2023-06-01 04:55:00
Recently, there is a disease that actor Ma Dong-seok has declared as an ‘enemy of immunity’ in TV commercials. It is shingles that often occurs during the change of seasons when the daily temperature difference is severe. Today, we will look at the most frequently asked questions from patients regarding what kind of disease shingles is and how to prevent it.
1. What kind of disease is shingles and who gets it?
Shingles is a viral skin disease caused by the Varicella-Zoster Virus, a type of herpes virus (herpes type 3) that penetrates the nerves and causes pain along with rashes or blisters on the skin. .
It is often caused by a decrease in immunity due to old age, but if a young person is infected, it is usually caused by overwork or a decrease in immunity due to severe stress. However, it is rare that stress is the cause, and nutritional imbalance due to excessive diet or the habit of filling one meal with carbohydrates (ramen noodles, grain milk), and the habit of consuming only excessive carbohydrates without eating fat or minerals (fruits, vegetables) In most cases, immunity is low. In addition, there are cases where immunity is weakened due to lack of physical activity, so it can be seen that the usual lifestyle affects awakening the latent virus.
Recently, a research paper was also published stating that the risk of developing herpes simplex or shingles in relation to COVID-19 infection has increased. Another study reported that the risk of developing herpes zoster was regarding 15% higher in the confirmed group of COVID-19 compared to non-confirmed patients, and in particular, the risk increased to 21% in patients hospitalized with severe COVID-19.
According to the British NHS website, regarding 1 out of 4 people experience shingles, and in Korea, according to the National Health Insurance Corporation, 1 out of 3 people have the disease, and two-thirds of all patients are over 60 years old and female are 1.6 times more likely than men. The number of patients, which was 480,000 in 2010, increased significantly to 750,000 in 2018. In addition, neuralgia following skin disease appears in 1 in 4 people, and the probability increases with age.
2. How do you get shingles?
The identity of the shingles virus is the varicella virus, which has been infected at least once as a child. After causing chickenpox in childhood, the chickenpox virus remains dormant in the dorsal root ganglion, which makes up the spinal cord. . Therefore, if you have not had chickenpox, shingles does not occur until you die, and it is impossible to cure it because it repeats latent and onset like herpes. If you’ve had chickenpox, you need to maintain your immunity to avoid getting shingles.
So theoretically, if you’ve never had chickenpox, you shouldn’t get it. However, in the case of the elderly, the quarantine status was not good when they were in school, and even if it was not expressed as chickenpox, it is recommended to get vaccinated as much as possible because only the virus can remain dormant and suddenly appear due to its unique contagiousness. This vaccination refers to the shingles vaccine, not the chickenpox vaccine.
3. Are the symptoms of shingles only blisters and pain? You say it hurts a lot, but how much is it?
Shingles usually causes symptoms along the nerve trunk near the waist or lower chest, but in fact, it is a skin disease that can occur all over the body like athlete’s foot.
The main symptoms include red spots, blisters, pustules, scabs, skin paresthesia, headache, and pain. In the beginning, red spots appear around the skin, then turn into blisters and spread to the entire skin along the nerve trunk. Since these blisters are created along the nerve trunk, they feel hot and quite painful when touched, but one or two out of 10 people have no pain at all, and some feel itchy like an insect bite. Of course, treatment should not be neglected just because the pain is less. Although acute pain is not severe, there are cases where severe pain begins as neuralgia begins to take root.
And this pain may vary from person to person, but in the worst case, a strong pain that cannot be tolerated with over-the-counter painkillers comes. In particular, the most severe pain is the head, and in severe cases, you can feel the pain as if you were hit in the head with a hammer. Even in this case, the pain can come as if it is pulled out not only in the wrist but also in the arm and elbow and shoulder.
Therefore, it can occur on almost any part of the body surface from the scalp to the soles of the feet, and usually occurs most often in the abdomen and armpits near the chest, followed by the eyelids, nose, and forehead. Occasionally, it occurs in the eyeball. In this case, vision deteriorates and spreads to the pupil, which can lead to blindness. If it spreads to the brain, it is a dangerous skin disease that causes meningitis.
4. What is the difference between shingles and herpes simplex?
Blisters, or blisters, occur in both diseases, but it is easy to distinguish by location and pain.
Herpes simplex occurs in clusters of small blisters, and recurrence is common. Herpes simplex is divided into type 1 and type 2. Type 1 occurs around the lips, type 2 occurs around the genitals, and type 2 is classified as a sexually transmitted disease. In most cases, symptoms and complications are not severe.
