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Ouch! It’s Shingles!

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Woman Scratching Rash

How often do you find a rash and panic that it might be shingles?!  It’s that rash that everyone fears, and for good reason!  It can be very itchy and painful and leave lingering pain at the site. 

Shingles comes from the varicella-zoster virus and can only occur in someone who has already had chicken pox or who was exposed to chicken pox in the past. 

Once someone (usually a child) recovers from chicken pox, the virus goes into a dormant stage and “sleeps” in the nerve ganglions along the spine until it is reactivated. 

The chance of getting a shingles outbreak increases as we age, with the majority of cases occurring after age 50.  Reactivation of the virus occurs with a decline in the immune system, whether it be from age, a disease, an autoimmune disorder or immune suppressing medications, to name a few. 

A shingles outbreak is not widespread like rash of chicken pox.  It only occurs on one side of the body and along 1-2 nerve roots, with few exceptions.  So, if you have a rash on both arms or both legs, it very likely is NOT shingles.  The lesions are typically small red pustules that often develop into clusters.  The outbreak may be preceded by a headache, fatigue or a tingling sensation.  A unilateral rash on the face or head should be evaluated right away since there can be serious complications if the virus is in the eye. 

People with shingles can transmit the virus and cause chicken pox in someone who has never had chicken pox or who never had the chicken pox vaccine.  The virus is transmitted through contact with the shingles lesions or through the airborne respiratory particles.  Once the pustules start crusting over, they are no longer considered contagious. 

There is medication to help reduce the duration of the rash and it should be started within 72 hours to have the most benefit.  It is possible that the medication may also help to prevent something called post-herpetic neuralgia (nerve pain at the site of the rash that lasts beyond 3 months). 

And, last but not least, there is the shingles vaccine….another topic for another day!

If you suspect shingles, bring it to the attention of your doctor right away!  And talk to your doctor to see if the shingles vaccine is right for you! 

From my home to yours, Happy Thanksgiving!

Guest Author: Dr. Christine Pluta, Schuylkill Medical Associates, LLC

Dr Pluta

Dr. Pluta is a concierge house call physician who specializes in primary care for seniors.  She has been caring for seniors in Philadelphia for over 20 years.  If you are interested in having a house call physician who goes above and beyond to be your advocate and to keep you healthy at home, call 215-913-0892.

Written by Fountain View at Logan Square

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