Shingles is caused by the varicella zoster virus, which is also responsible for chickenpox in children. If shingles develops, this means that the pathogen has been reactivated.
After the initial infection, the virus remains in the patient for life. Different situations, such as stress or a weakened immune system, can lead to a new outbreak. Since the viruses move via nerve tracts, the rash in shingles only occurs to a limited extent in the area that is supplied by the affected nerve. Shingles is associated with pain and a rash.
Shingles is caused by the reactivation of the varicella-zoster viruses, which stay in the body for life. As a result of a previous chickenpox infection in childhood, the viruses are stored in nerve nodes and, if the outbreak occurs repeatedly, they infect the supply area of the corresponding nerve.
The following symptoms are pain, paresthesia and an impressive rash, which is usually confined to the area where the nerve is supplied. After activation of the virus, pain and abnormal sensations in the nervous supply area occur after a short time. The Rash (Rash) is usually a few days in coming. This time span is called Prodromal phase and usually lasts for 3 to 5 days.
After this initial phase, if the pain persists, group-like vesicle formations develop. This process takes about a day. The vesicles fill with a clear liquid over 2 to 3 days and eventually merge into large bubbles. After the final blister size has formed, the contents of the skin appear cloudy. With the entry of lymph, the blisters burst and dry out over the next 7 to 12 days. With the formation of a yellowish crust, existing shingles heals in people with a functioning immune system over two to three weeks. Patients with weakened immune systems often struggle with shingles for longer. The rash keeps forming and the cycle of the disease repeats itself - for up to several months.
$config[ads_text1] not found
Since the immune system is weakened during the illness, one should avoid any exposure to it. You can find out whether you can drink alcohol during drug therapy for shingles on our website: Zostex and alcohol - is it compatible?
Read more about the duration of shingles, e.g. on the head, under: Shingles on the head - you should definitely pay attention to this!
The aim of therapy for shingles is to inhibit the multiplication of the varicella-zoster viruses; this is called antiviral therapy. In addition, an attempt is made to dry out the resulting bubbles as quickly as possible with zinc ointment. If this therapy regimen is started as early as possible, the disease can heal within two to three weeks and there is only a low risk of complications and long-term effects.
However, if shingles is not adequately treated, the course of the disease can take a long time and there is an increased risk of late effects, such as post-zoster neuralgia, i.e. permanent nerve pain after the disease has subsided. This is mainly due to the fact that the viruses can multiply longer without antiviral medication until the immune system can fight them effectively. In addition, the blisters take much longer to heal because they are not dried out by special ointments. For these reasons, without therapy, a duration of four to five weeks can be expected, which is associated with an increased risk of developing complications. Therefore, if you have shingles, you should always try to initiate adequate therapy as quickly as possible.
In principle, shingles can occur several times in the course of life, as the viruses that cause it remain in the body. However, a multiple outbreak is relatively rare. As a rule, there is only a second outbreak if various risk factors are present, such as an immune deficiency or a lot of stress. If no immunodeficiency is known and there have been several outbreaks of shingles, one should consider the presence of an immunodeficiency and carry out an appropriate diagnosis.
A patient becomes ill Shingles, so he typically develops a limited one Rash. In most cases (80%) this rash is preceded by a clinically silent phase, the so-called Prodromal stagein which there are no noticeable symptoms. Usually this stage lasts 3 to 5 days. After this period of time, initially inconspicuous spots develop. In the area of Erythema (Rash) will develop after 12 to 24 hours. These stand in groups and fill with clear liquid before they close after another 2 to 4 days larger blisters merge. Then the contents of the skin symptoms become cloudy. The blisters usually dry out over 7 to about 12 days. It arise Crusts over the areas on which the vesicles have formed. Until these have also disappeared, it usually passes in patients with a healthy immune system 2 to 3 weeks.
$config[ads_text2] not found
$config[ads_text3] not foundIf there were already problems with the immune system before the shingles became ill, the disease and the skin symptoms can continue for months. In the process, new groups of bubbles are formed over and over again and run through the cycle described.
The unilateral pain in shingles is concentrated on the area that is supplied by the affected nerve. The pain is often one of the first symptoms and occurs shortly after the virus has reactivated. In addition, general symptoms of the disease can develop, which can be accompanied by headaches. The pain in the innervation area (supply area of the nerve), in which the rash subsequently develops, remains during the acute course of the disease.
The pain should be relieved as it heals. In order to avoid a later chronification, the pain can be relieved with medication.
In some cases a so-called Post-zoster neuralgia (nerve pain after shingles). The affected area hurts for a long time after the actual disease has healed. The risk group is people aged 55 to 60 years. Months of pain therapy with different approaches can be the result of such a complication.
