1. Who can get herpes
zoster?
Anyone who’s had chicken pox can develop herpes zoster, or
shingles. The reason is that same virus that causes chicken pox
causes herpes zoster. The virus remains in a dormant state in certain
nerve cells of the body and then reactivates, causing herpes zoster.
About 20 percent of the population are affected at some time during
their lives.
Most physicians believe there is a temporary weakness
in the body’s ability to fight off disease. This allows the
virus to start reproducing and move along nerve fibers toward the
skin.
People whose ability to ward off disease is weakened
are more prone to develop herpes zoster. They are also more likely
to have a serious form of it. This includes some people with cancer,
such as leukemia or lymphoma, or who have undergone chemotherapy
or radiation therapy for cancer. People who have had organ transplants
and are taking drugs to ward off transplant rejection may also be
more susceptible, as well as those with diseases that affect the
immunological system, such as AIDS.
2. What are the symptoms
of zoster?
The first symptom of herpes zoster is a burning pain or tingling
and extreme sensitivity in one area of the skin. This may be present
for one to three days before a red rash occurs. The rash soon turns
into groups of blisters that look a lot like chicken pox. The blisters
generally last for two to three weeks. The blisters will then crust
over and begin to disappear. The pain may last longer.
3. Where does zoster
usually appear on the body?
The blisters of herpes zoster are most common on the trunk and buttocks.
If the blisters involve the eye region, permanent eye damage can
result. And if blisters appear on the end of the nose, this means
the eye may be involved.
4. What are the complications
of zoster?
Post-herpetic neuralgia is a condition in which either constant
pain or periods of pain can continue after the skin has healed.
It can last for years. This complication is more common in older
people.
Another complication is when the disease spreads all
over the body. This is similar to chicken pox and it happens in
only about two to five percent of people. It also happens more often
in those with other diseases or weakened immunological systems.
Even internal organs may be affected by herpes zoster.
5. How is zoster diagnosed?
Usually the diagnosis of herpes zoster is based on the way the blisters
look and the existence of pain on one side of the body. To be sure,
the dermatologist may do a special test in which skin cells from
a blister are examined under the microscope or may send a specimen
to the lab for analysis.
6. Is zoster contagious?
The virus that causes herpes zoster can be passed on to others,
but they will develop chicken pox, not herpes zoster. Herpes zoster
is much less contagious than chicken pox. Persons with herpes zoster
can only transmit the virus to someone who never has had chicken
pox. Newborns, pregnant women or those who are immunosuppressed,
such as cancer patients, are at the highest risk.
7. Is there much scarring?
Scarring usually occurs only in persons who have more severe infections,
such as elderly people, patients with weakened immune systems or
those whose blisters become infected with bacteria.
8. What about treatment?
The anti-viral drugs acyclovir and famcyclovir are usually prescribed
for severe cases of herpes zoster or for those who are immunosuppressed.
These drugs do not seem to prevent post-herpetic neuralgia. Corticosteroids
are used for severe infections to reduce swelling and post-herpetic
neurglia. If it develops, post-herpetic neuralgia can be treated
with an anti-depressant drug at night and frequent use of pain relievers
during the day.
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