Shingles

en españolEl herpes zóster

What Is Shingles?

Shingles is pretty rare in kids and teens who have healthy immune systems. But if you've heard about it or know someone who's had it, you might be wondering what it is.

Shingles is a skin rash caused by a viral infection of the nerves just below the skin. The virus that causes shingles is the same one that causes chickenpox. Most teens who get shingles have mild cases; it's usually only when people are older that the rash is painful.

Shingles usually appears as a line of irritated skin and blisters on one side of the chest and back. It can happen anywhere on the body, though, including on the face and near the eyes.

Because shingles is caused by the same virus that causes chickenpox, it's highly contagious. It's easy to pass the virus on to people who aren't immune to chickenpox (like people who have never had chickenpox or who didn't get the chickenpox vaccine). The difference is that if they get infected, they won't get shingles. They'll get chickenpox instead.

A case of shingles will generally disappear in about a month. Although a shingles flare-up usually gets better on its own, treatments can help people heal more quickly and also can reduce the chance of other having other problems that can go along with shingles.

What Causes Shingles?

Shingles and chickenpox are both caused by the varicella zoster virus. This virus is related to (but not the same as) the herpes viruses that cause cold sores and genital herpes, which is why shingles is sometimes called herpes zoster.

After someone has chickenpox, the virus stays in that person's nervous system for the rest of his or her life. It remains dormant, or sleeping, for years. In many people, it never reappears. For others, though, the virus flares up and causes shingles. People can get shingles flare-ups more than once — though that doesn't usually happen.

Doctors aren't sure why the zoster virus suddenly flares up again after months or years of being dormant. It could be because the immune system becomes more vulnerable to infections as people age. This may be why shingles is more common in older adults. It's also more common in people whose immune systems are weakened by diseases (such as AIDS or cancer) or who are taking medicines that weaken their immune system.

What Are the Signs of Shingles?

In many cases, the first thing someone notices with shingles is a tingling, pain, or itching in the area where the rash is going to appear. This can happen a few days before the rash, which means someone with shingles may feel itching, tingling, or pain and have no idea what's causing it.

When the rash appears, it often starts as groups or lines of pimples on one side of the body or face. The pimples change to pus-filled blisters that break open and scab over in about 7 to 10 days. When the blisters are scabbed over, they begin to heal. The scabs usually heal and fall off about 2 to 4 weeks after the rash appears.

Some people with shingles also may have a fever, headache, fatigue, or general achiness. In rare cases, a person can have the pain of shingles without getting a rash. Some people (usually older people) have more severe symptoms.

Complications

Most cases of shingles will heal on their own and won't lead to any other problems. In a few rare cases, shingles can lead to complications like these:

• Ongoing pain. Damaged nerve fibers in the skin can send confused messages to the brain, leading to pain that can go on for a long time after a shingles rash has disappeared. Doctors call this post-herpetic neuralgia.
• Vision problems. If a person has shingles near or in an eye, it can lead to vision loss. If someone starts to show signs of a blister or rash in the eye area, they should see their doctor right away.
• Additional skin infections. A shingles rash can become infected with bacteria, leading to skin infections like impetigo or cellulitis that may need antibiotics to cure.
• Nervous system problems. Shingles on the face may involve nerves that connect to the brain. This can lead to problems like trouble moving a part of the face, hearing trouble, and problems with balance. In very rare cases, shingles can lead to encephalitis (inflammation of the brain).

What Should You Do?

If you think you might have shingles, call a doctor. If you think you have shingles on your face, get in touch with a doctor right away to keep the infection from spreading to your eyes. People with weakened immune systems should get medical help right away to help avoid complications.

Usually, a doctor can diagnose shingles just by examining someone's rash and blisters. In rare cases, doctors may remove a small sample of the infected tissue so it can be examined in a laboratory.

How Is It Treated?

Antiviral medications can make a shingles flare-up heal faster and reduce the chances of having complications. Not everyone needs to take antiviral medicines, though — your doctor will prescribe them if necessary. If you do need to take them, the earlier you start, the more effective they will be.

Antiviral medicines can't eliminate the virus from the body completely, so they won't stop someone from having future flare-ups.

To ease any pain that might come with shingles, doctors or nurse practitioners may prescribe a cream, spray, or skin patch to numb the skin. Some prescription and over-the-counter medications also can help treat pain. Don't take aspirin, though. It can put teens at risk of a rare but serious illness called Reye syndrome.

If you have shingles that itch, your doctor may recommend lotions or medicines called antihistamines.

Keep the rash area clean by washing with water and a mild soap. Apply cool, wet compresses to the blisters several times a day to reduce the pain and itching. Oatmeal baths also can bring relief.

Can I Prevent Shingles?

It's not possible to prevent shingles entirely. The chickenpox vaccine can make a case of shingles less serious. So if you haven't had chickenpox, it's not too late to ask your doctor about getting the chickenpox vaccine.

There is a vaccine against shingles, but doctors usually only give it to older adults. That's partly because the older someone is, the more severe shingles can be. As a teen, you're unlikely to be seriously affected by shingles.

If you get shingles, you can help keep the virus from spreading by keeping the rash covered at all times and getting treatment if you need it.

People with shingles can spread it pretty easily. Until their rash is completely healed, they need to stay away from newborn babies, pregnant women, anyone with a weakened immune system, or anyone who is not vaccinated against chickenpox. So teens who get shingles may need to stay home from school for a while. It all depends on the person and the situation. Your doctor will give you advice.

Shingles may sound scary, but that's mainly because of how it affects older people. The good news is that the infection doesn't usually happen to teens. And, even when teens do get shingles, it's usually not serious.