Read more on the subject at: Shingles pain
The actual nerve pain, which is associated with shingles in almost all cases, subsides within the next two weeks as the disease heals. The therapy of this pain is the focus of the treatment in addition to the antivirals and the drying out of the blisters. However, in some cases, the nerve pain caused by the viruses can last longer.
From four weeks after the actual illness has subsided, one speaks of so-called post-zoster neuralgia. This can become chronic and the pain therefore persists. Particular risk factors for developing such chronic nerve pain are above all the occurrence of shingles in the head area and the increasing age of those affected. For example, 70 to 80 year olds have a very high risk of developing post-zoster neuralgia as a result of shingles, which requires adequate therapy.
$config[ads_text4] not found
In most cases, itching is one of the first signs of shingles before the typical symptoms such as belt-shaped vesicles or nerve pain occur. The itching is limited to a circumscribed area of skin that is sensitively supplied by the affected nerves. The itching usually gets worse as the typical blisters form, but it also disappears as they heal. For this reason, the use of zinc ointment to dry out the blisters also has a very good effect on the very unpleasant itching. For most patients, this process takes about three weeks after the first symptoms appear.
In terms of the development and the actual symptoms of the disease, there are actually no differences between shingles of the face and other regions of the body. Thus the normal duration of illness is between three and four weeks. It is important to know, however, that shingles on the face can increasingly be associated with various, sometimes very serious, complications. In addition to the increased risk of developing neuralgia and nerve pain, these also include blindness or hearing loss, even if these complications only occur very rarely. Such severe consequences can persist even after the actual shingles has healed.
Read more on the subject at: Shingles on the face
The Shingles does not necessarily have to be treated for patients under 50 years of age, as the immune system can deal with the pathogens independently. In patients over 50 years, at difficult courses, if infected in Area of the head or on the neck, at weakened immune system and at Involvement of the cranial nerves should have antiviral treatment Antivirals to support the immune system.
If the attending physician decides on drug therapy, this should be started as soon as possible. For the best possible therapeutic success, the first dose should be administered within the first 48 to a maximum of 72 hours after the first skin abnormalities were noticed. Usually the antiviral treatment Carried out 7 days, whereby the dosage can vary from drug to drug. Good doctor-patient communication is important here. Become the antivirals Glucocorticoids (e.g. Prednisolone), their administration may take longer because the dose is slowly reduced over 10 to 14 days. Painkillers may also be needed for a long time, as the Pain after shingles often take longer than the actual disease. The dosage and duration of the administration is to be adjusted individually to the pain perception of the patient.
$config[ads_text1] not foundThe occurrence of shingles does not mean that you are not allowed to shower for three to four weeks. In general, care should be taken to keep the affected skin area as dry as possible and to protect it. However, hygienic measures should not be underestimated here either. It is recommended to reduce normal showering habits a little and not to apply any shampoos or similar to the skin area.In addition, zinc ointment should be applied to the skin after a shower so that the blisters dry out.
In principle, exercising after the shingles have completely healed is not a problem, as long as you feel fit enough. It is important, however, that you should refrain from such activities as long as there are still blisters, as the primary goal of therapy is to dehydrate these blisters.
If you are now physically active and sweat, this prevents dehydration and allows bacteria to attach themselves to these open and damp areas. So you shouldn't start exercising too early, as this can greatly prolong the healing process of shingles. In addition, shingles is always accompanied by a feeling of exhaustion and tiredness, which should first be cured before you start to do full sport again.
With regard to the risk of infection, shingles behaves like its predecessor, chickenpox. When the last blisters are dried out and crusted, the risk of infection is over. The fluid in the vesicles plays a key role: it contains the viruses that are transmitted upon contact. Contact with people who have already had chickenpox or even shingles is usually not a problem. The disease will not be transmitted to people who already have the virus and are immunized.
However, you should be careful with people who have not yet had chickenpox and therefore do not have active protection against the viruses. If such a person comes into contact with the contents of the skin blisters, the virus can be transmitted - which in the infected person does not trigger shingles, but chickenpox. In adults, it can sometimes become severe.
Read more on the subject at: How contagious is shingles?
The duration of the incapacity for work or sick leave depends on the course of the disease and certain risk factors. As a rule, sick leave takes place for the period in which the patient is potentially contagious. This period of time varies depending on the course, but can generally be assumed to be around 2 weeks (sometimes 3 weeks). For certain professions or very mild courses, there is the possibility of resuming work early. This does not include people with professions that require close contact with people, e.g. educators or medical staff. Risk patients should also take it easy and allow a certain period of time before resuming professional activities. These include elderly people (over 55 to 60 years) and, for example, patients with a weakened immune system.
$config[ads_text2] not found
