Shingles treatment: Does alcohol use affect therapy?

Does moderate alcohol use interfere with shingles treatment?

Answer From Pritish K. Tosh, M.D.

Generally, it’s best to avoid alcohol during shingles treatment.

Shingles (herpes zoster) is a viral infection that causes a painful rash. An episode of shingles usually heals on its own within a few weeks. However, immediate shingles treatment — often including an antiviral drug, such as acyclovir (Zovirax, Sitavig), famciclovir or valacyclovir (Valtrex) — can reduce pain, speed healing and reduce the risk of complications.

Although alcohol warnings aren’t specifically listed in the product labels for the antiviral drugs most often used to treat shingles, it’s usually best to avoid mixing alcohol and medication. Alcohol can reduce the effectiveness of certain medications, as well as increase the risk of side effects, such as dizziness, especially in older adults.

With

Pritish K. Tosh, M.D.

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• Shingles vaccine: Can I transmit the vaccine virus to others?

July 22, 2021

Show references

1. Shingles (herpes zoster). Centers for Disease Control and Prevention. http://www.cdc.gov/shingles/about/index.html. Accessed April 7, 2021.
2. Albrecht MA. Treatment of herpes zoster in the immunocompetent host. https://www.uptodate.com/contents/search. Accessed April 7, 2021.
3. Harmful interactions: Mixing alcohol with medicines. National Institute on Alcohol Abuse and Alcoholism. https://www.niaaa.nih.gov/publications/brochures-and-fact-sheets/harmful-interactions-mixing-alcohol-with-medicines. Accessed April 7, 2021.
4. Shingles: Hope through research. National Institute of Neurological Disorders and Stroke. https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Hope-Through-Research/Shingles-Hope-Through-Research. Accessed April 7, 2021.

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Shingles Treatment and Prevention: Vaccines and Medications

While there’s no cure for shingles, getting immediate treatment can help speed the healing process and reduce your risk of complications.

Antiviral drugs, such as Valtrex (valacyclovir), can shorten the duration and severity of shingles, but they’re most effective if you start them as quickly as possible after the rash emerges, or even before it erupts, according to the Centers for Disease Control and Prevention (CDC).

Prescription or over-the-counter (OTC) pain medication may also help relieve pain, along with home remedies like oatmeal baths, wet compresses, and calamine lotion.

What Drugs Are Prescribed for Shingles?

Per the CDC, to help diminish the length and severity of shingles, your physician may prescribe an antiviral drug, such as the following:

Ideally, you should take antiviral medication as soon as the rash appears (if not sooner). Taking these drugs within 72 hours of the eruption of the rash will help prevent postherpetic neuralgia (PHN), according to Mayo Clinic.

PHN is a condition in which nerve fibers, inflamed or damaged by shingles, continue to send pain signals to your brain months or even years after the blisters have gone away. Shingles can cause severe pain. Per Mayo Clinic, in addition to antivirals, your doctor may prescribe the following treatments for pain:

If postherpetic neuralgia develops, similar medications are used to treat PHN pain.

While it may seem strange for your doctor to prescribe drugs for shingles that are commonly used to treat depression and prevent seizures, shingles is at root a nerve disorder, and these drugs work in different ways to calm overactive nerves.

“Antiepileptics in general are thought to reduce the ability of the neurons to fire at high frequency,” says Sangeetha Kodoth, MD, an allergist and immunologist with Allergy Specialists of Knoxville in Tennessee.

It’s believed that tricyclic antidepressants — an older class of antidepressants — work by increasing the levels of the neurotransmitters serotonin and norepinephrine, which then modify pain response.

Antibacterial agents may also be prescribed if a bacterial infection occurs with the shingles rash.

Before taking any medication for shingles, be sure to talk to your doctor about possible side effects.

RELATED: Is That Rash Psoriasis, or Is It Something Else?

What if You Have Shingles Around — or in — Your Eye?

According to MedlinePlus, it’s estimated that up to 20 percent of cases of shingles cases appear in or around the eye, which can cause permanent vision impairment.

Prompt antiviral treatment can reduce the risk of chronic eye complications by 20 to 30 percent, according to an article published in March 2020 in Community Eye Health.

If shingles are in the eye, they most often show up inside the eyelid and on the surface or the eyeball, says Rebecca Taylor, MD, an ophthalmologist with Nashville Vision Associates in Tennessee.

