What is Shingles or Herpes Zoster?
Shingles or herpes zoster is a medical condition which causes a painful and blistering skin rash. The cause for this is the varicella-zoster virus, which also causes chickenpox. Treatment is done by taking antiviral drugs such as acyclovir, famciclovir, and valacyclovir.
Risk Factors and Causes of Shingles or Herpes Zoster
After the patient suffers from chickenpox, the virus remains dormant in some nerves of the body. Many years later, when this virus becomes active again, it causes shingles. The cause for this virus suddenly becoming active is not known. There is usually one attack. Patients from any age group can have shingles, but the risk for developing shingles or herpes zoster increases if:
- You are over 60 years of age.
- You had chickenpox before your first birthday.
- Some diseases or medications that have weakened your immune system.
If an adult or child who never had chicken pox and has had a direct contact with the shingles rash may develop chickenpox, not shingles.
Signs and Symptoms of Shingles or Herpes Zoster
- One-sided pain, burning or tingling. There may be severe pain and burning, which is often present before the appearance of the rash.
- Red patches appear on the skin which is then followed by small blisters.
- The blisters rupture, forming small sores which dry and form crusts. These crusts fall off within 2 to 3 weeks. Scarring rarely occurs.
- The rash usually occurs in a narrow region from the spine around to the anterior part of the chest or the belly area.
- The rash may also involve the face, eyes, mouth and ears.
Other Symptoms of Shingles or Herpes Zoster are:
- Pain in the abdomen.
- Fever and chills.
- Generally not feeling well.
- Sores in the genital region.
- Joint pain.
- Swelling in the lymph nodes.
If the shingles affects a nerve in the face, then patient may also have a rash in different parts of the face along with pain and muscle weakness with the following symptoms:
- Difficulty in moving some facial muscles.
- Ptosis (drooping eyelid).
- Loss of hearing.
- Loss of eye movements.
- Problems with taste.
- Vision problems.
Tests to Diagnose Shingles or Herpes Zoster
- Medical history and physical examination.
- A skin sample may be done to check if the skin is infected with the shingles causing virus.
- Blood tests help in detecting the increase in the white blood cells count and antibodies to the chickenpox virus.
Treatment for Shingles or Herpes Zoster
- Antiviral drugs such as acyclovir, famciclovir and valacyclovir are given to help with relieving the pain, preventing complications, and reducing the course of the disease.
- These medications should be started within 72 hours of feeling pain or burning and are best started before the appearance of blisters. These medications are given in high doses and some patients may require the medicine intravenously.
- Corticosteroids such as prednisone may also be given to help reduce swelling and pain; however, not every patient benefits from this.
- Antihistamines can be given to reduce itching.
- Pain killers such as Tylenol or NSAIDs help alleviate pain.
- Cool wet compresses can be applied to help reduce pain.
- Soothing baths such as colloidal oatmeal bath, starch baths can be taken.
- Lotions, such as calamine lotion, help in relieving discomfort and itching.
- Patient should take complete bed rest till the fever has subsided.
- The skin should be kept clean and contaminated things should not be re-used.
- Non-disposable items should be washed in boiling water or disinfected before re-use.
- Patient should avoid meeting other people (especially pregnant women) while their sores are oozing as their condition is highly contagious.
- Shingles can be prevented by taking a herpes zoster vaccine and avoiding those individuals who are affected by shingles.
Complications for Shingles or Herpes Zoster
- Another attack of shingles.
- Bacterial skin infections.
- Blindness. (if the eyes are affected from shingles)
- Infections such as encephalitis or sepsis, especially in patients who have a weak immune system.
- If the nerves in the face are affected by shingles, it may cause Ramsay Hunt syndrome.