Shingles: symptoms, photo of pimples, contagious?

Auricular, ophthalmic, intercostal… shingles can affect different parts of the body (face, eyes, ears…). This infectious disease is linked to a reactivation of varicella virus. Stress is one of the possible causes of this disease. Shingles is manifested by skin symptoms (papules, pus). Having shingles increases the risk of stroke by about 80% according to a study by Professor of Neurology Andrew Bubak and published in the American journal Journal of Infectious Diseases on October 6, 2022. The risk would persist for up to 1 year after recovery from shingles. Apart from treatments, vaccines exist, but they are only reimbursed for people aged over 65. Is shingles contagious ? How do we catch it? Can it hide cancer? Picture of buttons and shingles info.

Definition: what is shingles?

Shingles is a infectious disease related to a new contact with the virus responsible for chickenpox, commonly referred to as the VZV. “Years after a chicken pox, the same virus can re-infect the weakened body and colonize a cutaneous nerve territory“, explains Dr. Jean-Luc Rigon, dermatologist-venerologist. The virus can spread through the nerves to the skin and mucous membranes where it creates vesicles similar to those of chickenpox. “Shingles appears on a well-limited nervous territory; its manifestations are located most of the time on one side of the body“, specifies the specialist. The reactivation of the virus can occur mainly in the elderly or during a reduction in the body’s defenses.

Where can shingles be located?

Shingles can affect different areas, depending on the nervous territory attacked. “Some areas are more dangerous than others, such as the face or the eye; the consequences can be more serious“, says Dr. Rigon.

► Intercostal area. It is the most common shingles, called “the ring of fire”. A nerve located at the level of the spine is infected, causing symptoms to appear in the innervated area on one side of the thorax : we speak of a semi-girdle eruption between 2 ribs. “This shingles evolves in two or three weeks, it is often benign“, reassures the dermatologist. Less common, abdominal shingles develops in the abdomen, with a less clear shape.

► Ophthalmic herpes zoster (eyes). It’s about a rare and potentially serious form of shingles. The disease is manifested by sharp pains on one side of the face followed by a rash and eyelid and eye burns. “This shingles may be responsible for a loss of sight due to clouding of the cornea and must be treated urgently“.

► Area of ​​the face (facial). Classically, it is a shingles, which appears on one side of the face. It corresponds to the attack of one of the 3 branches of the trigeminal nerve responsible for the sensitivity of the face.

► Ear shingles (ear). When he reaches the wrisberg nerve, shingles is said to be auricular or otitic and causes specific symptoms: ear pain, loss of tongue sensitivity and sometimes dizziness or hearing problems associated with facial paralysis. “It is a more rare and difficult to diagnose shingles, because it only affects part of the ear canal“.

What are the symptoms of shingles?

“Shingles is a burn“, sums up Dr. Rigon. As such, the warning signs of a shingles outbreak are often characteristic:

• tingling sensation
• burning sensation
• rashes (papules). It is small blister-like vesicles filled with pus localized along the path of a sensory nerve. After a few days, these vesicles dry up and form scabs which eventually fall off. This cycle can last between 2 and 4 weeks, during which we generally observe 2 or 3 outbreaks.
• of the sequel pain often very inconvenient, called postherpetic pain. “The elderly in particular are affected by chronic neuralgia, a pain similar to an electric shock that can cause a lot of discomfort – depression, sleep disorders…“.

Is shingles contagious?

The virus can only be transmitted to someone who has never had chickenpox.

A person who has already had chickenpox cannot get shingles. with a person who has shingles themselves. On the other hand, the virus can be transmitted to a person who has never contracted chickenpox. The fluid in the vesicles contains VZV; if this vesicular fluid comes into contact with the mucous membranes of a non-immune person, he could contaminate it. “But the risk is low, given that almost everyone has had chickenpox.“, points out Jean-Luc Rigon. Attention must however be paid to newborns, in whom VZV can have serious consequences. There is no contagious risk from one area to another in the same person: intercostal shingles will not generate ophthalmic shingles, but a good hygiene should be adopted. “Having intercostal shingles, scratching, then putting on contact lenses without washing your hands is guaranteed disaster! One can easily get an infected eye. Antiseptics and occlusive dressings are used to avoid the risk of superinfection“, advocates Dr. Rigon.

9 out of 10 adults have already contracted the chickenpox virus

To know that nine out of ten adults in the world have already contracted the varicella virus and are therefore carriers of the VZV virus. Among these people, it is estimated that a small number will one day be affected by shingles. The virus is reactivated when the immune defenses decline. This may be due to stress, or to an illness (cancer, leukemia…). “During flu epidemics, for example, one may be more vulnerable“, adds Jean-Luc Rigon.

The local treatments prevent bacterial superinfection of the vesicles. The use of a dermatological soap and the application of local antiseptics are recommended, as well as wearing an occlusive dressing. “It is also necessary to adopt hygiene measures, wash your hands regularly“, advises Dr. Rigon. Pain can be treated with analgesics such as paracetamol.

Of the antiviral treatments (valaciclovir) can be prescribed but they must be taken within the first 3 days following the appearance of the first lesions, otherwise they are ineffective. At last, “vaccines exist against the VZV, but they are only reimbursed by Social Security for people over 65due to the increased risk of complications“. As for people with postherpetic pain, “they often have to be taken care of in centers specialized in the treatment of pain“, concludes the dermatologist.

Thanks to Dr Jean-Luc Rigon, dermatologist venerologist in Nancy (Meurthe-et-Moselle).