Shingles

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Shingles

Cool a Nerve Rash

On the surface, shingles may appear to be just a red, blistery rash, but there is much more to this serious nerve rash than meets the eye.

"Shingles is actually a reactivation of the chicken pox virus--meaning that it strikes only people who have had the chicken pox," says Mary Ruth Buchness, M.D., chief of dermatology at St. Vincent's Hospital and Medical Center in New York City. "The chicken pox virus never really goes away. It lies dormant in a nerve bundle in the spinal cord."

Then, during times of stress or illness, the virus can reactivate in certain people. It multiplies and travels down the nerve route to the skin.

"Wherever that nerve supplies sensation is where you will see the rash," says Amy Newburger, M.D., assistant clinical professor of dermatology at Columbia University College of Physicians and Surgeons in New York City and a dermatologist in Scarsdale, New York. This could be on your forehead, scalp, chest, down your shoulder and arm, on your trunk, on your buttock or down your leg.

The shingles rash is marked by blistery, water-filled bumps that sit on areas of reddened underlying skin. "Some people feel pain, tingling or discomfort in the area a few days before the blisters develop," says Susan C. Taylor, M.D., assistant clinical professor of medicine in the Department of Dermatology at the University of Pennsylvania School of Medicine in Philadelphia. The blisters will turn to pustules (bumps filled with pus) and then crust over, scab and heal--a process that can take up to three or four weeks. At that point the virus goes into remission, but it will always live dormant in your body. Shingles may or may not recur.

If you have shingles, realize that the blisters are filled with a contagious virus, which should not be touched by other people, especially if they have not had chicken pox. "Keep those areas covered," urges Dr. Newburger.

A HOST OF OPTIONS

If your doctor has confirmed that you have shingles, women doctors offer ways to relieve the pain and discomfort.

Baby yourself. Treat your body gently during an outbreak. "Do everything that you can to rest and avoid stressing the inflamed nerve route," advises Dr. Newburger. That means do not exercise; do not try to work through the pain. Give the rash time to heal. "Motion will increase inflammation of the nerve route, and you could end up with hefty scarring around the nerve--which means persistent pain--for six months, a year, maybe even forever. So take it easy," she warns.

Keep blisters wet to dry them up. Anything wet that you put on blisters will help dry them out, because as the liquid evaporates from your skin, it dries blisters along with it, says Dr. Buchness.

Calamine lotion works well. Discontinue the calamine after the blisters dry. Or use a compress made from cool water and Domeboro astringent solution. "Domeboro is an aluminum acetate preparation that helps dry blisters. It comes in the form of tablets or powder, which you mix with water to make a solution," explains Dr. Buchness.

Spill some milk. "Soak a washcloth in cold milk and hold it on the blisters," suggests Dr. Buchness. "There's something about milk that is soothing to blistery skin rashes."

Use antibacterial ointment. Once blisters crust over and start to scab, apply an antibacterial ointment to prevent infection, keep them soft, help them heal and reduce scarring, says Dr. Buchness.

Dr. Newburger recommends Bacitracin or Polysporin. Dr. Buchness advises avoiding ointments containing neomycin, since a fair number of people are allergic to it.

Put on a paste. To dry up blisters and soothe itching, make a paste from water mixed with baking powder and spread that on the shingles rash, suggests Dr. Taylor.

When To See A Doctor Shingles is distinctively different from other kinds of rashes. With shingles, the rash is confined to either the left or the right side of your body and does not cross the midline. If you think that you're developing shingles, get to a doctor immediately. "If you treat it within 48 hours of onset, you should be able to get the virus under control and minimize the risk of scarring around the nerve route," says Amy Newburger, M.D., assistant clinical professor of dermatology at Columbia University College of Physicians and Surgeons in New York City and a dermatologist in Scarsdale, New York. Studies suggest that if you start taking antiviral medication right away, you may be able to prevent the lingering, persistent nerve pain that often trails in the wake of shingles.

Try some pepper power. Zostrix, an over-the-counter cream preparation made from an ingredient in red chili peppers called capsaicin, is effective at relieving the pain of shingles, but only after your skin rash or blisters have healed, says Patricia Farris Walters, M.D., clinical assistant professor of dermatology at Tulane University School of Medicine in New Orleans and a spokesperson for the American Academy of Dermatology. "The medicine makes the nerve endings release their pain-causing chemicals. It causes nerve endings to keep firing until there is no chemical left," she says.

"Zostrix can sting and burn for a while when first applied," says Dr. Walters. "But if you stick it out for a few days, you can really get relief." Apply a thin film of the cream three to four times a day for several days and as long as the pain is present.