Shingles are the reactivation of the herpes zoster virus that causes chicken pox. With the initial infection, chicken pox lesions are seen and they heal. These are described as dew drop on a rose petal in the medical literature. The lesions are red with fluid in the center and are in multiple stages at one time. Some are drying up and leaving as others are developing.
When the body’s immune system overcomes the virus, it lives dormant in the nerve endings in the skin, until something stresses the immune system and it allows the virus to reactivate (shingles).
In medicine, the skin on the body is divided into sections called dermatomes. When the virus reactivates, it is in one dermatome at a time. One person may have only one reactivation of shingles, or that same person can have repeated episodes. A few people have continuous problems with pain from shingles.
Shingles cause pain in the skin before lesions can be seen. Treatment with oral medications needs to start immediately in order to try to shorten the course of the shingles. A person with shingles can transmit chicken pox to a person who has never had the chicken pox or did not make antibodies to the vaccine. Care needs to be taken to not expose anyone with a depressed immune system, such as a person on chemotherapy, because they can develop chicken pox.
Gay Fulkerson, MD, is a board-certified family physician and wound care/hyperbaric specialist.