Skin Problems and How to Treat Them: Shingles and Hives
Skin problems are sometimes inevitable especially in certain areas or workplaces where dirt is always present. Some of the reasons for having skin problems include bacteria trapped in skin pores and hair follicles, fungus, parasites, or microorganisms living on the skin, viruses, weakened immune system, contact with allergens, irritants, or another person’s infected skin and lastly – genetic factors. Here we will know more information about Shingles and Hives.
What are Shingles or Herpes Zoster?
“Shingles, also known as zoster or herpes zoster, is a viral disease characterized by a painful skin rash with blisters in a localized area. Typically the rash occurs in a single, wide stripe either on the left or right side of the body or face. Two to four days before the rash occurs there may be tingling or local pain in the area. Otherwise, there are typically few symptoms though some may have fever or headache, or feel tired. The rash usually heals within two to four weeks, however, some people develop ongoing nerve pain which can last for months or years, a condition called postherpetic neuralgia (PHN). In those with poor immune function, the rash may occur widely. If the rash involves the eye, vision loss may occur.
Shingles are due to a reactivation of varicella-zoster virus (VZV) in a person’s body. The disease chickenpox is caused by the initial infection with VZV. Once chickenpox has resolved, the virus may remain inactive in nerve cells. When it reactivates, it travels from the nerve body to the endings in the skin, producing blisters. Risk factors for reactivation include old age, poor immune function, and having had chickenpox before 18 months of age. How the virus remains in the body or subsequently re-activates is not well understood. Exposure to the virus in the blisters can cause chickenpox in someone who has not had it, but will not trigger shingles. Diagnosis is typically based on a person’s signs and symptoms. Varicella-zoster virus is not the same as the herpes simplex virus; however, they belong to the same family of viruses.
The shingles vaccine reduces the risk of shingles by 50% to 90%, depending on the vaccine used. It also decreases rates of postherpetic neuralgia, and if shingles occur, its severity. If shingles develop, antiviral medications such as aciclovir can reduce the severity and duration of disease if started within 72 hours of the appearance of the rash. Evidence does not show a significant effect of antivirals or steroids on rates of postherpetic neuralgia. Paracetamol, NSAIDs, or opioids may be used to help with acute pain.
It is estimated that about a third of people develop shingles at some point in their life. While more common among older people, children may also get the disease. The number of new cases per year ranges from 1.2 to 3.4 per 1,000 person-years among healthy individuals to 3.9 to 11.8 per 1,000 person-years among those older than 65 years of age. About half of those living to age 85 will have at least one attack, and less than 5% will have more than one attack. The disease has been recognized since ancient times.” – Wikipedia
How to Prevent Shingles?
“Shingles can be prevented by the chickenpox vaccine if the vaccine is administered before the individual gets chickenpox. If the primary infection has already occurred, there are shingles vaccines that reduce the risk of developing shingles or developing severe shingles if the disease occurs. They include a live attenuated virus vaccine, Zostavax, and an adjuvanted subunit vaccine, Shingrix.
A review by Cochrane concluded that Zostavax was useful for preventing shingles for at least three years. This equates to about 50% relative risk reduction. The vaccine reduced rates of persistent, severe pain after shingles by 66% in people who contracted shingles despite vaccination. Vaccine efficacy was maintained through four years of follow up. It has been recommended that people with primary or acquired immunodeficiency should not receive the live vaccine.
Two doses of Shingrix are recommended, which provide about 90% protection at 3.5 years. As of 2016, it had been studied only in people with an intact immune system. It appears to also be effective in the very old.
In England, Zostavax is offered by the National Health Service (NHS) to all people age 70 and 78. By August 2017, just under half of eligible 70–78-year-olds had been vaccinated. About 3% of those eligible by age but who have conditions that suppress their immune system, should not receive the vaccine. There had been 1,104 adverse reaction reports by April 2018. In the US, it is recommended that healthy adults 50 years and older receive two doses of Shingrix, two to six months apart.”-Wikipedia
What are Hives?
“Hives, also known as urticaria, is a kind of skin rash with red, raised, itchy bumps. They may also burn or sting. Often the patches of rash move around. Typically they last a few days and do not leave any long-lasting skin changes. Fewer than 5% of cases last for more than six weeks. The condition frequently recurs.
Hives frequently occur following an infection or as a result of an allergic reaction such as to medication, insect bites, or food. Psychological stress, cold temperature, or vibration may also be a trigger. In half of the cases the cause remains unknown. Risk factors include having conditions such as hay fever or asthma. Diagnosis is typically based on appearance. Patch testing may be useful to determine the allergy.
Prevention is by avoiding whatever it is that causes the condition. Treatment is typical with antihistamines such as diphenhydramine and ranitidine. In severe cases, corticosteroids or leukotriene inhibitors may also be used. Keeping the environmental temperature cool is also useful. For cases that last more than six weeks immunosuppressants such as ciclosporin may be used.
About 20% of people are affected. Cases of short duration occur equally in males and females while cases of long duration are more common in females. Cases of short duration are more common among children while cases of long duration are more common among those who are middle-aged. Hives have been described at least since the time of Hippocrates. The term urticaria is from the Latin urtica meaning “nettle”.-Wikipedia
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