Thursday, October 1, 2009

Shingles Pain Management

By Barb Hicks

Are you one of the millions of people suffering from the pain of a herpes zoster outbreak? Herpes zoster is the wrath of chickenpox, otherwise known as shingles that affects millions of people in the US every year. Shingles is a painful red rash that turns into blisters that leak a clear fluid when the blister breaks open.

Shingles and chickenpox are caused by the same virus. It generally lies dormant in someone who has had the chickenpox as a child and becomes reactivated when an outside source has weakened the immune system later in life.

What weakens the immune system?

Shingles or VZV can be distinguished from Varicella or Chickenpox by the fact that it begins as a tingling or burning of the skin which follows the nerve route and only appears on one side of the body. Common causes for this viral infection include prolonged exposure to stress, chemotherapy patients, anti-rejection medications for transplant recipients and HIV/AIDS. All these sources weaken the immune system, thus allowing the dormant virus to come alive wreaking havoc on the body.

Time is a factor with the Herpes Zoster virus. In order for medications to work, they must be implemented within 72 hours of the initial outbreak. Unfortunately, this debilitating pain and discomfort can last up to six months and in some cases can become chronic, lasting for several years.

What you need to deal with the pain:

Excessive pain and discomfort accompany the Herpes Zoster virus. Therefore, pain medications and antivirals must be administered. However, in order for these medications to work, they must be implemented within 72 hours of the initial outbreak of symptoms.

Medications:

Corticosteroids: These would include the drug Prednisone which would then be combined with acyclovir. These will decrease pain while at the same time reduce inflammation of the nerves. In addition, these two medications when put together have also shown to decrease residual nerve damage.

Analgesics: Pain can range from mild to severe and relief may be obtained from over-the-counter analgesics when pain is mild to moderate, while narcotics may be needed for more severe pain symptoms.

Skin lotions such as calamine are great for combating pain when applied to the leaking blisters. In addition, capsaicin is effective for blisters that have crusted over. Furthermore, pain patches such as lidocaine or Xylocaine and nerve blocks are highly effective in easing zoster infection pain.

Eye Shingles or Herpes Zoster Keratitis is a severe complication of shingles. This condition is generally treated with antivirals and can lead to temporary or permanent vision loss. This condition requires immediate medical attention.

An additional serious complication of the zoster infection is Postherpetic Neuralgia. This condition is comprised of severe, debilitating pain that occurs long after the blisters have healed. Unfortunately, it can last for six months or longer and requires medications such as topical skin applications, analgesics, antidepressants, and anticonvulsants in order to manage it.

Herpes zoster is mostly seen in people 60 years of age and older, although children and young adults get it as well. Having had a prior chickenpox infection makes you vulnerable for developing shingles. However, if you have never had chickenpox before and have never been vaccinated against it, avoid people who have an active shingles infection, or you could find yourself with your first case of chickenpox!

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