Call it shingles. Call it herpes zoster. Call it zona. By any name, it can be described in just one word: ouch!
The likelihood of developing shingles increases with age, affecting the elderly most frequently and with the most severity, but it gets its start in childhood. About 95% of the American population has been exposed to the virus, varicella zoster virus (VZV), the bug that causes chicken pox. Once that miserable rash of childhood clears up, it’s no promise the virus goes away, too. That virus hangs around in the body forever, just waiting for the opportune moment to spring back to itchy life in the form of shingles.
When dormancy ends and the virus returns, an outbreak of shingles causes incredibly painful blisters to form in a band-like pattern along a nerve. Shingles outbreaks usually cluster on one side of the body causing pain that ranges from very uncomfortable to debilitating. Outbreaks can last several weeks or linger for years. Because the reactivated VZV targets the nerves, permanent damage to the nerve is always a concern.
Until recently, the only remedies for shingles involved pain management. There was no way to confront the virus itself. Now, however, several proven effective in viral inhibition and are especially beneficial in patients who suffer from compromised or suppressed immune systems. Patients who suffer recurring bouts of shingles may find the most relief by taking several oral doses throughout the day. Those with compromised immunity may find the best relief when it’s administered intravenously (by IV). Healthier patients, with no impairments to the immune system, are likely to find relief when antiviral treatments begin within the first 72 hours after the rash develops.
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Corticosteroids are often used to treat various forms of infection although clinical trials don’t always confirm the benefits of the steroid use. One trial that does substantiate the benefit compared patients 50 years old or more who had localized outbreaks of shingles. A control group used acyclovir for one month while the test group took acyclovir and prednisone, too. Lesions healed about twice as fast when prednisone (steroid) was taken along with the antiviral drug (acyclovir).
Clinical trials revealed such impressive results with Zostavax, a vaccine against VZV, that the Centers for Disease Control and Prevention (CDC) issued the strong recommendation that it be administered to everyone over age 60. The CDC announcement came after the vaccine met approval by the US Food and Drug Administration (FDA) in 2006. In clinical trials, the rate of shingles drop by about 50% in all age groups who were given the vaccine but the group aged 60 to 69 fared the best, with a reduction of occurrence of 64%.
Prompt, effective treatment is desirable to reduce pain and heal the unsightly lesions the VZV causes but it promotes improved quality of life after the outbreak is over, too. The longer and more severe the outbreak, the greater the risk of lasting damage to the affected nerves.
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