Shingles Aftereffects, Postherpetic Neuralgia

Today, let's talk about shingles. Shingles is a viral infectious disease. It is a very common condition, with about 20% of the population experiencing shingles at least once in their lifetime. Shingles symptoms appear when the varicella-zoster virus, which has been dormant in the body after an initial infection, becomes reactivated. In the early stages of shingles, the pain is very severe, and blisters form on the skin. While blisters often subside within 1 to 3 weeks, the pain can persist for a long time, requiring careful attention.

What Causes Shingles?

Shingles primarily affects adults. The varicella-zoster virus, which lies dormant, reactivates and causes symptoms when the immune system is weakened, such as due to overwork. This is why shingles often recurs. It's important to manage your physical condition carefully, as shingles can recur when your body is not in good shape. Patients often consider and seek traditional Korean medicine treatment when shingles frequently recurs or when postherpetic neuralgia becomes chronic. This is often because symptoms are not well controlled solely with antiviral medications.

Shingles and Immunity?

Shingles occurs when the varicella-zoster virus, which has infected and been dormant in the nerves, reactivates. Various factors influencing viral reactivation can lead to the onset of shingles. Stress and overwork are typical causes. Shingles can also appear in situations where immunity is lowered, such as with steroid hormone use, immunosuppressants, chemotherapy, or after surgery. Patients often experience significant physical and mental burden when shingles develops on top of an already poor physical condition, adding insult to injury. This is why shingles frequently appears in middle-aged and older adults, particularly those over 50, where immune suppression is more pronounced.

Early Symptoms of Shingles

When shingles symptoms begin to emerge, they first appear on the skin. Since the varicella-zoster virus lies dormant at the spinal cord level and then reactivates, symptoms primarily manifest in the skin dermatome associated with that spinal segment. The key early symptom of shingles is a unilateral burning and tingling sensation in a specific skin area. Subsequently, over 48 to 72 hours, red rashes, blisters, and vesicles form on the skin. In other words, if blisters accompanied by a burning sensation appear unilaterally in a specific area, shingles should be suspected. Shingles can also be accompanied by flu-like symptoms such as chills, fever, and headache.

Shingles Complications

Shingles can lead to sequelae or complications. If shingles appears around the eyes, it can affect vision and, in severe cases, lead to blindness. Shingles around the ears can affect the ears and impact hearing. Shingles in the facial area can cause facial nerve paralysis. When shingles occurs in these specific areas, it can lead to severe complications, thus requiring careful and appropriate treatment. A common sequela of shingles is postherpetic neuralgia (PHN), which refers to nerve pain that persists long after the blisters have healed.

What is Postherpetic Neuralgia?

The persistent neuropathic pain experienced after shingles significantly diminishes the quality of life. Postherpetic sequelae often become chronic, especially in older adults over 60. Medications used for neuropathic pain are stronger than general anti-inflammatory analgesics, but even with these, the pain may not respond well to treatment. In neuropathic conditions, patients often report various sensory abnormalities in addition to nerve pain. These can include various forms of paresthesia, such as a crawling sensation, a feeling of foreign body (like being submerged in water), or decreased sensation. Since post-shingles nerve pain is often not well controlled with analgesics, many patients consider and visit for traditional Korean medicine treatment.

Preventing Shingles Recurrence

It is true that if shingles recurs, there is significant concern about further recurrences. Shingles has a considerably high recurrence rate. The likelihood of recurrence increases when shingles pain has persisted for a long time. It is reported that one in three people who have had shingles once will experience a recurrence. Specifically, individuals whose shingles pain lasted for more than 60 days are known to have about five times higher risk of recurrence compared to those who recovered quickly. This is also why it's important to treat shingles effectively in its early stages to prevent it from becoming prolonged.

Treatment for Shingles

In some patients, shingles may resolve spontaneously with observation alone. However, in most cases, it is advisable to initiate appropriate treatment in the early stages. Key aspects of shingles management include suppressing viral activity and preventing the chronicity of chronic pain and neuropathic symptoms. Pain in shingles is often not well controlled even with analgesics. As the use of opioid analgesics can be burdensome, acupuncture may be considered for pain management. Herbal medicine can also be beneficial for neuropathic pain, and by restoring vital energy, it can boost immunity, aiding in shingles recovery and recurrence prevention.

Traditional Korean Medicine Treatment for Shingles?

The goals of traditional Korean medicine treatment for shingles are to alleviate shingles symptoms, minimize postherpetic sequelae, and reduce the likelihood of recurrence. Since shingles symptoms include severe pain along with skin manifestations, short-term symptom relief is also crucial. In cases of postherpetic neuralgia, symptoms can become chronic and may not respond well to analgesics, so it is also necessary to prevent the progression from early shingles symptoms to chronic pain. As the dormant varicella-zoster virus can reactivate and recur when immunity is weakened, it is essential to improve overall bodily condition to reduce the possibility of shingles recurrence. To achieve these various treatment goals, a range of traditional Korean medicine options are selected and applied. Various treatments such as herbal medicine, acupuncture, pharmacopuncture, bee venom acupuncture, and electroacupuncture can help address the diverse issues faced by shingles patients.