Sheng She: What You Need to Know About Shingles

Shingles

Hello, doctor: May I ask what the disease referred to as "生蛇" in Taiwanese is, as I am not familiar with the correct terminology? What are the potential effects? If there is severe itching in the lower back, does that relate to a type of herpes?

Ying, 50~59 year old female. Ask Date: 2004/03/16

Dr. Zhong Yitun reply Dermatology

The common saying "to have a snake" refers to what is medically known as shingles, or herpes zoster.
Its pathogen is the same as that of chickenpox.
The cause is that after having chickenpox in childhood, some of the virus remains dormant in the nerve roots near the spinal cord (commonly referred to as the "dragon bone marrow").
As one ages, the virus may reactivate, often during times of stress or weakness, traveling along the nerves and eventually manifesting on the skin.
Because the nerves are also damaged, this can lead to unusual and very painful symptoms along the affected nerve pathway.
In the past, people believed it was caused by "snake spirits." However, modern science explains it as described above.

If shingles occurs in the head or near the anus or bladder, it can lead to complications such as encephalitis or severe bowel movement difficulties, in which case special antiviral medications are covered by health insurance.
For shingles occurring in other areas, unless there is cancer or a clear immune deficiency, patients will need to purchase antiviral medications out-of-pocket.
However, for individuals without cancer or immune deficiencies, and not located in the head, anus, or bladder, symptomatic treatment is usually recommended.
With adequate rest and avoiding excessive activity, the condition typically improves over time; this is also the approach taken in advanced countries.

Reply Date: 2004/03/16

More Info

Shingles, known in Mandarin as "生蛇" (Sheng She), is the common term for herpes zoster. This viral infection is caused by the reactivation of the varicella-zoster virus (VZV), which is the same virus that causes chickenpox. After a person has chickenpox, the virus remains dormant in the nerve tissues and can reactivate later in life, leading to shingles.
The condition is characterized by a painful rash that typically appears on one side of the body, often in a band-like pattern. The rash usually starts as red patches that develop into fluid-filled blisters. These blisters eventually crust over and heal. The pain associated with shingles can be quite severe and is often described as burning or tingling. In some cases, individuals may experience itching in the affected area, which you mentioned in your question regarding the itching in your lower back.

Shingles can have several impacts on a person's health. The most immediate concern is the pain and discomfort caused by the rash. In some cases, the pain can persist even after the rash has healed, a condition known as postherpetic neuralgia (PHN). This can significantly affect a person's quality of life, leading to difficulties in daily activities and sleep disturbances.

In addition to pain, shingles can also lead to other complications, especially in individuals with weakened immune systems or older adults. These complications can include:
1. Vision Problems: If shingles affects the eye (herpes zoster ophthalmicus), it can lead to serious eye complications, including vision loss.

2. Neurological Issues: In rare cases, shingles can cause inflammation of the brain (encephalitis) or other neurological complications.

3. Skin Infections: The blisters can become infected with bacteria, leading to further complications.

4. Scarring: The rash can leave scars after healing, particularly if the blisters were scratched or not properly cared for.

It's important to note that shingles is contagious to individuals who have never had chickenpox or have not been vaccinated against it. However, those who are exposed will develop chickenpox, not shingles.
If you suspect you have shingles, especially with the symptoms of itching and pain in the lower back, it is advisable to consult a healthcare professional. Early treatment with antiviral medications can help reduce the severity and duration of the symptoms, as well as lower the risk of complications.
In summary, "生蛇" refers to shingles, a painful condition caused by the reactivation of the varicella-zoster virus. It can lead to significant discomfort and potential complications, particularly in vulnerable populations. If you are experiencing symptoms, seeking medical advice is crucial for effective management and treatment.

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