Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
Many cases of shingles go away by themselves, with or without treatment. The rash and pain should be gone in two to three weeks. However, shingles may last longer and be more likely to recur if the person is older, especially older than 50 years
of age, or if they have a serious medical problem.
Pain may last after the rash is gone. This is called postherpetic neuralgia (PHN). About 10%-15% of all shingles patients get PHN. The older the patient, the more likely they will develop PHN, and the pain that develops frequently is severe. PHN pain often lasts months and occasionally may go on for years. A new drug, Horizant (described above) may reduce the PHN symptoms.
Other possible complications include a bacterial skin infection, spread of infection to internal organs of the body, or eye damage. Scarring is common. Lesions in the mouth make it difficult for patients to eat and drink.
About 10%-25% of people with shingles develop the complication of eye involvement. This is termed herpes zoster ophthalmicus and may involve several eye structures. The disease can lead to blindness and should be considered a medical emergency. Ramsay Hunt syndrome is a variation of this infection that involves the facial nerves and results in facial paralysis, usually on one side of the face, and may also result in hearing loss.
Unfortunately, individuals can get shingles more than once. Although multiple shingles outbreaks are seen infrequently, they are significant because they usually occur in people with multiple medical problems or increasingly weakened immune responses. This complication of shingles often indicates that the person has increasing medical problems that need to be diagnosed or aggressively treated (or both).
Pregnant females who get shingles are not at as high a risk for viral complications as those pregnant females
who become infected with chickenpox. However, if shingles develops within a few weeks of the delivery date, the infant may be at risk for viral complications, and the affected woman should notify her OB-GYN doctor immediately. In addition, shingles at any time during pregnancy may require special treatments; the OB-GYN physician needs to be contacted to help arrange individualized treatment plans.