What is Shingles?

Shingles, also called Herpes Zoster, is viral skin condition treatable using Chinese Medicine. For a person who has had chicken pox, the varicella-zoster virus that caused it may have lain dormant in the peripheral nerves exiting his/her spinal cord.

The varicella virus sits latent in the nervous system. At some point in adulthood, during a time of reduced immune function, this inactive virus is activated and causes excruciating pain in affected areas. It usually starts with an area of pain, which is then accompanied by purulent blisters. This is an outbreak of Shingles (Herpes Zoster).

Is Shingles contagious?

During a Herpes Zoster outbreak, first a rash appears, and then the rash enters the blister phase. It is the shingles blisters that are contagious. It is not contagious before the blisters appear, nor is it once the blisters erupt and are crusted.
Q: Do I need to have had chickenpox to get Shingles?

The only way you can get shingles is if you have had chickenpox before. If you do not already have the chickenpox (varicella) virus in your system, it is very unlikely for you to get the shingles disease.

Can I get Shingles from a person with Shingles?

If you have never had chickenpox and come in contact with someone with active shingles, you could contract the virus and get chicken pox if the person is contagious.

The person is contagious if the rash has turned to blisters and you are exposed to the shingles blisters.

Can a vaccinated person be infected by a person with Shingles?

If you have received vaccination for chicken pox, you’re also protected from shingles as an adult.

Differentiating between the two Herpes diseases

Oral/Genital Herpes and Herpes Zoster (Shingles) are two different conditions; they are not the same virus. The confusion often happens because when the word “HERPES” is mentioned. “Herpes” is often associated with genital herpes. The fact is this: “not all herpes is genital herpes.”

Here’s one way to differentiate between them both.

  • Herpes Simplex happens either as cold sores around the mouth (oral herpes), or as blisters and open sores in the genital area (genital herpes).
  • Herpes Zoster happens around the side of the face or the ribs. This is Shingles.

They are both viral conditions and an outbreak often coincides with a weakened immune system. In both conditions, there is usually a burning sensation associated with the skin outbreak.

But Shingles has nothing to do with genital infection or STDs.

TCM treatment for Shingles in Singapore

You should consider Chinese medicine (TCM) treatment for shingles.

Shingles is commonly treated with a high degree of efficacy by TCM physicians in Singapore. A TCM physician who has been trained in China would likely have seen numerous cases of shingles being treated successfully by acupuncture alone.

In the treatment of shingles using TCM, we do not just treat shingles lesions at the ribs; we are especially good at treating face shingles or shingles around the eyes.

We are also proponents of using Chinese herbs in addition to acupuncture treatment, because we have seen how this speeds up the disease process, allowing the patient’s body to recover much faster.

Usage of Chinese herbs by our TCM physicians also prevents the occurrence of post herpetic neuralgia (PHN), where the shingles pain continues even when the shingles outbreak has already come and gone. Too little consideration is given to PHN, and the best approach is to undergo TCM treatment as soon as possible; your body will thank you for making this decision.

The Shingles Outbreak

Shingles is an acute skin infection associated with chicken pox virus. During the chicken pox infection (often in childhood), the virus enters the cutaneous nerves, making its way to the dorsal root ganglia where it lies dormant. In a adulthood, this virus becomes active again, usually due to the following which causes the immune system to become compromised.:

  • Stress and mental overwhelm (usually a big event in life)
  • Emotional stress (usually a big event in life)
  • Debilitating medical condition which overwhelms the physical body (usually a big event in life)
  • Usage of immunosuppressant drugs or vaccination

Turning points in our life somehow causes the virus to travel back from the dorsal root ganglia to the cutaneous nerve, which causes nerve pain, red rashes and blisters along the line of the cutaneous nerve.

What is the experience of the acute phase of Shingles like?

Of all the symptoms that come with a herpes zoster infection, the most outstanding one is pain. Pain is experienced as a sensitive, tingling sensation or burning pain, usually on the ribs on one side of the body, but sometimes also on the face. Thereafter, red rashes appear, the rashes spread and groups of blisters start to appear.

Note that the lesions are one-sided (asymmetrical). Shingles occur in the form of a one-sided eruption of a red rash, accompanied by blisters and severe pain.

