Facts:

*After an individual has been exposed to the varicella virus through chickenpox or via vaccination, the virus remains dormant in the dorsal root ganglia of a nerve. Herpes Zoster (HZ) or shingles is caused by the reactivation or release of this varicella zoster virus.

*According to the Center for Disease Control (CDC), there are over 1 million cases of shingles in the US each year and 1 out of 3 people will experience shingles in their lifetime. Cases of shingles have increased significantly during the COVID epidemic primarily due to accumulated stress.

*The risk of getting shingles becomes higher with age (over 50, but individuals even in their 20’s can get shingles) and for individuals with chronic health conditions, weak immune systems or taking immunosuppressive medications like corticosteroids.

*Shingles are not contagious and cannot be passed from one person to another. It can, however, cause chickenpox in someone who never had chickenpox before if they came in direct contact with the fluid oil of a shingles blister.

*Shingles affects mostly one dermatome or area of skin that sends signals to the brain through spinal nerves. While shingles can appear anywhere on the body, it primarily wraps around either the left or the right side of one's torso. However, 2 to 3 separate areas of the body can be involved including cranial and peripheral nerves which can cause serious eye damage. 

*Shingles generally begins as a rash or erythematous papules (reddening of the skin, usually in patches), progresses to pustules after 3-4 days and scales or crusts over in 7-10 days. Pain can be constant or intermittent and is often described by patients as burning, throbbing or stabbing sensations. Up to 75% of patients report some level of internal pain or tingling sensations days or weeks before an actual rash appears as the virus attaches to the roots of the nerves. As one's immune system goes into high gear to drive out the virus, patients may also experience a low grade fever and chills, flushing of the skin, headache, fatigue, decreased appetite, brain fog, nausea and vomiting or general malaise 48-72 hours before a rash appears. After the rash does appear, the shingles pain will probably get worse and itching may present itself. 

*Postherpetic neuralgia (PHN) is the most common complication of shingles, causing persistent pain in the lesion-affected area which generally lasts for 2 to 6 weeks. PHN pain, however, can last for many years causing great discomfort and disability for many. Among those 60 and older, 13% will develop PHN after contracting HZ. 

*Early diagnosis and treatment is key to success especially the use of antiviral medications within 72 hours of the onset of symptoms (acyclovir in tablet and/or topical cream or ointment; valacyclovir and famciclovir). Antiviral medications can stop the multiplication of the virus, lesion and the severity and duration of the pain, prevent the formation of new lesions and promote the rapid healing of existing lesions.

*In addition to antiviral medications, applying cold compresses to rashes can help reduce pain and cool oatmeal baths, calamine lotion and Benadryl can help with itching. For nerve pain, doctors often prescribe ibuprofen, gabapentin capsules/ tablets or lidocaine patches or creams to help freeze the pain. 

After years of treating patients with shingles, Wellness Rx also recommends: 

Taking one tablespoonful of Elderberry Tonic at the first signs of shingles every 4 to 6 hours along with 500 mg. of Vitamin C. Elderberry tonic is a fast immune booster and is anti-viral.

Applying the powerful astringent Burow’s Solution (acetic acid) directly to rash patches to help relieve itching and reduce inflammation.

Applying a blended mixture of Comfrey ointment, Lemon Balm Extract and Silver Ointment in a special homeopathic pain cream. Comfrey helps with inflammation, to remove heat from the body and with the regeneration of new skin cells. Lemon Balm and Silver Ointment are antiviral and the special homeopathic base cream helps to break up fluid in the inflamed pain areas. Lidocaine viscous and acyclovir suspension can be added to the formula at the request of a health provider. It is not recommended to apply this cream to open lesions or areas that nerve endings may be exposed.

For open lesions, we recommend applying silver ointment alone to help prevent any infection. Silver ions kill all types of germs by interfering with their oxidation process of the pathogen. 

*Shingles can be dangerous for some patients especially if the face and eyes have been impacted. This can result in permanent vision loss, bacterial infection or full or partial muscle paralysis (Palsies). According to JAMA, shingles of the eye have tripled in the US. It is highly encouraged that anybody experiencing shingles on the face or eyes see an ophthalmologist as soon as possible.  It is also encouraged that one sees a doctor if after about 5 days new lesions keep forming, a new fever has developed or the nerve pain becomes more severe.

For patients over age 50, a herpes zoster vaccine is available and often covered by one's health insurance. The first vaccine approved by the FDA in 2006 was a live vaccine called Zostavax which was provided as a single subcutaneous injection. The vaccine claimed a 50% probability that the patient would never experience shingles again and if they did, the symptoms and potential nerve damage would be reduced. In 2007 the FDA approved a zoster vaccine recombinant (DNA or gene technology), adjuvanted called Singrix which works by increasing the body’s immune response. Singrix claims a 90% probability of no shingles return after receiving a series of two intramuscular injections given 2 to 6 months apart. Early results from the Singrix injections, however, are showing a relatively high number of side effects including injection site reactions (pain, redness, and swelling), tiredness, muscle pain, headache, shivering, fever, stomach pain and nausea. In most cases, the side effects go away in less than 3 days.

‍

Wellness Rx offers consultations and evaluations if you think you are having a shingles outbreak. Everything recommended in this article is available at Wellness Rx Pharmacy on the mountain top in Tannersville, NY.

‍