On the surface, says Dr. Taylor, they mainly show up on the cornea, which is the clear dome of tissue that covers your iris (where you put your contact lenses), and the conjunctiva — the clear tissue that covers the whites of your eye and the inside of your eyelid.

“If shingles is in these places,” she says, “you’ll be prescribed eye drops with steroids to calm the lesions, and lubricating tears for comfort.”

If you have had shingles in your eye, says Taylor, your eye doctor will monitor you for 3 to 12 months to make sure that your eye is returning to health and that no new developments have occurred. You may also be encouraged to have a yearly eye exam (if you don’t already) until otherwise instructed by your eye doctor.

Who Should Get the Shingles Vaccine? 

Getting the shingles vaccine is the only way to reduce the risk of developing shingles and to lessen the risk of postherpetic neuralgia.

The U.S. Food and Drug Administration (FDA) approved recombinant zoster vaccine, known as Shingrix, for adults ages 50 years old and older in 2017. In July 2021, the FDA also approved Shingrix for adults ages 18 years old and older who are or will be at increased risk of herpes zoster due to immunodeficiency or immunosuppression caused by disease or therapy, according to a press release issued by Shingrix manufacturer GlaxoSmithKline (GSK). In October 2021, the CDC’s Advisory Committee on Immunization Practices (ACIP) also voted to recommend Shingrix in adults 19 and older who are or will be immunodeficient or immunosuppressed due to disease or therapy, according to a press release issued by GSK. 

RELATED: CDC Committee Gives Green Light to Shingles Vaccine for Immunocompromised Adults

Sales of an older, live vaccine, Zostavax, were discontinued in July 2020. Even if you’ve already had shingles, received Zostavax, or aren’t sure whether you ever had chickenpox, you should get vaccinated, per the CDC.

Shingrix is given as two shots that are two to six months apart.

How Effective Is the Shingles Vaccine?

In an 18-country study published in 2015 in The New England Journal of Medicine, researchers found that Shingrix was 97.2 percent effective in preventing shingles among those ages 50 and older.

In a second study, published in 2016 in The New England Journal of Medicine, the same researchers found that Shingrix had a 91. 2 percent effectiveness rate in preventing postherpetic neuralgia in adults ages 50 and older. It was 88.8 percent effective in preventing it in adults age 70 years and older.

Out-of-pocket costs for Shingrix may vary. Many private health insurance plans cover the vaccine, but there may be some cost to you depending on which plan you have, per the CDC.

Medicare Part D (the Medicare prescription drug plan) should cover all or some of the cost.

RELATED: 8 Screening Tests Women Over 50 Should Have

Additional reporting by Carlene Bauer.

Shingles and Antibiotics

Thanks to many of the advances in modern science and medicine, researchers have developed antibiotics which significantly help people suffering from a case of shingles. Although there are a variety of antibiotics that may be prescribed by a doctor to someone suffering from shingles, they all perform the same basic functions.

Many doctors prefer to prescribe an antibiotic to their patients with shingles. These antibiotics are designed to not only ease the pain and irritation of the shingles rash, but also to decrease the duration that the rash lasts. Antibiotics for shingles include Zovirax, Valtrex and Famvir. Regardless of which antibiotic your doctor chooses to prescribe you, the key element is that you begin the antibiotic in the early stages of shingles. It has been proven in several different studies that these antibiotics are most effective when taken within three days of the initial symptoms of shingles. By beginning an antibiotic at this stage of shingles, you can ensure that it has the maximum effect on reducing irritation and duration.

Although some doctors choose to prescribe antibiotics to their patients with shingles, other doctors choose to only treat the symptoms of pain. In these cases, a doctor will recommend a common pain reliever such as Tylenol or Advil. The use of pain medications may be necessary for some patients even after the rash phase of shingles has ended. There are a percentage of shingles sufferers who experience postherpetic neuralgia, also known as PHN for short. PHN is basically a persistent pain that continues to occur even after the physical signs of shingles disappear. However, it is important to note that some doctors may prescribe an additional antibiotic to treat the symptoms of PHN.

