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SHINGLES

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.

June 3rd, 2013
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About the Author: Gabe Mirkin, MD

Sports medicine doctor, fitness guru and long-time radio host Gabe Mirkin, M.D., brings you news and tips for your healthful lifestyle. A practicing physician for more than 50 years and a radio talk show host for 25 years, Dr. Mirkin is a graduate of Harvard University and Baylor University College of Medicine. He is board-certified in four specialties: Sports Medicine, Allergy and Immunology, Pediatrics and Pediatric Immunology. The Dr. Mirkin Show, his call-in show on fitness and health, was syndicated in more than 120 cities. Read More
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