In the beginning, when the red rash occurs, it is difficult to give a precise diagnosis, as the body may also experience symptoms such as fever, headache, loss of appetite and tiredness. These symptoms are common in the initial stages of many early-stage viral infections. It is only when the painful blisters appear that it becomes obvious it is an outbreak of shingles.

The ribs are most commonly affected area, and pain may be experienced even a few weeks before skin changes are seen. In the situation where no skin lesions are visible, it is called zoster sine herpete.

What is the recovery phase of Shingles like?

There is no NEW varicella zoster rash erupting in the recovery phase. The initial rash has started to fade, and the skin starts to heal. For some people, even though the rash has resolved, there may continue to be abnormal or even painful sensations at the site of the lesion. This is because the nerve damage may cause exaggerated sensory response. This is post herpetic neuralgia (PHN), and you would want to consider using TCM to treat this.

What is the best medical treatment for Shingles

Antivirals are the first line of treatment in this day and age. You need not visit the National Skin Centre to get access to antivirals medication. Even a GP clinic is able to offer this prescription. While oral antiviral drugs are effective, corticosteroids (even topical creams) are considered ineffective or even harmful treatment for shingles.

TCM is the next line of treatment. In the long past, patients may have done well with TCM alone, but at our TCM Clinic, we may still advise for you to get antiviral drugs while seeing us. We just want you to get the best recovery possible. You do not need to go to the National Skin Centre to get antiviral, any GP clinic will be able to prescribe for you.

This is not to downplay the effectiveness of Traditional Chinese medicine TCM. Rather, it is to recognize the effectiveness of combined treatment for shingles. Treat with both pharmaceutical drugs and TCM; it does not have to be one or the other! You will only benefit from receiving TCM session in tandem with early use of antivirals.

TCM Diagnosis and Treatment for Shingles infection

Because the shingles lesions often coincide with the parts of the body traversed by the Liver and Gall Bladder meridians, the TCM strategy in the treatment for shingles revolves around clearing Damp Heat in the Liver and Gall Bladder. One way of clearing out damp heat is through acupuncture. Those who have received acupuncture for shingles will be quick to affirm a significant change in the way they feel after treatment. Acupuncture can reduce painful sensations very effectively and most of the patients at our TCM clinic attest to its efficacy.

Herbal medicine is the other way to treat shingles using TCM. The herbal aspect of traditional Chinese medicine is often overlooked in the treatment for shingles. We thoroughly recommend it, because it is crucial in the prevention of postherpetic neuralgia (PHN).

In the acute phase of shingles, herbal medicine will always include herbs like Gardenia and Skullcap to drain out pathogenic damp, as well as a slew of herbs like Bupleurum and Lonicera that have anti-inflammatory and anti-viral action.

How the shingles blisters present also affects how we choose herbs for our patients. The size of the blisters, how much they ooze, as well as possible accompanying symptoms like fatigue and poor appetite, help the TCM physician determine the optimal mix of herbs. For some patients, the TCM herbs may focus more on clearing Liver fire; for others, the focus may be more on draining Spleen damp.

In some patients with a weak constitution, tonic herbs are added in with care to support the immune system in a gentle manner. As the intensity of the acute phase begins to peter out, the TCM herbal formula is modified to take into account the need for enhanced circulation, with the intent to prevent postherpetic neuralgia.

As certain foods are not optimal for the body, the patient is advised to stay away from both raw and spicy foods, and to not indulge in rich foods for the time being.

While shingles blisters are very painful, it is post herpetic neuralgia that has longer-term consequences! Post herpetic neuralgia is where the pain persists even after the outbreak is over. Some patients experience severe nerve pain if the nerves are damaged. The pain can last for a very long time, up to years after the rash has disappeared. Sometimes, it is not so much pain but unfamiliar and uncomfortable sensations that remain after the outbreak. This is why Herpes Zoster should be treated once it is diagnosed, even if you are already on antiviral medication in the acute phase of the outbreak.

For outbreaks on the face, in addition to acupuncture treatment , we highly recommend you be treated with TCM herbs. The herbs are crucial in preventing post herpetic neuralgia as well as restoring normal nerve sensation.