In addition to pain medications and antibiotics, researchers are currently pursuing other forms of treatment. One of the more promising advances in the field of shingles treatment has been a vaccine to prevent occurrences of shingles. Although there has been a chickenpox vaccine for several years, researchers have not developed a completely effective shingles vaccine. However, several months ago, the FDA approved a shingles vaccine which is currently being used in high risk patients. Over the next few years, it is expected that this vaccine will be used in an increasing amount of the general population. Thanks to extensive research and development, people are being presented with a steadily increasing amount of treatment options for cases of shingles.

Please remember the advice and information in this article isn’t meant nor intended to replace professional medical advice. If you think you may be suffering from shingles you should speak to a doctor or special care practitioner as soon as possible and try to limit your contact with those around you until you know whether or not you have shingles.

Shingles

 
US Pharm. 2018;43(3):13-14.

Shingles is an illness caused by the varicella-zoster virus, the same virus that causes chickenpox. Although people recover from the symptoms of chickenpox, the virus remains inactive in the body, hidden in the nerve cells near the spinal cord and brain. Sometimes, for unknown reasons, the virus reactivates and travels along the nerves to the skin, where it causes a painful, itchy, blistery rash known as shingles. The rash typically heals in 2 to 4 weeks; however, the associated pain can last for months. Only people who previously had chickenpox develop shingles, but there is a vaccine to reduce the risk.

Shingles occurs in over 1 million people each year. Approximately half of all cases occur in people over age 60 years, but it can also affect children with a history of chickenpox. Since the virus is more likely to reactivate in individuals with a weakened immune system, older adults and people with HIV/AIDS, lymphoma, or leukemia are at greatest risk. The likelihood of shingles is also higher in people taking medications that suppress the immune system, such as chemotherapy or steroids, or medications taken after an organ transplant.

Most of the time, shingles begins with pain, burning, or tingling sensations and sensitivity, usually on one side of the body, but also around the eye or neck.  Within a few days, the blistery rash appears in a band-like pattern following the nerve path. The rash begins as small, itchy bumps that fill with fluid, break open, and crust over into scabs. The area usually heals without scarring unless it becomes infected. Shingles can also cause fever, headache, fatigue, and sensitivity to light.

Prompt Diagnosis Helps

To diagnose shingles, the physician considers the physical symptoms, the patient’s health history, and laboratory tests. Individuals diagnosed with shingles can spread the virus and cause chickenpox in those who have never had chickenpox or its vaccine. They cannot spread chickenpox to those who have already had it, since shingles occurs only when the dormant chickenpox virus reactivates.

There is no cure for shingles. However, antiviral medications such as acyclovir, famciclovir, or valacyclovir taken within 72 hours of symptom onset can shorten the duration of the illness, reduce the severity of symptoms, and decrease the risk of complications.

In addition to antiviral medications, soaking in a cool bath, taking an oatmeal bath, or using calamine lotion may help relieve the pain and itching of shingles and speed healing of the blisters. Other drugs that may be helpful in controlling the pain include capsaicin, numbing agents such as lidocaine, steroids, antidepressants, and anticonvulsants.

Potential Complications

Most people recover from shingles without complications. However, when complications arise, they can be serious. The shingles rash can become infected due to scratching and may require treatment with antibiotics. If the rash is near the eyes or ears, vision damage or hearing loss can result. Another serious complication of shingles is postherpetic neuralgia, a sharp or throbbing pain under the skin that remains after the rash has healed. Postherpetic neuralgia can cause pain so severe that it hurts to have clothes touching the skin. The older the person is when shingles develops, the greater the chance for postherpetic neuralgia to develop. This nerve pain can last for months or even years, making routine activities difficult, which can cause depression.

Preventive Measure

Since it is impossible to predict whether the varicella-zoster virus will reactivate, the best way to prevent shingles is vaccination. There are two vaccines: Zostavax and Shingrix, a new, more effective one that became available in 2017. The CDC recommends Shingrix for all adults aged 50 years and older—even those previously vaccinated with Zostavax. People with a history of shingles should also consider vaccination because the virus can reactivate more than once. Talk to your pharmacist to find out if vaccination is right for you.

To comment on this article, contact [email protected].

Shingles Q&A: Is Shingles Contagious & Everything Else You Need to Know

Ask anyone who’s had shingles, and they’ll likely recount a pretty miserable, painful, uncomfortable experience that couldn’t end soon enough. Ask your doctor about shingles, and he or she will likely inform you that there’s a vaccine to help prevent it.

