Shingles – The Gift That Keeps on Giving
Herpes zoster, better known as shingles, will affect one in five Australians during their lifetime, with more than 220,000 adults aged over 50 diagnosed every year.
It is also one of the most commonly searched health terms on Google, so while it may be painfully prevalent, what’s clear is that we don’t know what it is, what it looks like or how to get rid of it.
So what is it?
Shingles is the reactivation of varicella zoster virus (VZV- the chicken pox virus) which has lain dormant in a dorsal nerve root ganglion.
Known also as herpes zoster, shingles can happen decades after the original infection.
There have been some reported cases of individuals contracting shingles after the chicken pox vaccination.
Reactivation of the VZV leads to a crop of painful blisters over the area of a dermatome – an area of the skin supplied by nerves from a single spinal root.
The shingles rash develops into itchy blisters usually occurring on one side of the body either on the face, chest, back, abdomen or pelvis, and can take several weeks to settle.
Around 1 in 100 Australians who are older than 50, are thought to have had shingles at some stage, however children can also get the condition.
The Chicken Pox Connection
You must have had chickenpox to get shingles. If you have had chickenpox in the past, the virus stays in the nerve cells near the spine, but is not active.
You cannot catch shingles from someone who has shingles. But, if you have not had chickenpox you can catch chickenpox by being in direct contact with fluid on the blisters of someone who has shingles.
Almost all people have had chickenpox by the time they turn 40 and may be at risk of developing shingles.
Sometimes shingles can occur with no known trigger. However, shingles is more likely to occur if you:
- Are older than 50, particularly those who are older than 80
- Have HIV and AIDS
- Have had an organ transplant
- Have recently had a bone-marrow transplant
- Have a condition which requires treatment that impacts the immune system, such as chemotherapy for cancer, radiation, immunosuppressive medication, lymphoma
- Are experiencing physical and emotional stress
- Have a depressed immune system
- Have a infected family member or close contact with an infected person
- Have had surgery or damage to the spinal cord
Many patients develop a painful postherpetic neuralgia (a nerve pain due to damage caused by the varicella zoster virus).
Some patients may present with a case where herpes zoster has appeared with pain in a dermatome region but without the characteristic rash.
This condition is known as zoster sine herpete and may be more complicated, affecting multiple levels of the nervous system and causing a number of complications including nerve pain in the brain or brainstem (multiple cranial neuropathies), pain in the nerves of the periphery (polyneuritis), inflammation of the spinal cord (myelitis) or the layers lining the brain (meninges) become inflamed (aseptic meningitis).
A diagnosis of shingles is generally based on clinical findings.
A common pathology test requested is the Antibody Detection tests which is performed via immunofluorescence and is used to distinguish zoster from herpes simplex.
Symptoms & Signs
Common signs and symptoms of shingles include the following:
- Pain is most often the first symptom. This pain can be characterised as stinging, tingling, numbing, or throbbing, and can be pronounced with quick intense stabs.
- Within 3 days an area of red lesions develop which gradually turn into small blisters filled with clear fluid, before they finally crust over.
- A general feeling of unwellness often occurs, with malaise, fever, headache, which may precede the rash.
- In some cases, the rash does not form blisters, but has an appearance much like urticaria (“hives”).
- Lesions may occur on the face (trigeminal ganglia), trunk (thoracic ganglia), shoulders and neck (cervical ganglia), and lower extremities (lumbar or sacral ganglia).
- Zoster ophthalmicus (singles infection of the eye) may occur if the ophthalmic branch of the trigeminal nerve is involved.
- Tingling and itching may progress to severe pain.
Diet and lifestyle may assist in the management of shingles.
- Rest as much as possible during infection to support immune function.
- Avoid or minimise stress as much as possible, as this reduces immune activity.
Diet should be based on fresh, whole foods. Nutrients are essential for adequate immune function.
The dietary approach is to control insulin levels, optimise nutritional intake and whole foods and eliminate pro inflammatory foods in order to support immune function.
The herpes family of viruses are particularly affected by a person’s L-arginine to L-lysine ratio. These are natural amino acids that are found inside the human body, but they come from foods. There must be a greater level of arginine in the body for herpes viruses to thrive.
Lysine is found in proteins, dairy, and most vegetables. Arginine is found in nuts, chocolate, and tomatoes. Use the chart below to ensure that the diet is higher in lysine foods, until the outbreak passes.
Avoid foods that inhibit immune activity and stimulate inflammation, such as saturated fats, refined foods (biscuits and bread), sugars, juice, excess alcohol and caffeine
- Echinacea – may help to boost immune function
- Olive leaf – may help to support immunity and has antioxidant properties.
- Zinc – zinc is necessary for healthy immune function
- Vitamin D – optimal vitamin D levels help support normal immune function.
Pain relief from shingles
Herbal remedies traditionally used to help with shingles pain include:
- St John’s wort
Taking good care of skin sores
- Avoid picking at and scratching blisters. If left alone, blisters will crust over and fall off naturally.
- Use cool, moist compresses to help ease discomfort.
There are a number of home remedies that have reportedly had some success with varying individuals
- Apply cornstarch or baking soda to help dry the sores so that they heal more quickly.
- To reduce pain, bring relief to the itching sensation and stimulate recovery, soak a cloth rag in apple cider vinegar (ACV). Next, sprinkle cayenne pepper powder over the lesions, and cover them with the dampened rag. Put a hot water bottle on top of the rag, or use some other safe source for heat. Exhibit care so as to not burn yourself or the individual.
- Luke warm oatmeal baths may provide relief from itching and burning. Place 1 cup of oats in a sock and let soak in tub. Squeeze the sock to release the soothing oat milk.
- Prepare a tea from peppermint leaf (Mentha piperita), cool and place in a spray bottle. Spray on lesions for temporary pain relief.
- Applying essential oils topically may help to provide pain relief and help the healing process of the affected areas of the skin. One of the best oils to use is bergamot. Bergamot has antiviral and antiseptic properties and combines well with tea tree oil and lavender against shingles. Lavender and German chamomile in a base of St John’s wort-infused oil may provide relief from postherpetic pain.
Postherpetic pain relief
Postherpetic neuralgia is sharp, stabbing, shooting pain that occurs more than a month after the initial attack of shingles.
The pain experienced as a result of shingles can range from mild to severe, and many people find it very distressing. The risk of this kind of pain increases with age.
Acupuncture has a long traditional use for the management of pain relief and has been shown to be of some benefit in postherpetic neuralgia.
Contracting shingles can leave an individual feeling very uncomfortable. By taking appropriate supplements, and modifying diet and lifestyle , the impact and duration of shingles can be minimised.
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