If you had chickenpox as a child, watch out for shingles

By Oswald Mikell CONTRIBUTOR

You might have already received your Covid vaccines, but don’t forget about the shingles vaccines. An estimated 98% of adults in the United States have been infected with the chickenpox virus and are at risk for shingles.

Did you know that shingles can occur only in people who have had chickenpox? After you’ve had chickenpox, the virus lies inactive in nerve tissue near your spinal cord and brain. Years later, the virus may reactivate.

Q: What are the symptoms?

A: The first sign of shingles is often burning or tingling pain, or itch, in one particular location on only one side of the body. After several days or a week, a rash of fluid-filled blisters, similar to chickenpox, appears in one area on one side of the body. Other symptoms may include fever, headache, chills and upset stomach.

Q: Can shingles be passed on to others?

A: Yes, a person with a shingles rash can pass the virus to someone who has never had chickenpox if it enters their respiratory system or gets on their mucous membranes. The person will develop chickenpox, not shingles. The person must come into direct contact with the open sores of the shingles rash during the blistering phase.

Q: How do you know when to see a doctor?

A: Contact your doctor promptly if you suspect shingles, but especially in the following situations:

• The pain and rash occur near an eye. If left untreated, this infection can lead to permanent eye damage.

• You’re 50 or older, which increases your risk of complications.

• You or someone in your family has a weakened immune system (due to cancer, medications or chronic illness).

• The rash is widespread and painful.

Q: What is the treatment for shingles?

A: Starting antiviral medicine in the first few days can help your rash heal faster and be less painful. So, if you think you might have shingles, see your doctor right away. Also, good home care can help you feel better faster. Take care of any skin sores and keep them clean. Take your medicines as directed.

Q: Can anything be done to prevent shingles?

A: Two vaccines may help prevent shingles – the chickenpox (varicella) vaccine and the shingles (varicella-zoster) vaccine. However, the vaccines are used only as a prevention strategy and are not intended to treat people who currently have the disease.

Q: Who is at risk?

A: While anyone who’s had chicken pox is at risk, the older you get – the higher your risk. This is because your body can’t defend itself against the virus that causes Shingles as well as it could when you were younger.

While shingles isn’t a life-threatening condition, it can be very painful. Early treatment can help shorten a shingles infection and lessen the chance of complications. If you think you may have shingles, call your dermatologist.

Dr. Oswald Lightsey Mikell, certified by the American Board of Dermatology and the American Board of Cosmetic Surgery, is the owner of Dermatology Associates of the Lowcountry.

By E. Ronald Finger CONTRIBUTOR

Noses are complicated because they have so many parts, each influencing the other parts. There are two bones and four main cartilages, not counting the septum with its bones and cartilage, which separates one nostril from the other and which also influences the shape of the nose.

If you are considering changing yours, consider the following:

Step 1: Decide what you do not like about your nose. Is it too long or short; do you have a hump: is it crooked; is the tip too wide and flaring: are the bones too wide in the upper half of the nose; does the tip point down? Can you breathe well through both nostrils? Discuss all of this with your plastic surgeon so you can come together with the procedure that meets your goals and discuss what is achievable.

Do you want an improvement but still retain ethnic heritage? Be as specific as possible when discussing this.

Step 2: Discuss the plan with your plastic surgeon and have the surgeon show diagrams as to how the possibilities will be achieved. Are cartilage grafts, usually taken from the septum, needed for creating more nasal tip projection or for filling in certain depressions seen in crooked noses?

Your plastic surgeon will point out certain aspects of your nose that you might not have noticed, such as a retracted columella (the skin strut that separates the nostrils). The columella should be parallel with the outer rim of the nostrils. A retracted columella allows the tip to droop and may make the upper lip look too long, and it reduces the attractiveness of the nose.

Step 3: Discuss the post-operative course and care and what to expect. Typically, if the nasal bones must be “broken” (an incorrect term, as they are cut with an instrument called an “osteotome”), there will be a splint on your nose for a week to keep the bones in place. Much of the swelling will subside in two to three weeks, but there will still be some swelling that will last for a year, although the nose should look significantly improved by the end of the month.

It’s important to know that about 10% of all rhinoplasties require some adjustment or small procedure when all of the swelling has subsided, and the nose can be properly evaluated. Sometimes the adjustment can be as simple as an injection of long-acting fillers.