Shingles

Encyclopedia of Alternative Medicine by Liz Swain

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Definition

Shingles, also called herpes zoster, gets its name from both the Latin and French words for belt or girdle and refers to girdle-like skin eruptions that may occur on the trunk of the body. The virus that causes chickenpox, the Varicella zoster virus (VSV), can become dormant in nerve cells after an episode of chickenpox and later re-emerge as shingles.

Initially, red patches of rash develop into blisters. Because the virus travels along the nerve to the skin, it can damage the nerve and cause it to become inflamed. This condition can be very painful. If the pain persists long after the rash disappears, it is known as post-herpetic neuralgia (PHN).

Description

Any individual who has had chickenpox can develop shingles. Approximately 300,000 cases of shingles occur every year in the United States. Overall, approximately 20% of those who have had chickenpox as children develop shingles at some time in their lives. People of all ages--even children--can be affected, but the incidence increases with age. Newborns, bone marrow and other transplant recipients, and individuals with immune systems weakened by disease or drugs are also at increased risk. However, most individuals who develop shingles do not have any underlying malignancy or other immunosuppressive condition.

Causes & symptoms

Shingles erupts along the course of the affected nerve, producing lesions anywhere on the body. The condition may cause severe nerve pain. The most common areas to be affected are the face and trunk, which correspond to the areas where the chickenpox rash is most concentrated. There is usually a vague line from the spine along the path of the affected nerve on one side of the body.

The disease is caused by a reactivation of the chickenpox virus that has lain dormant in certain nerves following an episode of chickenpox. Exactly how or why this reactivation occurs is not clear. However, it is believed that the reactivation is triggered when the immune system becomes weakened as a result of age, stress, fatigue, certain medications, chemotherapy, or diseases such as cancer or HIV. Furthermore, in persons with HIV, shingles can be an early sign that the immune system has deteriorated.

Early signs of shingles are often vague and can easily be mistaken for other illnesses. The condition may begin with fever and malaise (a vague feeling of weakness or discomfort). Within two to four days, severe pain, itching, and numbness/tingling (paresthesia) or extreme sensitivity to touch (hyperesthesia) can develop, usually on the trunk and occasionally on the arms and legs.

Pain may be continuous or intermittent, usually lasting 1-3 weeks. It may occur at the time of the eruption, but can precede the eruption by days, occasionally making the diagnosis difficult.

Signs and symptoms may include the following:

• itching, tingling, or severe burning pain
• red patches that develop into blisters
• grouped, dense, deep, small blisters that ooze and crust
• swollen lymph nodes

Diagnosis

Diagnosis usually is not possible until the skin lesions develop. Once they develop, however, the pattern and location of the blisters and the type of cell damage displayed are very characteristic of the disease. This allows an accurate diagnosis based primarily upon the physical examination. Although tests are rarely necessary, they may include the following:

• Viral culture of skin lesion.
• Microscopic examination using a Tzanck preparation. This involves staining a smear obtained from a blister. Cells infected with the herpes virus appear very large and contain many dark cell centers or nuclei.
• Complete blood count (CBC) may show an elevated white blood cell count (WBC), a nonspecific sign of infection.

Treatment

A person with shingles should immediately see a doctor or health practitioner. Although the condition generally clears up within three to five weeks, treatment can ease the painful symptoms. Alternative medicine remedies and therapies will not cure shingles, but they will provide pain relief, reduce inflammation, and speed recovery.

Herbal remedies

Many herbs can be used to treat shingles. Some remedies involve brewing tea and then consuming and/or applying it to the affected area. Herbs used to treat shingles include:

• Red pepper, also known as capsicum or cayenne, is so effective that it's an ingredient in commercial ointments approved by the U.S. Food and Drug Administration. Commercial preparations include Zostrix and Capzasin-P. Red pepper is hot, so the ointment should be applied only to healed blisters. Red pepper is useful for treating painful PHN.
• Topical applications of lemon balm , licorice, or peppermint may reduce pain and blistering. These herbs may be brewed as teas and then consumed and applied to the skin.
• Herbal antivirals, such as echinacea, can be effective in fighting infection and boosting the immune system.
• Calendula ointment or lotion works to counter the virus.
• Sedative herbs such as passionflower can be brewed for a tea. Such herbs can help with treatment of post-herpetic neuralgia.
• Vervain helps relieve pain and inflammation. St. John's wort, lavender, chamomile, and marjoram also help relieve inflammation.