Shingles: The Most Effective Dietary Supplements

Shingles is a viral disease caused by the reactivation of the varicella-zoster virus (VZV), the same virus responsible for chickenpox. After primary infection, often during childhood, the virus remains dormant in the nerve ganglia and can reactivate years later, causing shingles. Shingles presents as a painful skin rash and vesicles located along one or more dermatomes, which are areas of skin connected to the affected nerve.

Pathogenesis

The virus remains dormant in the sensory nerve ganglia following the initial chickenpox infection. Its reactivation is often associated with: • Advanced age (> 50 years). • Immunosuppression (due to diseases like cancer or HIV, or immunosuppressive treatments). • Chronic stress or acute infections (including COVID-19 and its vaccination). This reactivation of the virus leads to inflammation of the affected nerves and spreading of viral particles along the sensory nerve fibers. The skin lesions correspond to the dermatomes innervated by the infected ganglia. Pain is a central element of the pathogenesis of shingles. It is caused by inflammation of the affected nerves as well as structural damage to the nerve fibers.

Symptoms

Shingles often begins with pain, itching, or a burning sensation localized in a specific skin area, typically on one side of the body. A few days later, a vesicular rash appears in this area, accompanied by redness and acute pain. The rash evolves into crusts in one to two weeks, and healing takes about three to four weeks. In some cases, neuropathic pain may persist for several months or even years after the rash heals, a condition called postherpetic neuralgia (PHN).

Complications

The most common and debilitating complication of shingles is postherpetic neuralgia (PHN), which occurs in about 10 to 15% of patients, especially older individuals. This condition results in chronic and severe pain in the affected area, lasting for several months after the skin lesions disappear. Other complications include infection of the skin lesions, ocular involvement (ophthalmic shingles) that can lead to blindness, and neurological complications such as facial paralysis or encephalitis.

Epidemiology

Shingles affects about 3 to 5 individuals per 1000 per year, with an incidence increasing after 60 years, reaching up to 11 cases per 1000 among older individuals. Women are slightly more affected than men. The emergence of reactivations related to COVID-19 or its vaccination is a recently observed phenomenon. mRNA vaccines have been associated with an increased risk of reactivation.

Treatment

Treatment for shingles aims to accelerate healing of the skin lesions, reduce pain, and prevent complications. Antivirals, such as acyclovir, valacyclovir, and famciclovir, are effective in reducing the duration and severity of symptoms if administered within the first 72 hours of lesion onset. Complementary treatments, such as analgesics (including opioids for severe pain) and topical agents like lidocaine or capsaicin patches, are often necessary to manage acute pain. In cases of postherpetic neuralgia, tricyclic antidepressants, anticonvulsants (gabapentin or pregabalin), and local anesthetics may be used.

Prevention

Prevention of shingles primarily relies on vaccination and maintaining a good specific immunity to the varicella-zoster virus. The shingles vaccine, based on an attenuated live virus, has shown noteworthy efficacy, with a 51% reduction in the incidence of shingles and a 67% decrease in postherpetic pain in vaccinated subjects.

Natural Approaches

Complementary approaches useful for soothing symptoms and supporting immunity: • Peppermint essential oil (Mentha piperita): known for its analgesic effect, it may help relieve localized pain. • Immunostimulating essential oils: Ravintsara (Cinnamomum camphora CT cineole), niaouli (Melaleuca quinquenervia CT cineole) and thyme linalool (Thymus vulgaris CT linalool): they help strengthen the body's natural defenses against the virus. • Anti-inflammatory essential oils: Lemon eucalyptus (Eucalyptus citriodora), spike lavender (Lavandula spica) and Roman chamomile (Chamaemelum nobile): these oils soothe skin inflammations and promote tissue regeneration. • Echinacea (Echinacea purpurea): this plant is traditionally used to stimulate the immune system, improving resistance to viral infections such as shingles. • Trace elements: the Copper-Gold-Silver (Cu-Au-Ag) complex acts as an immune stimulant and supports tissue regeneration.