Questions and answers

I have shingles – what should I know?

(Bild: adobe stock – ryanking999, Christoph Hopf)

Shingles, or herpes zoster, is a painful skin rash with blisters. The disease can occur at any age, but those affected are usually older than 50. Dr. Christian Mate, a general practitioner, explains everything you need to know here and on KroneMED.

Shingles is caused by so-called varicella zoster viruses. These are the same viruses that usually cause chickenpox in children. After such a chickenpox infection, our body cannot completely get rid of the viruses. They can become active again years later and then trigger shingles (herpes zoster).

Good to know

Symptoms: Shingles often begins with an unpleasant discomfort in the affected area, which can manifest itself as itching or burning pain. Some sufferers also report general symptoms such as fever and headaches. A reddish rash is typical, which is accompanied by blisters that can be caused by mild to severe pain. These blisters usually appear on one side, in a band-like pattern over the back and chest, but can also occur in other parts of the body. As they progress, the blisters can burst, crust over and heal slowly within seven to ten days.

Reason: A trigger for shingles is often a previous chickenpox infection in childhood, as the virus remains in the body and can be reactivated later. Current factors that favor reactivation are mainly stress and infections such as pneumonia or influenza. Serious illnesses, such as cancer, can also increase the risk. In general, there is a higher risk if the immune system is weakened for other reasons.

Preventive care: Prophylaxis consists of a vaccination, which is recommended for all adults aged 60 and over and for people with immune deficiencies aged 18 and over. This vaccination is also possible if you have already contracted shingles.

How your general practitioner can help
The disease usually presents a very characteristic picture and can usually be diagnosed and treated by a GP. The aim is to provide adequate pain relief and to reduce itching and discomfort. The "classic" painkillers ibuprofen and paracetamol are usually used to relieve the pain. Talk to your doctor about possible side effects. The health hotline 1450 is also available at night and at weekends to answer your health-related questions. The health portal at gesundheit.gv.at provides you with a comprehensive range of information on the Internet.

Lotions with tanning agents can be used to reduce the often agonizing itching. Mixtures with zinc are no longer recommended. Although they reduce the itching, they promote bacterial infection of the blisters. Your GP may also prescribe antiviral (anti-viral) therapy. This treatment should be started within three days of the first symptoms appearing. Unfortunately, the disease can sometimes be followed by prolonged, excruciating nerve pain. Timely antiviral treatment can significantly reduce the risk of such courses.

When to see a specialist?
Shingles is primarily a disease of the skin and therefore falls within the specialist field of dermatology. If the diagnosis is not clear or treatment needs to be optimized, your family doctor can give you a referral. They can use their expertise to clarify an unclear diagnosis and take the right therapeutic measures in difficult cases. 

If the shingles affects the eye area or if there is half-sided facial paralysis, ear pain and herpes zoster blisters in the ear canal, your GP will send you to a specialist in ophthalmology or ear, nose and throat medicine and may also refer you to a neurologist.

What to do in severe cases?
It is usually sufficient to take the antiviral medication in tablet form - only in severe cases and also in cases of shingles in the head and neck area is intravenous treatment, i.e. administration via the vein during a hospital stay, recommended. Inpatient treatment may also be necessary in the event of imminent or existing complications, e.g. in the eye area. 

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