reduces the severity of complications such as post herpetic neuralgia. Examples of these medicines are:
• Acyclovir
• Valacyclovir
• Peniclovir
• famicyclovir

Patients most complaints while having shingles are the itchiness of the rashes and pain (post herpetic neuralgia) which is oftentimes intractable. The pain may last for weeks or months after the blister have crusted and healed. A quality care to a patient infected with shingles is pain control. Analgesics is one of the common over-the-counter oral pain reliever used in the management of mild to moderate pain associated with the disease.
Analgesics
• Oxycodone
• Acetaminophen
• Ibuprofen
• Naproxen

Topical agents
Capsaicin cream. It acts as an agonist in an ion channel receptor on nociceptive skin nerve fibers. It causes initial pain on the treated area upon stimulation of the ion channel then followed by pain relief. The recurrence of neuropathic pain may be experience gradually over several months as possible result of nerve fiber reinnervation.

 Home remedies

Wear comfortable clothing
Avoid using tight clothing that is made up of synthetic material. Make use of cotton or silk clothing instead.

Practice good hygiene
Skin care is very important to avoid cross contamination and infecting others. Always keep the affected area clean and dry. Avoid scratching and bursting the blisters as it will increase the risk of secondary bacterial infection from broken skin. Keep the affected area exposed to air as much as possible.

Calamine lotion
A mixture of seventy eight percent calamine lotion, twenty percent rubbing alcohol, one percent phenol and one percent menthol is helpful to cut down on itching.

Wet compress
With the use of a towel or a piece of cloth, soak it in cool water (do not use ice pack). Draw out the water from the towel by squeezing it and damp it over the affected areas for several minutes. The cooling effect of this remedy may help numb the pain.

Colloidal oatmeal baths or starch baths
Soothing baths may help to lessen the itching and help heal irritated skin and painful rash. Add the products in a lukewarm bath (do not use hot water because it will further cause irritation).