Excruciating Pain Like Skin Tearing 'Shingles'... Golden Time is 72 Hours After Blister Occurrence [Weekend Health]

If you feel extreme pain as if your skin is tearing even with just a brush of clothing on your chest and face, you might suspect shingles. According to McGill University in Canada, the pain from shingles is more severe than post-childbirth pain, indicating how much it can disrupt daily life. To escape this pain and prevent the virus from damaging nerves, it is important to adhere to the 'golden time'. Experts advise starting antiviral medication within 72 hours of blister occurrence.

■ 800,000 patients... More common in women over 50

According to the Health Insurance Review and Assessment Service on the 29th, as of 2023, there are about 750,000 shingles patients. The lifetime prevalence of shingles is 30%, and while it can occur at any age, the incidence and risk of postherpetic neuralgia increase with age. In fact, as of 2023, 65% of patients were over 50.

By gender, women are 1.5 times more likely to develop it than men. In addition to age and gender, chronic diseases like hypertension and diabetes, immunosuppressant use, and environments causing physical and mental stress are considered risk factors. The Korean Society of Infectious Diseases recommends vaccination for adults over 50 and severely immunocompromised individuals over 18.

The hallmark of shingles is skin symptoms. The shingles virus gradually moves to the skin following the infected nerve ganglia, causing characteristic lesions and pain in the skin area governed by these ganglia. It appears in a belt shape, reminiscent of the old Korean traditional belt, which is why it's called 'shingles' (daesangpojin in Korean, meaning 'belt-like rash').

Shingles is not airborne like through coughing or sneezing, but there is a possibility of transmission until scabs form on the skin. It is advisable to avoid contact with infants, pregnant women, and immunocompromised individuals.

■ Initial antiviral treatment within 72 hours

70-80% of shingles patients experience prodromal symptoms before skin lesions appear. Some report stabbing or shooting pain and itching, while others complain of muscle pain similar to the flu.

These prodromal symptoms can last from 2-3 days to as long as a week, making diagnosis difficult as there are no skin lesions during this period. After the prodromal phase, characteristic skin lesions appear. Erythema and papules occur along the dermatomes, leading to blister formation. About three days later, these turn into pustules, and by the 7th to 10th day, scabs form. The skin lesions heal as the scabs fall off in about 2-3 weeks.

Experts advise that early treatment of shingles is crucial to prevent the virus from damaging nerves. Professor Kim Eung-don of the Department of Pain Medicine at Catholic University Daejeon St. Mary's Hospital strongly recommends starting antiviral medication within 72 hours of blister occurrence, stating, "If persistent pain signals are left untreated, nerve degeneration will occur. Once nerve degeneration occurs, it is very difficult to reverse, so quick and proactive treatment is very important."

To control pain, medication such as analgesics and anti-inflammatory drugs should be used, and if necessary, nerve treatments should be actively implemented. Shingles is considered a distressing disease because it can be accompanied by the sequelae of neuralgia. Even if the skin heals, if pain persists for three months, it can be considered a stage of postherpetic neuralgia. If this pain lasts for more than six months, it is regarded as chronic postherpetic neuralgia, which becomes intractable pain.

■ It could be simple herpes... What is the difference with shingles?

Shingles can easily be confused with simple herpes. While simple herpes occurs in a localized area, shingles causes blisters in a belt shape along the nerves. Experts advise that it is difficult for the general public to distinguish the disease based solely on blisters, so it is important to visit a medical institution for an accurate diagnosis and early treatment.

Simple herpes is also related to weakened immunity, like shingles, and is characterized by clusters of blisters resembling grape bunches. It is classified into type 1, which occurs above the waist, and type 2, which occurs below the waist, with symptom differences depending on the individual's immune status or the affected area.

The most common type 1 herpes is lip herpes, which occurs from the lip border to the cheeks, chin, nose, and oral mucosa. Before blisters appear, burning, pain, and itching may accompany. In the case of type 2, which causes blisters around the genitals, it is a type of sexually transmitted disease and can be accompanied by muscle pain, fever, malaise, and fatigue in addition to blisters.

Simple herpes is transmitted through physical contact with an infected person. Once infected, even after treatment, it remains dormant in the nerve tissue called the dorsal root ganglion and can easily recur and cause symptoms when immunity is lowered or due to stress or inflammation.

Kim Yoon-mi, director of the Comprehensive Health Checkup Center at Daedong Hospital, advised, "Shingles can be prevented through vaccination, but the best prevention for common blister viruses is lifestyle improvement," adding, "To prevent simple herpes and others, you should pay attention to condition management and personal hygiene."

stand@fnnews.com Seo Ji-yoon Reporter