Q: I am a 48-year-old female. I broke out with shingles on my forehead and was put on an antibiotic and prednisone as well as a cream for the area.
The after effects of the prednisone were not great. I had headaches, depression, stomach problems and night sweating. My head was cloudy and my eyes were blurry. These symptoms lasted for weeks after the treatment, although the medication did stop the rash from spreading.
I recently heard that three other members of my family also had shingles. Does stress or a low immune system have anything to do with it? I did have chicken pox as a child.
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A: Shingles is one of the most misunderstood and confusing diseases.
It is caused by the same Varicella/Zoster virus that causes chicken pox. Unfortunately, it never leaves the body and can lie dormant for years in the ganglia or nerve roots of the spinal cord.
You are right about stress and lowered immunity. These factors can definitely lead to the reactivation of the virus into the form of shingles, where it causes a painful, blistering rash in the distribution area of the affected nerves, often in the face or trunk. It is nasty if it affects the eye.
Older people are more likely to get shingles because the aging process lowers their immune systems. Shingles sufferers are often in their 80s and 90s.
People can get shingles only if they have previously had chicken pox. You cannot catch shingles itself, but it is possible for someone to get chicken pox from it if they are in close proximity to open sores.
It may have just been a coincidence that three other members of your family had shingles, although research indicates there may be a genetic susceptibility that runs in some families. They did not catch it from you or each other.
Oral corticosteroids such as prednisone are frequently used to treat the infection, despite clinical trials of this treatment being unconvincing.
I expect and hope that you were given an antiviral drug and not an antibiotic. Antibiotics only work on bacterial infections, and shingles are caused by a virus.
Painkillers may be needed as well. The prednisone would not stop the rash from spreading because the lesions appear only in the distribution area of the affected nerve root. It cannot spread beyond this.
Prednisone has nasty side effects. Because of the risks of corticosteroid treatment, it is recommended that the combination of drugs be used only in people older than 50 because of their greater risk of postherpetic neuralgia. This is a severe nerve pain that persists for weeks or months after the rash has disappeared.
Children are now being vaccinated for chicken pox, so hopefully there will be fewer cases of shingles in future generations.
Clare Rowson is a retired medical doctor with a practice near Belleville, Ont. Her columns are intended for general information only. Individuals are encouraged to also seek the advice of their own doctor regarding medical questions and treatments.