Whether you think you may have shingles and are looking for answers or you just want to make sure you don’t ever get it in the first place, Dr. Donald Brown, primary care practitioner at Houston Methodist, is here to answer common questions about shingles and the shingles vaccine.

How does shingles start?

Technically, your chance of getting shingles “started” the day you got chickenpox. (You remember that itchy rash that spread from your head to your toes, as well as through your kindergarten classroom, right?)

That’s because shingles and chickenpox are caused by the same virus, called the varicella zoster virus. After you have chickenpox, the varicella zoster virus hides away in your body — where it can lie dormant for many, many years.

“The varicella zoster virus that initially causes chickenpox can come back to life, so to speak. When it does, it causes a different disease — called herpes zoster, or shingles,” says Dr.Brown. “The result is still a rash, but this rash is typically localized to a single area on your skin and is much more painful than the itchy rash you experienced during chickenpox.”

While shingles can appear anywhere on your body, it typically affects the chest, torso, shoulder or back.

Can anyone get shingles?

So, to get shingles, you have to have first had chickenpox. But, not everyone who’s had chickenpox will get shingles. Confused yet? Here’s Dr. Brown again:

“Anyone who’s had chickenpox is susceptible to developing shingles, and somewhere around 20% of those people will get shingles during his or her lifetime. Shingles can develop at any age, but it becomes more common with increasing age or as a result of other health-related factors.”

The other factors that can increase your risk of developing shingles include:

• Being over the age of 50
• Having a weakened immune system
• Certain cancers or cancer treatments
• Taking medications that suppress your system

What does shingles look like?

Rashes are always concerning, and a lot of different things can cause them. There are heat rashes, rashes caused by reactions to medications or allergens, and the list goes on. So how can you tell if your rash is in fact shingles or not?

“Before the rash even develops, shingles usually causes itching, burning or tingling sensations on a specific area of your skin. You may also have a fever, headache or just feel generally unwell. A few days later, the rash appears — typically as a band of blisters isolated to a particular area of your body,” explains Dr. Brown.

Shingles symptoms are typically limited to the area of the rash itself, and the symptoms of shingles include:

• Pain (of varying intensity)
• Skin sensitivity
• Fluid-filled blisters that ooze and eventually crust over
• Itchiness
• Fever
• Headache
• Fatigue
• Sensitivity to light

How long is shingles contagious?

Similar to chickenpox, shingles is a contagious illness. But, before we address how long you may be contagious, we need to talk about how shingles spreads — which might actually surprise you.

“Shingles is indeed contagious, but it can only be spread to people who haven’t yet had chickenpox, or the chickenpox vaccine. In these cases, the shingles virus typically spreads via direct contact with the opened blisters of your rash. After being infected, a person doesn’t develop shingles, though — he or she develops chickenpox,” explains Dr. Brown.

Since you can’t really know who is and who isn’t susceptible to chickenpox, it’s important to take safety measures if you have shingles.

“When you have shingles, you’re considered contagious until your open sores crust and scab over. This generally takes between 7 to 10 days,” says Dr. Brown. “Depending on where your rash develops on your body and where you work, you may (or may not) be able to return to work before your shingles dry up.”

Before your rash dries up, Dr. Brown recommends the following to prevent spreading shingles to others:

• Make sure your rash is covered with gauze
• Limit interaction with other people if your shingles rash is on your face
• Consult with your doctor about returning to work if you work in a medical setting or nursing home, as well as if you interact with people frequently while at work

Will shingles go away on its own?

Shingles isn’t life-threatening, but it can be incredibly painful and, in some cases, complications can arise. While this rash typically goes away its own, prompt treatment can reduce your pain and help shingles go away faster.

“Several antivirals can be used to treat shingles. These drugs can help you heal more quickly and reduce your pain, but they are most effective when started within 72 hours of your rash appearing. This means it’s important to see your doctor as soon as you suspect shingles,” says Dr. Brown. “When it comes to the pain associated with shingles, most people are able to manage it using over-the-counter pain relievers. But, pain can be severe for some people. In these cases, your doctor can prescribe stronger pain medications.”

