On the surface, a shingles rash may appear similar to other conditions, such as contact dermatitis or herpes simplex. The chronic pain that accompanies shingles is sometimes mistaken as prodromal pain, angina, appendicitis, a peptic ulcer, biliary colic or renal colic. Strangely enough, the painful rash may also look very similar to a brown recluse spider bite. If a person is over the age of 60, has had chickenpox in the past and may have a weakened immune system, then shingles is likely the culprit. Even more telling is the painfulness that comes along with the rash, since most rashes are itchy but don’t deliver acute pain.
By the time you notice the red patches of the shingles rash on your skin, you have already had an active herpes virus in your system for one or two days. The shingles painful rash develops on one side of the face, chest or abdomen, where the nerves have been carrying the virus. The area where the rash develops is usually red, swollen and painful. The blistering is a brighter red and clusters together to form a “band-like” pattern around the body. During this time, an infected person could transmit the chickenpox virus to people who have never had it before. After three to five days, the blisters will scab over and the contagiousness phase is over. Within 2-4 weeks, the scabs fall off and the skin begins to heal.
There are several things a patient can do at home to reduce the itching and pain of the shingles rash. The sores can be cleansed with anti-bacterial soap and lukewarm water once or twice each day. Patients should be cautious not to scrub vigorously, however, or the rash could spread to other parts of the body. Once the washing and rinsing cycles are complete, it’s best to let the skin air-dry. Cool compresses with chilled ice packs may be put on to relieve pain and itching. Anti-itching treatments like calamine lotion will provide relief, and an aluminum acetate solution helps to dry up the blisters. Bandages may be placed on the painful rash to prevent spreading, although the scabs may take slightly longer to heal this way. Patients are advised to wear loose fitting clothing to prevent further agitation of the lesions.
While the shingles rash is undeniably ugly, patients say the pain is the worst part. The herpes zoster rash can feel as poignant as a heart attack because the damaged nerves are sending their distress signals along the path the virus has traveled. To prevent the occurrence of this painful rash, patients over the age of 60 are advised to get the varicella vaccine, which greatly reduces the risk of the virus. Even in the few patients who came down with shingles after getting the vaccine, the severity and duration of their symptoms are significantly minimized.
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