SHINGLES
BLAME CHICKENPOX. That mostly harmless illness we get as children
can come back to haunt us decades later. Varicella-zoster, the other name
for shingles, is the illness that occurs when the chickenpox virus, which
goes dormant in the nerves along the spine, becomes active again.
The reason the virus reactivates isn't clear, but it may have to do with a weakening of the immune system, which can occur with age. Stress can also impair immunity temporarily. Long-term illnesses, especially those that attack the immune system, such as AIDS or certain cancers, can lower resistance. So can medications that suppress the immune system, such as cortisone taken long-term or drugs used after a transplant or during chemotherapy.
When the chickenpox virus multiplies within the nerves, it produces a burning, tingling or intensely painful sensation in the area serviced by those nerves. Pain may follow a line that wraps from the back around one side of the ribs, or it may travel down an arm or a leg or spread across one side of the face. The affected skin may be extremely sensitive to touch. The person may also feel lousy in general, with slight fever and headache.
When the virus migrates along the nerves to the skin, it produces a rash of many clustered blisters. The rash, like the pain, involves only one side of the body. The blisters are often painful and sometimes itchy and take about ten days to crust, scab and heal. About 10 per cent of people have pain that lingers several months after the rash clears. The rash can become infected; if this happens, if the discomfort is severe, if you get shingles more than once or if your immune system is suppressed and you get shingles, see your doctor.
In general, people with compromised immune systems, whether due to long-term illness or immune-suppressing medications, receive more aggressive treatment for shingles because the outbreak can cause them to develop more severe illness.
GO TO THE LARDER, GET THE BOX
The basic home remedies for shingles are the same ones you or your mother
may have used for chickenpox and other itchy rashes: cool compresses, calamine
lotion, and simple pastes made of cornflour or bicarbonate of soda and
water.
Resist the temptation to buy gooey ointments and corticosteroid creams. Ointments
can impede the drying and crusting of the shingles lesions that healing requires
and may increase the risk of a crust falling off prematurely and producing
a scar. Once the scabs loosen on their own, ointments and salves are fine.
Creams containing corticosteroids (such as hydrocortisone) may decrease the
inflammation of shingles, but they also interfere with your skin's local
immune response.
Keep in mind that the virus is contagious. Wash your hands after touching
the rash, and take other precautions to avoid spreading it. Be especially
cautious around those who are pregnant; the virus can be dangerous to pregnant
women who have never had chickenpox.
DRUG TREATMENT
Analgesics
Aspirin, ibuprofen, naproxen, paracetamol. Function: reduce pain, fever and
(except paracetamol) inflammation. Aspirin side effects: heartburn, indigestion,
stomach irritation, mild nausea or vomiting. Ibuprofen and naproxen side
effects: dizziness, nausea, stomach ache, headache. Paracetamol side effects:
not common with short-term use and regular doses.
Antiviral Drugs
Aciclovir (Zovirax), famciclovir (Famvir), valaciclovir (Valtrex). Function:
kill viruses. Side effects aciclover: rashes, headache, dizziness, fatique,
stomach ache. Side effects famciclover and valaciclover: nausea, vomiting,
diarrhoea, tremor, dizziness, confusion, hallucinations, headache, stomach
ache, rash.
Tricyclic Antidepressants
Amitriptyline hydrochloride (Lentizol, Tryptizol), desipramine (Norpramin).
Function: help reduce pain. Side effects: tremor, headache, dry mouth,
unpleasant taste in mouth, constipation, diarrhoea, nausea, fatigue, weakness,
drowsiness, nervousness, excessive sweating, insomnia, blurred vision,
rashes, increased appetite, weight gain.
Corticosteroids
Prednisolone (Prednesol). Function: reduces pain. Side effects: increased
appetite, weight gain, fluid retention, indigestion, nausea, vomiting,
dizziness, insomnia, acne, poor wound-healing, decreased immune function,
hiccups.
HERBAL REMEDIES
Cayenne or Chilli Pepper (Capsicum spp.)
Why not fight fire with fire? Hot peppers contain capsaicin, which
depletes substance P, a chemical involved in the nerve transmission of pain.
Several studies have shown capsaicin-containing creams to be effective in
easing the pain of shingles. You can buy a commercial cream or you can make
your own by blending a small amount of cayenne powder into body lotion or
aloe vera gel. Aloe has its own benefits and may soothe the burning of cayenne,
which might be too irritating during the blister phase of shingles. Try combining
1 tablespoon of aloe gel with up to 1/8 teaspoon of cayenne pepper. Apply
to a test patch of normal skin; if it burns, add more aloe gel. Use as often
as necessary. Caution: when you use cayenne products, wash your hands afterwards
to avoid spreading the oil to your eyes or other sensitive areas.
Lemon Balm (Melissa officinalis)
Who would think that this leafy, lemon-scented herb would be an ally against
viruses? One study has proven lemon balm's effectiveness against the herpes
simplex virus, a relative of the one that causes shingles. So it's worth
a try, especially since it's very safe. Commercial creams containing it
are also available. If you have access to fresh lemon balm leaves, moisten
them, wrap them in a loosely woven damp cloth such as muslin or thin T-shirt
cotton, and apply to the blisters. To make a compress, make tea (steep
1 to 2 teaspoons of dried leaves in 1/4 litre of hot water for 10 minutes),
then strain and allow to cool. Dampen a clean cloth with the tea and apply
to the rash three to five times per day. You can also take lemon balm internally.