Beyond treating your immediate pain and rash, seeing your doctor is also important since serious complications can occur as a result of shingles, such as:

• Postherpetic neuralgia (PHN) – pain that lasts for months to years after the rash clears, with this pain being debilitating in some cases
• Skin infection – occurs if the open sores of your rash become infected with bacteria, which can require antibiotics and delay healing
• Vision problems – while rare, if your rash develops near your eye, the associated inflammation can damage your retina and, in some cases, result in vision loss

“In particular, we want you to come into the office so we can try to reduce your chances of developing PHN — the most common complication of shingles. This condition can result in long-term pain that, in some cases, can be severe enough to reduce sleep quality, lead to weight loss and generally interfere with daily activities,” warns Dr. Brown. “PHN occurs most frequently in those over the age of 60, and there’s evidence that antiviral treatment can reduce a person’s risk of developing this complication.”

Can shingles come back?

Given that shingles results from the varicella zoster virus reactivating some amount of time after having chickenpox, you may be wondering if the virus can…re-reactivate after having shingles.

“Once shingles clears up, the virus simply goes back into hiding — and, unfortunately, it can reactivate again in the future,” says Dr. Brown. “As far as the likelihood of shingles reoccurring, that’s still largely up for debate. One study found that the chance of getting shingles a second time is about 5%, but other studies show this number to be lower.”

One way to reduce your risk of getting shingles twice is the same preventive measure that helps prevent you from ever getting it in the first place: the shingles vaccine.

Which shingles vaccine is best?

Eventually, your doctor will start mentioning the shingles vaccine — which can help prevent shingles from developing, as well as reduce its severity if it does still develop. The shingles vaccine can also reduce your risk of postherpetic neuralgia, one of the most common complications of shingles.

“Because shingles becomes increasingly more common as a person ages, the shingles vaccine is currently recommended for people over the age of 50. There are two vaccine options, Shingrix and Zostavax, with Shingrix being the newer of the two vaccines — and the preferred choice as it is more effective.”

When it comes to how the shingles vaccine works, Shingrix is a shot that requires two doses administered six months apart. There are temporary side of effects of this shingles vaccine that can be unpleasant, however. Shingles vaccine side effects typically don’t last more than three days, but include:

• Sore arm
• Redness or swelling (at the location of the shot)
• Fatigue
• Muscle pain
• Headache
• Fever
• Nausea

“These vaccines don’t completely reduce your chance of getting shingles, but given the pain associated with this illness — as well as the complications that can occur — getting vaccinated for shingles is an important component of your preventive care as you age. “

Shingles Recovery Stages & Recovery Time: What to Expect

Shingles is a painful rash caused by the same virus that causes chickenpox. People older than 50 are at greater risk of getting shingles because the immune system weakens as we age, allowing the virus to reactivate after a long dormant period. Shingles recovery tends to follow a pattern and may take anywhere from 2 to 6 weeks or more. Some people develop complications after shingles, including nerve pain called post-herpetic neuropathy. Find out what the recovery stages of shingles are and how you can help minimize the symptoms. 

Before the shingles rash appears, you may have a burning sensation, itching or numbness in the area where the rash will appear. This stage of shingles can be very painful. If you have these symptoms, see your healthcare provider as soon as you can, because early treatment with an antiviral medication may help you recover more quickly and lessen the chance of complications.  

The location and size of the rash varies greatly between people. After chickenpox, the virus lies dormant (not replicating) in the nerve roots of the spinal cord. When the virus reactivates into shingles, it most commonly affects the thoracic section of the spine, so you develop a rash on the torso, or trunk area. However, it can affect higher or lower regions of the spine. The virus can also affect facial structures via the cranial nerves, such as the optic and trigeminal nerves, but this is not as common as reactivation along the trunk.

The Stages of Shingles Recovery

After the rash develops, which usually appears on only one side of the body, it forms blisters. You may feel like you have the flu or a mild fever. As you recover, you will typically go through these stages:

• Blisters begin to burst or weep about 5 days after they develop, and lasts from 7 to 10 days. You should take time off from work and other activities during this period, because you can spread the virus to others through the fluid in the blisters. Otherwise, you can return to work when you feel comfortable doing so.
• The blisters will scab over and begin to heal, which takes from 1 to 3 weeks, unless the rash is on your scalp in which case it can take several months.
• As they heal, the blisters become smaller and less painful, generally over a period of 3 to 5 weeks.
• About 10 to 15% of people with shingles will develop chronic nerve pain, which can be severe. Sensitivity to touch at the site of the rash is possible. The older you are, the more likely it is you will develop this disorder, called post-herpetic neuralgia, or PHN. The pain often lessens over time. Available treatments include anti-inflammatory injections, nerve blocks, certain tricyclic antidepressants, or capsaicin cream, which is made from chili peppers and can help ease nerve pain.

