SHINGLES
Report #7124; 5/25/97
One out of every six North Americans will suffer from shingles (1), a painful rash caused by getting chicken pox for the second or more times.
The first time you get chicken pox, you get blisters over most of your body and a cough and running eyes and nose. After a week, your immunity drives the chicken pox virus from your bloodstream, but it remains in your nerve roots for the rest of your life. For one in six (1), the virus can escape many years later and cause painful grouped blisters on the skin over the infected nerve on one side of the body. 50% of people over 60 who develop shingles, and are not treated, will suffer from post-herpetic neuralgia and have severe pain in that nerve for the rest of their lives, while fewer than 7% treated with acyclovir will suffer permanent pain (2). Cortisones offer little protection.(3) So, it is very important that as soon as you develop unexplained pain in one small area in the body, and your doctor thinks that you may have shingles, you should start on acyclovir immediately and continue to take it until the blisters start to dry up. This alleviates pain sooner (4) and reduces your chances of suffering permanent pain (5). Recent research shows that newer drugs, Famcyclovir and Valicyclovir, are even more effective in preventing permanent pain in shingles (6). If you develop postherpetic neuralgia, you can be treated with a .025% capsaicin cream (7) and tegretol anticonvulsant pills.
By Gabe Mirkin, M.D., for CBS Radio News
1) JG Donahue, PW Choo, JE Manson, R Platt. The incidence of herpes zoster. Archives of
Internal Medicine 155: 15 (AUG 7 1995):1605-1609. 2) NEJM March 31, 1994;339(13):896-900. 3) RJ Whitley, H Weiss, JW Gnann, S Tyring, GJ Mertz, PG Pappas, CJ Schleupner, F
Hayden, J Wolf, SJ Soong, C Laughlin, J Gnann, L Sherrill, P Pappas, S Greenberg, J
Peacock, J Tilles, F Flowers, K Beutner. Acyclovir with and without prednisone for the
treatment of herpes zoster - A randomized, placebo-controlled trial. Annals of Internal
Medicine 125: 5 (SEP 1 1996):376-383. 4) MJ Wood, R Kay, RH Dworkin, SJ Soong, RJ Whitley. Oral acyclovir therapy accelerates
pain resolution in patients with herpes zoster: A meta-analysis of placebo-controlled
trials. Clinical Infectious Diseases 22: 2 (FEB 1996):341-347. 5) JL Jackson, R Gibbons, G Meyer, L Inouye. The effect of treating herpes zoster with
oral acyclovir in preventing postherpetic neuralgia: A meta-analysis. Archives of Internal
Medicine 157: 8 (APR 28 1997):909-912. 6) KS Erlich. Management of herpes simplex and varicella-zoster virus infections.
Western Journal of Medicine 166: 3 (MAR 1997):211-215. 7) WY Zhang, ALW P. The effectiveness of topically applied capsaicin - A meta-analysis.
European Journal of Clinical Pharmacology 46: 6 (JUL 1994):517-522.
Health Reports from The Dr. Gabe Mirkin Show and DrMirkin.com