The Herpesviridae are a large family of herpes viruses that cause disease in humans and animals. The word derives from the Greek word “herpein,” which means “to creep.” The disease shingles, genital herpes or cold sores are all similar in that they remain within the body, dormant at times, and recur later on. The symptoms of shingles herpes sometimes mimic other types of herpes with blistering, itching and pain. Additionally, there is no proven “cure” for this classification of virus yet, although there are ways to limit risk and treat symptoms.

For microbiologists, the most telltale sign of herpes viruses, including shingles, is large double-stranded, linear DNA genomes that encode 100 to 200 genes containing viral proteins and viral mRNAs, which enable it to replicate quickly within the cells. What triggers the Herpesviridae and what causes shingles exactly is still unknown. At the start of the infection, the herpes virus particle looks for certain types of vulnerable receptor molecules on cell surfaces. Once the viral envelope glycoproteins bind to the cell membrane’s receptors, the virion gets inside the cell nucleus, where viral DNA replication begins. After the primary infection subsides, the latent virus remains in the body for years. Later, they may be reactivated to cause a headache, fever, painful rash, swollen lymph nodes and a depleted level of “killer” T-cells.

The herpes virus is known for its ability to dodge the immune system and remain in the body for extended periods of time. Shingles herpes, like cold sores and genital herpes, encodes a protein that mimics Human Interleukin-10, which the body recognizes as a safe component. The virus will also deregulate the Major Histocompatibility Complex I and II in cells that are infected. Basically, in layman’s terms, the herpes zoster virus suppresses cell-initiated immune response and inhibits the activation of natural killer cells.

Currently, there is no cure for the herpes family of viruses, although doctors say the following tips can help. Over-the-counter aspirin or ibuprofen can sometimes alleviate some of the other symptoms that come along with shingles herpes or herpes simplex. For chickenpox or shingles, an antivirus should be administered within 72 hours of noticing the painful rash. Many people take lukewarm baths to soothe the itch. It’s important to keep the area dry and clean. Wearing loose-fitting cotton clothing is a good idea to prevent the open sores from rubbing up against the fabric. Placing cool compresses on the sores can sometimes ease some of the pain as well. It’s always best to speak with a doctor before self-medicating.

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Doctors say the “creepy-crawly” shingles pain is far worse than the tell-tale abdominal bands of scabs. This inflammation and chronic nerve pain can linger for months or even years following the re-emergence of the varicella zoster virus. Karl R. Beutner MD, PhD, of the University of California at San Francisco explains, “There have been quality-of-life studies showing that a bad case of shingles is worse than a heart attack in terms of how long the pain lasts.”

The first sign of a chickenpox virus reactivation is a burning sensation on the nerve paths where the virus is traveling. Since the nerve paths run in half-circles around the body, the burning, itching, tingling shingles pain occurs on one side of the face, chest or abdomen only. Within the first 24 hours, patients will notice a fever and enlarged lymph nodes. Within 48-72 hours, the skin rash appears like small blisters on top of swollen, red skin. Unlike chickenpox, which spreads all over the body from finger tips to toes, shingles are confined to smaller areas on the face, abdomen and chest. After three to five days, the rash has reached its peak and is now beginning to burst, turn into sores and slowly scab over. After two to three weeks, the scabs fall off, leaving the skin to heal. For many people, the rash region is extremely painful for weeks or months after the scabs have gone. Something as simple as having a shirt touch the skin can send waves of nerve pain radiating around the body.

Some cases of shingles pain are more dangerous than others, doctors explain, due to their close proximity to the eyes. “If you get involvement with this virus on your cornea,” says Joseph Jorizzo MD, “it can actually produce a permanent, vision-affecting scar on the cornea.” Shingles of the face can sometimes lead to blindness, deafness, paralysis or brain swelling. If patients feel a persistent burning, tingling sensation at the tip of the nose, they should see a physician at once so they can immediately begin lessening the pain of shingles and decreasing their risk of developing one of these more serious conditions. In Mayo Clinic research from 1976-1998, 9% of shingles patients who went without antiviral therapy suffered serious eye conditions within 5 years (compared to 2% who received antiviral drugs).