What You Can Do to Help Recover from Shingles 

There is no cure for shingles, but there are medications, including antiviral medications, such as acyclovir or valacyclovir, to help fight the infection.  

While your shingles is active, you should:

• Rest and relax. Try moderate activities, such as walking and listening to music that can help take your mind off the pain. For severe pain, your doctor may prescribe narcotic pain relievers, corticosteroids, and anticonvulsants.
• Wear loose-fitting clothes.
• Keep the rash clean and dry. Do not cover it or use ointments, which can prevent the blisters from bursting and beginning to scab over.
• Try cool compresses, calamine lotion, or an oatmeal bath to ease the itching and pain of the rash.
• Don’t share bedding, clothing or towels in order to avoid spreading the infection while you have blisters.

There are effective vaccinations available to prevent shingles, so if you have had chickenpox, talk with your healthcare provider about getting protected from shingles.

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Inflammatory diseases of the nervous system

Neurological department

Neuropathy (neuropathy) – one of the forms of developmental anomalies of the nervous system. Neuropathy is caused by the influence of hereditary constitutional factors, intrauterine and perinatal hazards, early somatogenic and psychogenic influences.

The pathogenetic basis of neuropathy is an imbalance in the functions of the autonomic nervous system.

Types of neuropathy:

Peripheral neuropathy – disruption of the nerves outside the brain and spinal cord. This type of neuropathy affects the nerve endings of the toes, feet, legs, fingers, palms, hands.

Cranial neuropathy – occurs when any of the twelve pairs of cranial nerves malfunction. There are two specific subtypes: visual and auditory. Optic is caused by damage or disease of the optic nerve, which carries signals from the retina of the eye to the brain and is responsible for vision. Auditory neuropathy occurs when the auditory nerve that carries signals from the inner ear to the brain and is responsible for hearing is damaged or diseased.

Autonomic neuropathy – damage to the nerves of the autonomic nervous system, which are responsible for the heart, blood flow, digestion, bladder and bowel function, sexual function, sweating. Damage to nerves and other organs is also possible.

Local neuropathy – occurs when a disease or damage to one or a group of nerves, one part of the body.

Causes of neuropathy:

• Diabetes mellitus. The risk of nerve damage increases with age and the duration of diabetes symptoms.This is especially true of those who are overweight, suffer from high blood lipids and high blood pressure.
• Lack of vitamin B12 and folic acid and other B vitamins can provoke the development of neuropathy.
• Autoimmune neuropathy. Autoimmune diseases (rheumatoid arthritis, systemic lupus erythematosus, Guillain-Barré syndrome) can cause neuropathy.
• Infection. Certain infections, including HIV / AIDS, Lyme disease, leprosy, and syphilis, can contribute to nerve damage.
• Postherpetic neuralgia is a complication of shingles.
• Alcoholic neuropathy. Alcoholism is quite often combined with peripheral neuropathy. It is likely that the disease develops due to the toxic effects of alcohol, as well as due to poor nutrition, lack of vitamins, characteristic of alcoholics.
• Genetic or congenital diseases. For example, Friedreich’s ataxia and Charcot-Marie-Tooth disease.
• Amyloidosis is a disease in which abnormal protein fibers are deposited in tissues and organs.This leads to damage to internal organs and can lead to neuropathy.
• Uremia – a high concentration of waste products of the body against the background of renal failure.
• Toxins and poisons (gold compounds, lead, arsenic, mercury, some industrial solvents, nitric oxide, phosphate fertilizers) can damage nerve fibers.
• Medicines such as anticancer drugs (vincristine) and antibiotics (metronidazole and isoniazid) have a detrimental effect on neurons.
• Injury / damage to nerves, prolonged compression of a nerve or group of nerves. Decreased blood supply (ischemia) to nerve fibers can also cause damage.
• Benign or malignant neoplasms of nerves and nearby structures.
• Idiopathic neuropathy. Damage to nerve fibers for no specific reason.

