The shingles can occur at any age, but usually affects people beyond mid-life. The shingles triggering virus (varicella-zoster) causes childhood chickenpox and then remains hidden in the nerve tracts. Under certain conditions, it can be reactivated - there is a shingles. The shingles, the specialist speaks of herpes zoster, is an acute, limited to certain regions infection, which is associated with highly infectious blisters and pain.
From chickenpox to shingles
The first infection with the varicella zoster virus usually occurs in childhood and manifests itself as a strong itchy chickenpox. Since the viruses are very infectious, the rate of infection is very high: after the age of eleven, 94 percent of the population have undergone this infection.
However, chickenpox does not completely disappear from the body after surviving the disease. Some remain "asleep" and held in check by the immune system for life in the ganglion cells of the nerves.
Under certain conditions, the viruses can be reactivated and cause unpleasant shingles. Depending on which nerve tracts are affected, the zoster infection pulls on one side and belt-shaped from the spine around the body, hence the name shingles.
The causes of reactivating the viruses are usually unknown, but it appears that with increasing age or, for example, in high stress, the immune status is lowered - the virus can then migrate back along the nerve tracts into the skin and cause shingles.
Even a weakened immune system due to a disease as well as intense UV radiation can promote the development of shingles.
Typical symptoms of shingles
The infection is initially noticeable as burning, itching or stinging pain .
The typical rash as one of the symptoms appears later - about 1 to 3 days after the virus reaches the skin. This rash consists of red patches on the skin and small blisters containing a virus-contaminated, infectious fluid.
The acute disease phase of shingles may also have the following symptoms:
- general fatigue
- a headache
After another 3 to 5 days, the bubbles break and gradually crusts, which fall off after 2 to 3 weeks. A shingles cure in most cases without consequences.
Shingles: start treatment early
The early treatment of shingles is important to stop the virus as early as possible and to prevent further damage to the nerves - the so-called post-herpetic neuralgia.
If early treatment is missed in people over 50 years of age and in the head or neck, this can lead to chronic pain lasting for months. Therefore, if you suspect a shingles you should immediately consult a doctor for treatment.
The immediately initiated acute treatment consists of two pillars:
- On the one hand from the medication with antiviral drugs.
- Secondly, the consistent treatment of the pain that causes shingles.
Rapid viral arrest is the basis for avoiding shingles complications. Quick relief of pain in the first few days can prevent postzosteroid neuralgia as a result of shingles.
Shingles: Postherpetic Neuralgia (PZN)
Especially the elderly can feel pain for months or even years on the areas affected by shingles, which are difficult to treat and can chronify. Shingles are no longer referred to as post-herpetic neuralgia (PZN). Once the pain has become chronic, it is often difficult to influence it.
The risk of this complication as a result of shingles increases with age. According to a rule of thumb, age is about the percentage risk. Postzosteric neuralgia (PZN) can in the worst case last for life and is sometimes unbearable for those affected.
Vaccination against shingles
Since 2013, a vaccine against herpes zoster is approved in Germany. The live vaccine is available under the trade name Zostavax® for people over 50 years. The vaccine reduces the likelihood of shingles infection and reduces the risk of severe disease progression, with the protective effect decreasing with age.
Another vaccine, which has been approved in the US since 2017, bears the trade name Shingrix® and is a so-called recombinant dead vaccine based, inter alia, on an antigen of the varicella-zoster virus.
If you are interested in a shingles vaccine, please discuss with your doctor if such a vaccine is suitable for you.
Incidentally, shingles is contagious only to people who did not have chickenpox. In direct contact with the secretion of the blisters, it is possible that it comes in the episode to an outbreak of chickenpox. However, a vaccine against chickenpox as a child does not protect you from getting infected in old age and subsequently getting shingles.
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