June 17, 2009 --
The Centers for Disease Control estimates about 1 million Americans are diagnosed with shingles every year, a painful skin rash caused by the varicella zoster virus -- the same virus that causes chickenpox. Shingles is a condition that occurs when the virus that originally caused chickenpox reactivates in the body. Although the varicella zoster virus always remains in the body after chickenpox, not everyone comes down with shingles. Experts say factors that contribute to the reactivation of the virus include old age, cancer, leukemia, lymphoma, HIV and taking immunosuppressive drugs like steroids. Anyone who has recovered from chickenpox can develop shingles -- including children -- but the condition most often affects people over 50 years of age. Second or third cases of shingles are rare. Although shingles itself isn't contagious, the virus can be spread and cause chickenpox in a person who hasn't been exposed to it. The condition can only be spread by direct contact with the rash. SYMPTOMS:
Shingles usually surfaces as a rash on one side of the face or body, often in a band across waistline. Before the rash breaks out, the person may experience a burning feeling, tingling pain, numbness or itch. Other symptoms can include fever, headache, chills and upset stomach. For most healthy people who receive prompt treatment after the outbreak of blisters, the rash heals and pain subsides within three to five weeks. However, shingles can be a serious health threat to people with compromised immune systems, especially if the system is weakened by HIV infection or cancer treatment.
PAIN LEFT BEHIND: For about 10 to 20 percent of people who suffer from shingles, a problem called postherpetic neuralgia remains after the rash subsides, according to Mayo Clinic. Postherpetic neuralgia takes place when nerve fibers are damaged during an outbreak of shingles. Those nerves send confused, exaggerated messages to the brain that cause chronic, often excruciating pain that can last years after shingles. About 50 percent of adults older than 60 experience the condition after shingles.
TREATMENTS: To treat postherpetic neuralgia, doctors sometimes recommend antidepressants, which alter the way the brain interprets pain. In other cases, anticonvulsants or injected steroids may be the best course of action. Painkillers like Percocet or OxyContin offer relief but carry the risk of addiction. Lidocaine patches are small, bandage-like patches that deliver pain-relieving medication directly to the skin. One advantage of patches is the lack of side effects that often accompany oral medications. Researchers are investigating a new kind of pain-relieving patch that uses a chemical called capsaicin to dull the pain caused by postherpetic neuralgia. Capsaicin is the chemical in hot peppers that makes them spicy, and it also affects the way nerves function. A recent Lancet study that investigated the effects of the capsaicin patch on 402 people with postherpetic neuralgia found 40 percent of patients experienced pain relief. The average drop in pain was reported to be 30 percent.
FOR MORE INFORMATION, PLEASE CONTACT:
UW Health East Pain Clinic (608) 263-9550