Shingles: Symptoms, Causes, and Diagnosis

Shingles disease is a viral infection that causes a painful rash and can appear anywhere on the body. It typically presents as a single stripe of blisters wrapping around the torso’s left or right side. Shingles causes are linked to the varicella-zoster virus, the same virus that causes chickenpox. Shingles disease is not life-threatening but can be very painful.

What Is Shingles?

Shingles virus is a viral illness that leads to painful shingles rash or blisters. The rash often appears as a band of rashes or blisters in a specific body area. Shingles stages include three phases:

1. Prodromal stage
2. Active stage
3. Healing stage

Shingles usually last 2 to 6 weeks, but postherpetic neuralgia (PHN) may cause lingering pain.

What Causes Shingles?

Anyone who has had chickenpox might develop the shingles virus as it enters the nervous system and stays inactive for years. The shingles virus, particularly the varicella-zoster virus, may sometimes reactivate and travel along the nerve pathways to the skin, leading to shingles. However, everyone who has chickenpox will not develop shingles virus.

The reason for shingles remains unclear, but shingles causes may be linked to lower immunity to infections as one grows old. Shingles disease is more common in older adults and people with weakened immune systems. The varicella-zoster virus is part of the herpes virus family. This is the same group of viruses that cause cold sores and genital herpes. This is why the shingles virus is also known as herpes zoster.

What Are the Symptoms of Shingles? 

Shingles symptoms occur in stages, changing as the infection progresses. Shingles stages follow a specific order, starting with mild discomfort and advancing to more severe skin and nerve complications. They include:

1. Early Shingles Symptoms (Prodromal Phase): Burning, tingling, or pain in a specific area, sometimes with fever and headache.

2. Rash Development: Red shingles rash appears, followed by fluid-filled blisters in a band-like pattern.

3. Blistering Stage: Blisters grow, may burst, and can be very painful.

4. Scabbing and Healing: Blisters dry, form scabs, and gradually heal over a few weeks.

5. Postherpetic Neuralgia (Possible Complication): Some may experience long-lasting nerve pain even after the shingles rash clears.

What Are the Risk Factors for Shingles? 

Some of the factors that might increase the risk of developing shingles include:

1. Age: Early shingles become common with age, mostly affecting people over 50. People over the age of 60 may experience severe complications.

2. Some diseases: Diseases that weaken the immune system, such as HIV/AIDS and cancer, might increase the risk of shingles virus.

3. Medications: Prolonged use of steroids and immunosuppressive drugs for organ transplant recipients can increase the risk of early shingles.

How Is Shingles Diagnosed? 

Shingles symptoms can be diagnosed from the appearance of a rash, which usually forms a band on one side of the body. However, in some cases,  a herpes zoster test may be required to confirm the diagnosis:

1. Polymerase Chain Reaction (PCR) Test: A sample is taken from a blister, crust, or blood and tested for the varicella-zoster virus (VZV) DNA. This test is highly sensitive and commonly used to confirm the shingles virus, especially in cases with unclear herpes zoster symptoms.

2. Direct Fluorescent Antibody (DFA) Test: A sample from a blister is stained with fluorescent antibodies that bind to the shingles virus, making it visible under a microscope. This test is faster than PCR but less sensitive.

3. Tzanck Smear Test: A scraping from a blister is examined under a microscope to detect characteristic multinucleated giant cells. It is quick but does not differentiate between varicella-zoster virus and herpes simplex virus (HSV). This test can help identify viral skin infections, including what is shingles.

4. Varicella-Zoster Virus (VZV) Antibody Test: It is a blood test that measures antibodies produced against the varicella-zoster virus. It helps determine past exposure but cannot diagnose an active shingles virus infection.

How Can Shingles Be Prevented? 

The Shingrix vaccine helps prevent the shingles virus and is recommended for:

1. People aged 50 and older, whether or not they have had shingles symptoms.
2. People aged 19 and older with weakened immune systems due to certain diseases or medications.

Although shingles is not life-threatening, it can lead to serious complications if not detected early. Any herpes zoster symptoms should be evaluated by a doctor promptly for diagnosis and appropriate care. After consultation, book a PCR varicella zoster virus test with Dr Lal PathLabs for accurate shingles disease diagnosis.

FAQs 

1. What is shingles? Is the shingles virus contagious?

Shingles is a viral disease that causes a painful shingles rash. It itself does not spread, but the varicella-zoster virus can infect someone without prior chickenpox exposure, leading to chickenpox instead.

2. Is shingles dangerous or even fatal?

Shingles disease is not usually life-threatening but can cause complications like blindness, hearing loss, pneumonia, and brain inflammation.