On the other hand, shingles appears anywhere on the body along the dermatome and is most common on the trunk. The biggest difference from herpes simplex is that it is accompanied by pain rather than itching. Even following the blisters subside, the pain persists for more than 1 to 3 months, so early diagnosis and treatment are very important.
5. Do blisters not become scars?
If the symptoms of both herpes simplex and shingles are severe, the blisters may later progress to ulcers or scabs, leaving scars as they heal. It should be noted that even if the blisters are not deep, temporary pigmentation may occur at the site where the blisters were formed.
6. Is shingles contagious to other people?
When a shingles patient occurs in a family member living with you, you become very concerned regarding whether or not you are contagious to other family members, but the conclusion is “It can be contagious.”
However, it is not contagious to others in the form of shingles, and the chickenpox virus is contagious to the body. Since the varicella virus is contained in the shingles blisters, it can be transmitted through direct skin contact. In other words, the chickenpox virus in the blisters can be transmitted to a person who has a weak immune system and does not have the chickenpox virus itself. For those who have already had chickenpox as a child, it can be considered irrelevant because they already have the virus in their body, but the problem is that infants who do not have the chickenpox virus are at risk of being infected with the chickenpox virus. It is characterized by the onset of systemic urticaria, such as chicken pox, rather than appearing as a form.
Therefore, since it is fatal for those with low immunity, pregnant women, and babies, patients with shingles should avoid contact with them, and it is recommended to refrain from public baths or swimming pools that expose the body until the symptoms improve.
7. How is shingles treated?
Like stroke or myocardial infarction, shingles also has a golden time, but it is true that symptoms occur and treatment within 3 days reduces complications. Usually, taking antiviral drugs within 3 days of blistering is the fastest treatment, and ointments used for herpes simplex are not very helpful. It is important to actively treat shingles because the appearance and pain of blisters can get worse as time goes by, and if not treated properly, there is a high possibility that scars will remain following neuralgia or blisters disappear following shingles. In other words, the goal of treatment should be to reduce pain, prevent the spread of skin lesions, and reduce postherpetic neuralgia. Immunocompromised patients may require intravenous therapy.
In addition, since shingles itself is caused by a decrease in immunity, simply using antiviral ointments and pills does not cure it right away. It is important to get plenty of rest if you get herpes.
8. Do many people suffer from neuralgia following shingles?
One of the reasons that shingles is a terrible disease is postherpetic neuralgia. “Postherpetic neuralgia”, in which pain continues even following the skin symptoms of shingles disappear, occurs when the chickenpox virus damages the nerves. In other words, following suffering from chickenpox, the varicella-zoster virus hides in the spinal nerves. If the immune system is weakened, this virus travels to the ganglion and damages the skin, causing blisters. Because of this, even taking antiviral drugs can lead to neuralgia.
The probability of suffering from neuralgia increases with age. About 60% of those in their 60s and 70% of those in their 70s are likely to develop neuralgia and suffer for a long time, but it gradually improves over time, and regarding 50% of patients Improvement occurs within 3 months, and approximately 70% of patients show improvement within 1 year.
As such, the pain can last for a long time and in some cases can be excruciating, so if postherpetic neuralgia is severe, anesthesia and pain medicine treatment becomes very important. In the Department of Anesthesiology and Pain Medicine, you can receive a lot of help because it focuses on preventing further damage to the nerve and breaking the pain cycle, such as nerve block, continuous nerve block, and ketamine-lidocaine injection.
9. How often does shingles recur?
The recurrence rate of shingles is not high, regarding 5%. There are many causes of relapse, but the weakening of the immune system is the main cause. Patients with chronic diseases, old age, or long duration of postherpetic neuralgia are highly likely to recur, so they must be careful and must be vaccinated to lower the possibility of recurrence.
10. Is there a way to prevent shingles?
Fortunately, shingles can be prevented with a vaccine. Newer vaccines are recommended for adults over the age of 50, but adults under the age of 50 (including immunocompromised persons over the age of 18) can also get it and should receive two doses two months apart.
In addition, previous vaccines required a grace period of at least six months following getting shingles, but recent vaccines can be administered immediately following acute symptoms pass. After two vaccinations, it is said that the prevention effect of regarding 90% or more lasts for 10 to 20 years, so it is worth considering vaccination at this opportunity.
Shingles, an enemy of immunity, is also a disease that can be sufficiently prevented by vaccination. You who are reading this article may also be eligible for shingles vaccination, so check it out today and prevent it early.
▲ Beom Hye-min, director of the Hyangnam Sympathy Council ⓒ Hwaseong Citizen Newspaper
holder (c) Ohmynews (citizen reporter), unauthorized reproduction and redistribution prohibited
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