Symptoms:

Autonomic neuropathy can be manifested by the following symptoms:

• nausea, vomiting, bloating;
• urinary incontinence, difficulty urinating;
• impotence;
• dizziness and fainting;
• constipation and diarrhea;
• blurry vision;
• heat intolerance or decreased sweating;
• asymptomatic hypoglycemia – a decrease in blood glucose levels, accompanied by hand tremors, increased sweating, palpitations.

Diagnostics:

Treatment:

No specific treatment for neuropathy has yet been invented. Therefore, general strengthening and symptomatic therapy, psycho-hygienic measures, hardening are used. For the prevention of the disease, it makes sense to take care of a healthy pregnancy in order to exclude the development of pathologies.
The course of treatment for neuropathy depends on the cause of the disease. In many cases, combating the underlying cause reduces or eliminates the symptoms of neuropathy. In the case of mechanical compression of a nerve fiber by a tumor or other structures, surgical intervention is required.
Controlling blood glucose levels is an essential part of treating diabetic neuropathy and helps prevent further development of it.

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Antibiotics for herpes on the body, on the lips

The herpes virus is found in the body of almost every person, but only under favorable conditions does it show symptoms and cause an acute course.Antiherpetic drugs are usually used for treatment, but sometimes they are ineffective and the patient is given antibiotics. In what cases and what antibiotics can be used for herpes?

Causes of herpes

Herpes is classified by type and localization of the rash. At the site of the rash, there are herpes on the lips, genital and shingles. There are eight types of herpesvirus in total, the most common are:

1. Herpes simplex virus – affects the lips and face.
2. Herpes simplex genital virus – affects the genitals of a person.
3. Herpes zoster of the third type – manifested by herpes zoster, chickenpox.
4. Epstein-Barr type IV VH – provokes the disease mononucleosis.
5. Herpes simplex virus of the fifth type (cytomegalovirus) – manifests itself as false rubella.

The other three types are less common and can provoke the development of malignant tumors and sarcomas, as well as cause problems with the human lymphatic system.

The main reasons for the appearance of herpesvirus are a weakening of the immune system, stress, an unhealthy lifestyle with systematic sleep disturbance and overwork. In addition, herpes occurs due to:

• violations of hygiene standards – infection occurs by contact-household method;
• sharp changes in climatic conditions;
• eating too fatty, spicy, sweet or salty foods;
• avitaminosis – deficiency of vitamins of natural origin;
• an excess of the amino acid arginine, present in pumpkin and sesame seeds, peanuts, seafood, chicken fillets, lean pork.

Note! Lack of arginine leads to decreased performance, fatigue, stress. The daily intake of this amino acid in adults should be 6 g, in children – 4. In athletes, this rate increases to 9 g.

Genital eruptions appear most often due to lack of personal hygiene when visiting a public toilet, swimming pool, sauna. Another reason is casual sex and unprotected contact with an infected partner.

In infants, infection occurs from the parents, intrauterine infection from the mother. Planned pregnancy will reduce the risk of infection, as parents undergo a full medical examination beforehand.

Symptoms of herpesvirus

Herpes begins with unpleasant sensations at the site of the future rash: burning, tight skin, itching. Then tiny bubbles filled with liquid appear. The bubbles grow, merge into a common blister, which opens after a certain period of time and turns into a painful crust.The resulting scab usually consists of microcracks that cause painful sensations. If untreated, the herpes infection goes into the body after 10 to 14 days.

In the future, the rash can spread to adjacent areas of the face, possibly affecting the area near the eyes. The virus is able to penetrate the mucous membrane and infect the eyes, nasopharynx and genitals.

Eye lesions

Lesions of the mucous membrane of the eyes are called keratoconjunctivitis, which can cause complications on the sclera in the form of scars and corneal opacity.The percentage of vision after a disease is significantly reduced, and blindness develops in a difficult course.

Lesion of the nasopharynx

Bubbles form on the mucous tissues of the oral cavity, which then turn into painful erosion. Although this phenomenon is rare, erosion is able to heal on its own in 10-14 days. This does not mean that the infection is gone. It moves deep into the oropharynx to the upper respiratory tract and into the esophagus, which is fraught with the occurrence of ulcerative esophagitis.