Experts believe the culprit behind postherpetic neuralgia is a chain of amino acids (known as “substance P”) that gets released by damaged nerve fibers. The persistent nerve damage causes a persistent leakage of substance P, which rears its ugly head as chronic shingles pain. Of the many treatment options available, none seem to be reliably effective. The first line of treatment is usually nonsteroidal anti-inflammatory drugs like aspirin or lidocaine. Other doctors might combine an anti-seizure medication (like Tegretol) with an antidepressant (like Elavil). More studies are currently underway to find additional pain management avenues.

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The first symptom of shingles is pain on the face, abdomen or chest, radiating in a semi-circle on one side of the body. Several days later, the patient notices tear-drop size bubbles forming on the skin. The shingles rash can be mistaken for dermatitis, a spider bite or hives. Most people who contract shingles are over the age of 60, have a weakened immune system and may or may not have had chickenpox as kids. While shingles is not usually life-threatening, the condition can be excruciatingly painful, especially if not treated within the first 72 hours.

By the time you notice the red patches of the shingles rash on your skin, you have already had an active herpes virus in your system for one or two days. The shingles painful rash develops on one side of the face, chest or abdomen, where the nerves have been carrying the virus. The area where the rash develops is usually red, swollen and painful. The blistering is a brighter red and clusters together to form a “band-like” pattern around the body. During this time, an infected person could transmit the chickenpox virus to people who have never had it before. After three to five days, the blisters will scab over and the contagiousness phase is over. Within 2-4 weeks, the scabs fall off and the skin begins to heal.

Early treatment of the shingles rash is critical to prevent worsening of symptoms and a condition known as post-herpetic neuralgia, which is excruciating pain caused by nerve damage. Patients should be seen by their primary practitioner within three days of noticing their painful rash. Doctors say there should be no confusion about what someone is suffering from because very few other rashes are both itchy and painful. After asking a few basic questions and taking a look at the lesions, the doctor will usually prescribe Zovirax, Famvir or Valtrex to treat the herpes virus and prevent the symptoms from worsening or taking a long time to heal.

There are many over-the-counter pain medicine options to relieve the shingles rash pain. NSAIDs like ibuprofen, Motrin, Advil and Tylenol are commonly taken. Anti-itch creams containing hydrocortisone, like Cortaid or Aveeno Anti-itch Cream, can be found in most drug stores as well. Calamine lotion is commonly used on children with chickenpox, but it also works on shingles patients. For people with severe itching, Benadryl often helps.

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The shingles disease, also known as herpes zoster, is a virus related to the chickenpox virus that causes open sores on the skin that typically last from one to two weeks. This contagious disease can be passed to anyone who hasn’t had chickenpox, usually through direct skin contact. Once infected, the individual will develop chickenpox rather than shingles. Chickenpox is dangerous for people with weak immune systems, newborn infants and pregnant women, who should avoid people with shingles blisters, at all costs, until they’ve scabbed over.

Shingles begin with pain, burning, tingling and numbness in a small section on one side of the body. Several days later, a red rash begins stretching across the skin. Soon fluid-filled blisters break open and crust over, causing intense itching. For many people, the skin rash is accompanied by fever, chills, body aches, headaches and fatigue. Pain is the worst symptom of shingles however, which is sometimes so bad that people presume they’re having heart, lung or kidney problems. Occasionally, shingles will appear encircling the eye, which can lead to infection or permanent damage. Patients are advised to call a doctor if the rash becomes widespread and painful.

To diagnose shingles disease, the doctor need only read over your medical history and look for the telltale blistering rash. Sometimes the doctor will take a painless tissue scraping to examine the herpes zoster virus under a microscope in the laboratory. Typically, shingles subsides on its own within a few weeks, but doctors recommend prompt medical treatment to ease the pain, quicken the healing and reduce the risk of serious complications, such as facial paralysis, brain swelling, bacterial skin infections, eye infections, hearing difficulty and balance problems.

There are two vaccines that work to prevent shingles disease; the varicella vaccine (for chickenpox) and the varicella zoster vaccine (for shingles). The vaccine for chickenpox is one of the routine childhood immunizations recommended by doctors and schools, although adults who’ve never had the disease may also receive it. The zoster vaccine is recommended for adults who are age 60+ and who’ve already had the chickenpox at some point in their lives. There is no guarantee with these vaccinations, but they significantly reduce the risk, the course and the severity of the diseases. There are certain people who should not receive the vaccines, such as those who are allergic to gelatin or neomycin, people who have HIV/AIDS or an autoimmune disease, those who are taking steroids, radiation or chemotherapy, and patients with a history of bone marrow or lymphatic cancer.

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