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Shingles — A 'Pain in the Rash'

ByJOHN F. TONEY, M.D.
January 08, 2009, 5:27 AM

May 18, 2007 — -- "Worse than labor pains."

"Excruciating." "It changed my life." "Burning, stabbing, throbbing, shooting pain."

Reading the above complaints, one may find it hard to believe that all are attributable to a rash.

But if that rash is shingles, you could be in for a world of hurt.

Rashes are common problems for most persons during their lives, and many are brief and uncomplicated. Some, however, cause significant problems — and shingles is one of these problem rashes.

Many people are not familiar with shingles, a disease that can occur at any age, but is more common among older people.

Shingles, known in medical circles as Herpes Zoster, is a frequently painful disease that is marked by a blistering rash.

The cause of shingles — the varicella-zoster virus — is the same virus that causes chickenpox.

Shingles can affect an individual at any time without warning. More than 90 percent of adults in the United States have had chickenpox — placing them at risk for shingles — with the occurrence and severity of shingles increasing with age.

With the initial infection of chickenpox, some of the virus particles leave the skin blisters and move into the nervous system, traveling back down some of the nerve fibers that were involved with the chickenpox outbreak.

The virus then stays in these nerve fibers, where it is dormant, or "asleep." When the varicella-zoster virus reactivates (or "wakes up"), the virus moves back down these long nerve fibers to the skin, where the virus multiplies, causing the rash and the disease we know as shingles.

The shingles rash usually appears on one side of the face or body and lasts from two to four weeks. Its main symptom is pain, which can be very severe.

Other symptoms associated with shingles outbreaks can include fever, headache, chills and upset stomach.

Rarely, a shingles outbreak can lead to scarring, pain from mild stimuli — such as the touch of soft clothing or a light breeze — pneumonia, hearing problems, blindness, brain inflammation (encephalitis), or death.

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