Q. Over the past year and a half I have had four attacks of shingles which have been terribly painful. Why does it keep coming back, and is there any cure?
A. Shingles is an infection of the nerves. The virus that causes it is the same virus that causes chicken pox. Its proper name is Varicella Zoster Virus and it is a kind of Herpes Virus. After you have had chickenpox, the virus stays in your nerves in a dormant form, without causing any problems. However, if it is reactivated it causes shingles. We do not know exactly why the virus is reactivated, but we do know that not everyone who gets chickenpox will get shingles. Around one in seven people who have had chickenpox will develop shingles at some point in their life.
There is currently no cure for shingles, although antiviral drugs can be used to speed recovery. To be most effective they need to be taken within seventy-two hours after the appearance of the rash. Oral antivirals include acyclovir and famciclovir.
You can get shingles more than once – it recurs in an estimated one to five percent of patients – and it can reappear many years after the initial episode of shingles.
The risk of complications from shingles increases with age, weakened immunity (the body’s ability to ward off disease) and delay or lack of treatment. Complications include post-herpetic neuralgia or PHN. Post-herpetic neuralgia is the name given to the pain that persists for months, or even years, after the shingles rash has healed. The risk of developing post-herpetic neuralgia is directly related to your age when shingles appears. The pain may be sharp, piercing, throbbing or stabbing, and it may extend beyond the area of the original shingles eruption. The skin may be unusually sensitive to even the lightest touch (as from clothing), to the smallest breeze, and to changes in temperature (either hot or cold).
Post-herpetic neuralgia is treated by a variety of pain-relieving approaches: nonsteroidal anti-inflammatory drugs, narcotic analgesics and specific medications for nerve-injury-related pain, including certain medications best known for treating depression and epilepsy. The effectiveness of treatment for post-herpetic neuralgia varies widely among patients.
A. Shingles is an infection of the nerves. The virus that causes it is the same virus that causes chicken pox. Its proper name is Varicella Zoster Virus and it is a kind of Herpes Virus. After you have had chickenpox, the virus stays in your nerves in a dormant form, without causing any problems. However, if it is reactivated it causes shingles. We do not know exactly why the virus is reactivated, but we do know that not everyone who gets chickenpox will get shingles. Around one in seven people who have had chickenpox will develop shingles at some point in their life.
There is currently no cure for shingles, although antiviral drugs can be used to speed recovery. To be most effective they need to be taken within seventy-two hours after the appearance of the rash. Oral antivirals include acyclovir and famciclovir.
You can get shingles more than once – it recurs in an estimated one to five percent of patients – and it can reappear many years after the initial episode of shingles.
The risk of complications from shingles increases with age, weakened immunity (the body’s ability to ward off disease) and delay or lack of treatment. Complications include post-herpetic neuralgia or PHN. Post-herpetic neuralgia is the name given to the pain that persists for months, or even years, after the shingles rash has healed. The risk of developing post-herpetic neuralgia is directly related to your age when shingles appears. The pain may be sharp, piercing, throbbing or stabbing, and it may extend beyond the area of the original shingles eruption. The skin may be unusually sensitive to even the lightest touch (as from clothing), to the smallest breeze, and to changes in temperature (either hot or cold).
Post-herpetic neuralgia is treated by a variety of pain-relieving approaches: nonsteroidal anti-inflammatory drugs, narcotic analgesics and specific medications for nerve-injury-related pain, including certain medications best known for treating depression and epilepsy. The effectiveness of treatment for post-herpetic neuralgia varies widely among patients.
Dr Lesley Colvin
Consultant Anaesthetist
Consultant Anaesthetist
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