Herpes Zoster (Shingles)
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.
Content courtesy of the American Academy of Dermatology