How painful is this "half-disfiguring" skin disease? It can be as painful as giving birth!

Many diseases can cause pain, but if we talk about the "king" among them, shingles must have a name. Let's see what people who have had the disease say.

Image source: Weibo

Now, shingles, which is more common among the elderly, is becoming younger and younger! Many young actors have been infected.

Shingles can also affect young people. Image source: Weibo

This change is mainly related to the change in young people's lifestyle. Today's young people are under great work pressure, like to stay up late, and have unhealthy eating habits. The direct consequence is that their immunity becomes weaker, giving viruses an opportunity to take advantage.

In fact, shingles can occur at any age, and there are clinical cases of infants suffering from shingles.

Even babies can get shingles.

Image source: References [1]

What kind of disease is shingles?

What is shingles

The name shingles may not sound familiar, but if you say "herpes zoster" or "shingles", it immediately feels less strange, right? It seems that we hear about people suffering from this disease from time to time.

Indeed, herpes zoster is not far from us. Its incidence is not low (about 1.2% to 4.8% in people with normal immunity), and the incidence rate continues to rise with age. When the age is over 50, the incidence rate of herpes zoster can reach 14.28%, and clinically about 90% of patients are elderly .

The two most typical characteristics of shingles are clusters of blisters and unbearable pain.

Shingles blisters can last from a few days to a few weeks. Image source: clevelandclinic

The distribution of shingles blisters is very "individual", often extending along one side of the body from the face to the trunk and limbs, like a winding snake, so it is called "snake zoster".

Shingles often spreads along one side of the body. Image source: National Center for Immunization and Respiratory Diseases, Division of Viral Diseases

Because many shingles patients have blisters concentrated on the waist and back, this disease is also called "herpes zoster".

Blisters distributed on the waist, image source: reference [2]

However, the clinical symptoms of shingles are not always typical. Sometimes, blisters may appear on both limbs. In some atypical cases, blisters may not appear at all (rashless shingles), which can cause a lot of difficulties for diagnosis.

This patient with shingles developed blisters on both legs. Image source: Reference [3]

The appearance of blisters is often accompanied by unbearable pain, which is the most torturous part of shingles.

Sometimes, even if blisters do not appear (or do not appear temporarily), patients will experience severe burning pain or stinging pain. Even the slight friction between clothes and skin will make the pain more intense. Some people will be in so much pain that they cannot sleep or work or study normally.

What’s even more annoying is that for some patients, even after the herpes is cured, the pain will not go away . This is because the herpes zoster virus will invade the nerves, and the damaged nerves will cause severe pain, which doctors call "postherpetic neuralgia", which makes patients suffer.

Why do you get herpes zoster?

Why is shingles so scary? How does it happen?

The culprit that causes shingles is called the varicella-zoster virus. As you may have guessed from the name, it is not only related to shingles, but also to chickenpox. Yes, that chickenpox that many people had when they were children.

Chickenpox on a child's legs, image source: Wikipedia

When a person is first infected with the varicella-zoster virus, they usually develop chickenpox (or they may carry the virus without developing the disease), which usually occurs during childhood.

It is not difficult to cure chickenpox, and chickenpox will not recur after it is cured, but this does not mean that the virus in the body has been completely eliminated. In fact, as a neurotropic virus (a virus that tends to infect neurons), the varicella-zoster virus will lie dormant in the nervous system (such as the spine and brain ganglia), silently waiting for the opportunity to make a comeback.

Varicella-zoster virus under an electron microscope, image source: Wikipedia

Until now, no one knows how the varicella-zoster virus can remain dormant in the human body for decades and then become active again to cause shingles.

But what we know is that the reactivation of the virus is related to the weakening of the human immune function , which is also one of the reasons why the elderly are more susceptible to the disease (the elderly have weakened immunity). In addition, long-term fatigue, taking immunosuppressive drugs, tumors, etc. are all risk factors for herpes zoster.

To summarize briefly, the occurrence of shingles requires two conditions: one is a previous infection with the varicella-zoster virus (chickenpox may or may not occur during the initial infection), and the other is a decrease in immunity, which gives the virus an opportunity to rapidly multiply and attack the human nervous system.

How is shingles treated? Can it be prevented?

The good news is that shingles is not an incurable disease. With prompt treatment, people usually recover and most cases do not relapse (though some people do get it again).

The idea of ​​treatment is also very clear. First, antiviral treatment is used to prevent the spread of varicella-zoster virus in the body. Second, analgesia is used to relieve the patient's pain. Usually, after actively seeking medical treatment, the patient can recover quickly (2-3 weeks). Some patients with milder illnesses can recover in 1 week.

Compared with the disease itself, postherpetic neuralgia is more troublesome. The pain subsides quickly after recovery in young people, but for patients over 50 years old, the pain often lasts for a long time, sometimes even for a year. In addition to medication, physical methods can also be used to treat pain, such as electrotherapy and ultraviolet irradiation. However, there are individual differences in treatment effects, and some patients have to endure pain for a long time.

Is there any way to prevent shingles? Yes, there is. The most effective way to prevent it is to get vaccinated . Studies have shown that the protection level of the vaccine can be maintained at more than 85% for people over 50 years old within 4 years after vaccination. Moreover, even if you are still unfortunately infected, the chance of postherpetic neuralgia will be greatly reduced.

However, the shingles vaccine is currently only available to people over 50 years old (this age group has a higher risk of disease), and it requires two injections, each costing around 1,500 to 2,000 yuan.

As for young people...everyone actually knows the solution, which is to maintain healthy living habits, improve immunity, and not give the virus the opportunity to take advantage of the opportunity to enter.

In addition, early detection and early treatment are also important. Early treatment can effectively control the severity and duration of pain and reduce the occurrence of sequelae.

I won’t say any more. I’ll go exercise now. It’s better not to experience this kind of severe pain.

References

[1] Huang Shengping. A case of herpes zoster in an infant[J]. Journal of Clinical Dermatology, 2013, 42(5):294.

[2] Sampathkumar P, Drage LA, Martin DP. Herpes zoster (shingles) and postherpetic neuralgia. Mayo Clin Proc. 2009 Mar;84(3):274-80.

[3] Guo Yong. Two cases of bilateral herpes zoster[J]. Journal of Clinical Dermatology, 2005, 34(9):620.

[4] Duan Mingyou. A case of rash-free herpes zoster[J]. Chinese Journal of Misdiagnosis, 2001, 1(7):965-965.

[5] Cui Changhong. Current status of research on epidemiological characteristics and prevention strategies of herpes zoster[J]. Disease Surveillance, 2013, 28(12): 1030-1034.

[6] Jia Qian, Lin Xuewu. Observation on the efficacy of nerve block combined with interferential electrotherapy in the treatment of postherpetic neuralgia[J]. Journal of Bengbu Medical College, 2018, 43(06): 734-736+740. DOI: 10.13898/j.cnki.issn.1000-2200.2018.06.011.

[7] Gao Liangchang, Qi Yonghong, Li Jian, Zhu Hui. Comparison of the analgesic effects of different electrotherapy and ultraviolet light on herpes zoster[J]. Chinese Journal of Clinical Rehabilitation, 2003(11):1720.

END

Author: Yiwanchop

Review expert: Zhang Yuhong, associate chief physician of dermatology, Zhengzhou Central Hospital Affiliated to Zhengzhou University.

Tadpole Musical Notation original article, please indicate the source when reprinting

Editor/Xiao Xitushuo