SHINGLES  People over 50 years.
Management
(HERPES ZOSTER)
What is SHINGLES?
‫ ڿ‬Shingles is an acute infection and
painful viral disease of the peripheral
nervous system in which a rash of small
blisters develops on the skin overlying
sensory nerve trunks.
What CAUSES the disease?
‫ ڿ‬Shingles is caused by the varicella-
zoster virus, the same virus that
causes chicken pox.
‫ ڿ‬While the exact cause of shingles is not
understood, scientists theorize that during
an attack of chicken pox, the virus may
invade large clusters of neurons (nerve
cells) found on either side of the spinal
cord.
‫ ڿ‬The virus may live dormant within
these neurons for years, held in check by
the body’s immune system.
‫ ڿ‬But if the immune system becomes
impaired, perhaps during the normal aging
process or as a result of disease, the virus
can reactivate, causing neurons to
become inflamed.
‫ ڿ‬Blisters develop on the skin that lies
above the inflamed neurons.
Predisposing Factors?
 Immunocompromised
patients (e.g., AIDS
patients).
 Age-related weakening of
the immune system.
 The disease may also result
from overwork, debility or
weakness, damp and chilly
weather, absorption of
certain drugs paricularly
compounds of arsenic, or
contact with a case of
chicken pox.
Common Signs and Symptoms
■ In a typical attack of shingles, a
person first feels pain in the area
that will later break out in blisters.
■ Other initial symptoms include
fever, headache, muscle soreness,
fatigue, stomach upset, and
diarrhea.
■ After three to five days of these
initial symptoms, the blisters
appear, often accompanied by
burning and tingling. The blisters
are usually confined to one side of
the body, most commonly in an
area extending from the upper half
of the spine to the breastbone. The
face, abdomen, arms, and legs may
also be affected. The rash usually
goes away after a few weeks
without complications.
Medical/Therapeutic:
~ If available and as ordered, compresses
moistened with Burow’s solution (5%
aluminum acetate solution) may be
applied to the affected skin areas for 15 to
20 minutes a day. At other times, calamine
lotion may be applied sparingly to relieve
itching.
~ If the skin breaks, the use of Bacitracin
topical ointment will help to prevent
infection as as prescribed.
~ Corticosteroid medication as prescribed
may be administered during the acute
phase of illness.
~ As available and as ordered, an electric
heating pad may be applied to the painful
area to relieve some of the discomfort.
~ A lidocaine patch, a stretchy bandage
coated with a long-acting topical
anesthetic, may be applied to the painful
area to numb affected nerve endings and
temporarily relieve pain. In addition, a
physician may prescribe antidepressants
and other drugs that help calm inflamed
nerves, lessening pain.
~ When shingles is diagnosed in patients
with suppressed immune systems, such
as those with acquired immunodeficiency
syndrome (AIDS) or cancer, the antiviral
drug acyclovir may be prescribed.
Home management:
~ Remain inactive for 7-14 days while the
discomfort is severe.
~ DO NOT OPEN blisters that appear on
the skin.
~ It is best to consult a physician in all
cases of shingles. ☺
PATIENT TEACHING PREPARED BY:

CERIACO, C.B.
Sanit Louis University, College of Nursing

REFERENCES:

Shryock, Harold, et. al., Modern Medical Guide, pp. 374-75. Cimindi, Bandung: Indonesia Publishing House. 1982.

Tortora, Gerard, et.al., Principles of Anatomy and Physiology, p. 447, 10th edition. New York: John Wiley and Sons, Inc.
2003.