Dear Readers

Geneviere from Manchester asks Lifeline: "What is shingles?" Her grandmother had a rash on one side of her body which spread around from her back to under her armpit and towards the front of the chest.

The rash is still painful. The doctor told her it was shingles and gave her medication. The rash took several weeks to clear up but her grandma is still experiencing pain and burning, and there are dark marks left on her skin. Geneviere is concerned that the shingles rash is still causing pain, even though it has cleared up, and the regular pain medication is not helping.

Chickenpox

Shingles is a form of chickenpox, which is caused by the virus, herpes zoster. When a person is first infected with the herpes virus and contracts chickenpox, they experience a generalised itchy, vesicular rash (a rash with a lot of small water and pus-filled blisters). After the chickenpox has seemingly disappeared, the virus becomes dormant in the nerve roots of the body. It never leaves the person. Later in life, under conditions of physical or emotional stress or depressed immunity, the virus can be reactivated. It presents itself in the adult as shingles.

Shingles often starts out with severe pain and itching on one side of the body, either at the face or the trunk level. The affected area of skin gets its nerve supply from nerves whose roots are infected with the herpes zoster virus.

A few days after comes the pain with small blisters appearing over the area, spreading out along the path supplied by the affected nerve on that side of the body. The blisters last two to three weeks, during which pain can be severe. The blister begins to dry up, form crusts and heal. Pain, some scarring, and sometimes even numbness, may continue for a long time after the blisters heal, even up to one year afterwards. This pain and numbness is called post-herpetic neuralgia. Occasionally shingles occurs near the eyes and can affect vision or cause a viral encephalitis (brain infection), especially in old people. This can be life threatening.

There is no known cure for any type of herpes infection, but the antiviral agents such as zoniraz, famvir and valtrex, when taken orally, often shorten the time required for healing of the blisters and also seem to lessen the pain experienced. The earlier these drugs are started, the better the results will be. Calamine lotion and topical zovirax (acyclovir) can also be applied directly to the skin to lessen the pain and itching experienced.

Pain kilers

Most of the commonly available pain killers can be taken for the pain, for example Panadol, Advil, Aleve, Napnosyn, Cataflam, Voltareen, Pirox, Cam. However, with severe nerve pain, these drugs might not help very well and more potent drugs, which focus on treating nerve pain, might be needed to diminish the discomfort, e.g. Tegnetol, neurontin.

Fish oil and vitamins B complex, B12 and vitamin C are all anti-inflammatory in action and boost the immune system.

They may also shorten the duration of the discomfort.

Write Lifeline

P.O. Box 1731

Kgn. 8