Typical dosage: 3 or more cups of tea per day (use the same recipe as above).
Liquorice
(Glycyrrhiza glabra)
One of this root's virus-fighting, active ingredients inhibits the herpes
simplex virus. Liquorice also coaxes the body to produce more interferon,
a natural antiviral substance. Plus it fights inflammation without the side
effects of cortisone drugs. Because liquorice tea is intensely sweet, you
may want to blend it with some of the other herbs listed in this section.
Good choices would be lemon balm, ginger, St John's wort and mullein. Typical
dose: 2 to 3 cups of tea per day (simmer 1 teaspoon of dried chopped root
in 450 millilitres of water for 15 minutes); the tea can also be cooled to
use in a compress. Caution: limit use to not more than six weeks. Do not
use if you have high blood pressure, diabetes, or a disease of the thyroid,
kidney, liver or heart. Do not use liquorice if you're pregnant or breastfeeding.
Baikal
Skullcap (Scutellaria baicalensis)
This Chinese herb works against both viruses and bacteria, so it's a good
one to apply topically to shingles. Grind the dried root to a powder in a
coffee mill or food grinder; then mix a tablespoon of powder with enough
water to form a paste and apply just as you would a paste of bicarbonate
of soda, up to six times per day as needed.
Mullein (Verbascum thapsus)
This flower can inhibit the herpes simplex virus; it can also gently reduce
pain. Used in a compress, a tea made from mullein leaves calms inflammation
and soothes irritated skin. Typical dosage: 4 to 6 cups of tea per day
(steep 1 heaped teaspoon of dried flowers and leaves in 4 litre of water
for 10 minutes); the tea can also be cooled and applied to the rash as
a compress as needed.
St John's Wort (Hypericum perforatum)
Used externally, St John's wort has a long history of healing wounds. It
can also help reduce pain and itching, which makes it a good choice for shingles.
Most commercial products that you'll see for external use are infused oils,
meaning an oil in which the flowers have been steeped for a few weeks. But,
during the blister and crust stages of shingles, you don't want to apply
an oil. Avoid these products until the scabs have dropped off, and use a
compress made with tea instead. Typical dosage: 15 to 40 drops of tincture
three times per day; or 300 milligrams of standardised capsules or tablets
three times per day. Or you can apply a compress made with a tea of St John's
wort (steep 2 teaspoons of flowering tops in 1/4 litre of hot water for 10
minutes; then strain and cool). Dampen a clean cloth with the tea and apply
for 15 minutes, up to three times per day. Caution: may increase skin reactions
to sun exposure. Do not take internally if you are on prescribed antidepressants
or l.-dopa, a drug for treating Parkinson's disease.
Turmeric (Curcuma longa)
This spice contains curcumin, which has potent anti-inflammatory properties.
Topical curcumin, like capsaicin from cayenne, is thought to ease pain by
depleting substance P, the nerve transmitter of pain. See 'Aloe-and-Herbs
Shingles Gel' below to use turmeric topically. Typical dosage: one
250- to 500-milligram standardised capsule, up to three times per day; or
10 to 30 drops of tincture up to three times per day. Caution: do not take
turmeric internally if you have gastritis, stomach ulcers, gallstones or
bile duct obstruction.
Aloe (Aloe vera)
Antibacterial and anti-inflammatory, aloe vera gel soothes irritated skin
and makes a great vehicle for other herbs. If you grow this plant, slice
the leaf lengthways, scoop out the gel and apply generously to the rash.
You can also use a commercial preparation of pure aloe vera gel, ideally
one without artificial colourings and preservatives. Apply as often as
needed to the rash during any of its stages.
ALOE-AND-HERBS SHINGLES GEL
If you have access to fresh leaves of lemon balm or flowering tops of St
John's wort, double the quantities of them in this recipe. (Flowering tops
are the flowers in bloom, plus about 8 to 13 centimetres of the stem.)
450 millilitres aloe vera gel
4 tablespoons lemon balm leaves
4 tablespoons St John's wort flowering tops 2 tablespoons cut dried liquorice
root
2 tablespoons cayenne or turmeric
8 drops of bergamot, lemon, tea tree or lavender essential oil
Blend the first five ingredients in a 1-litre jar. Let sit for 24 hours at
room temperature. Strain through a tightly woven cloth into a clean jar.
Add the essential oil and cap tightly. Store in the refrigerator.
Apply to a test patch of normal skin. If it burns on contact, add more aloe
vera gel. If it doesn't, you can try blending in a bit more cayenne. Apply
to the rash three to five times per day as needed.
After applying the gel,, be sure to wash your hands with soap to avoid spreading
the compounds that burn.
For most people with shingles, cayenne may be too irritating to apply during
the blister phase. In addition, some people with pain that lingers after
the shingles rash has healed find that cayenne burns too much. If this is
true for you, you can still use this gel; just omit the cayenne.
