Shingles: The Silent Pain Epidemic

What do Shingles look like?

Infection with the Varicella-Zoster virus (VZV) first results in the well known disease chickenpox after which it lies chronically dormant in the body until it is later reactivated causing the shingles. The virus lies dormant in the dorsal root ganglia coming from the spinal cord. Due to this, when the virus is reactivated it causes a rash along the area of skin associated with that nerve root. This area of skin is called a dermatome. Therefore, it is characteristic that the shingles rash generally occurs in a localized band on one side of the body and does not cross the midline. Also, the most common areas include the torso, shoulders, around the eye, or neck. Shingles progresses through multiple stages beginning with the prodromal phase.

Prodromal Phase:

Burning, tingling, numbness, and/or itching in the area on one side of the body where the rash will appear. This lasts 1-5 days.

Active Phase:

A band of small fluid filled blisters develops on one side of the body and does not cross the midline. The shingles rash can be extremely painful and potentially contagious. After 7-10 days the blisters will begin to crust over leaving scabs that should heal after two weeks. Anyone who is not immune to VZV should avoid contact with the rash as they are at risk of becoming infected and developing chickenpox.

Chronic Phase (aka Post Herpetic Neuralgia):

This phase does not occur in everyone who develops shingles. Patients are considered to be in the chronic phase if their shingles pain/numbness/tingling continues over four weeks after their blisters have healed. This can last anywhere from months to years.

EMERGENCY:

If shingles develops around the area of the eye and specifically on the tip of the nose this is an ocular emergency. Shingles of the eye can lead to infection/inflammation of the eye, glaucoma, or even blindness.

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