In young children, herpesvirus lesions are often diagnosed with stomatitis, since there are similar symptoms. It proceeds with an increase in lymph nodes and febrile conditions.

Lesion of genitals

It proceeds in different ways: in some patients, small formations are observed, which almost immediately combine into blisters with further transformation into erosion on the organs of the reproductive system. In some patients, genital herpes can be asymptomatic for a long time, without deviations in the general condition.

In an acute course and in the absence of treatment, herpes begins to spread to the adjacent areas of the body: the anal area, buttocks, inner thighs. In women, ulcers spread to the vagina and cervix. Complications of genital herpes are inguinal lymphopathy and hyperthermia.

Herpes zoster

With herpes zoster, nerve endings are involved in the process, which causes severe pain. A significant area of ​​the lesion does not allow a person to lead a normal life. The disease is accompanied by a febrile state and symptoms of general intoxication. Patients with herpes zoster are hospitalized without fail.

Treatment tactics

Herpes is suppressed by antiviral drugs, it is impossible to get rid of it with antibiotics. The virus is embedded in human DNA and multiplies. Antibacterial agents cannot penetrate into the cell, in contrast to antiviral drugs, which destroy the DNA of the herpes virus at the intracellular level.

Uncontrolled intake of antibiotics during the treatment of herpes of the first and second types can lead to a completely opposite result. Antibiotics destroy both pathogens and beneficial flora, thereby reducing human immunity. A weakened immune system is the root cause of the activation of the virus. As a result, herpes after antibiotics does not disappear, but appears.

Antiviral agents

The standard treatment is the use of drugs of the nucleoside group – Acyclovir, Ribavirin, Valacyclovir. Acyclovir is sold in the pharmacy network in tablet form and in the form of an ointment.

Acyclovir ointment is used at the initial stage of the disease for five days. If the activity of the herpesvirus does not decrease, an oral course of Acyclovir is prescribed, which lasts up to 7 days.

Ribavirin and Valacyclovir have a similar effect to Acyclovir, but are considered more effective. The course of these drugs is 3 – 5 days until the complete suppression of the herpes virus.

Antibiotics

Antibiotics are added to antiviral drugs only in cases of complications, when other diseases of bacterial or fungal origin are exacerbated against the background of herpesvirus:

• purulent dermatitis;
• bacterial diseases of the genitourinary organs;
• pleurisy;
• pneumonia:
• necrotizing tonsillitis;
• lacunar angina.

Antibiotics are prescribed only after laboratory tests by the attending physician. The indications are changes in blood composition, febrile conditions with a body temperature above 38.5 ° C for two or more days.

Internal use of antibiotics

As medical practice shows, secondary infections are usually caused by staphylococci, streptococci, Haemophilus influenzae, candida fungus. For their treatment, antibacterial agents of the following groups are used:

1. Macrolides.
2. Lincosamides.
3. Cephalosporins (second and third generation).
4. Antifungal agents.

Note! Preparations of a number of aminopenicillins (Ampicillin, Amoxicillin) are not used in the treatment of herpes, as they can provoke the appearance of a rash (exanthema) that is difficult to treat.

Preparations from the macrolide group (Erythromycin, Azithromycin) have the lowest toxicity. The antibacterial properties are further supported by the anti-inflammatory and immunomodulatory effects of these drugs. They are used for the development of infections on human soft tissues and skin.

From the group of cephalosporins, the most effective drugs are Cefazolin, Zinnat, Ceftriaxone, they act on staphylococci and streptococci.

From the group of lincosamides for the treatment of secondary infections in herpes, Clindamycin or Lincomycin are prescribed. These drugs suppress the activity of staphylococci, pneumococci, streptococci.

Antifungal drugs include Metronidazole, Trichopolum, Flucanazole.

Since antibacterial and antifungal agents, together with pathogenic flora, destroy beneficial microorganisms, biological preparations with probiotics are prescribed at the same time: Linex, Bifiform and other agents of similar action.

Antibacterial ointments

At the stage when the bubbles of herpes formations begin to burst, you can use the antibacterial ointments Pimafucin, Levomekol, as well as zinc, erythromycin or tetracycline ointment. Antibacterial ointments prevent:

• infection of herpes formations with bacteria;
• spread of herpes to adjacent areas of the body;
• development of furunculosis.

Note! For the treatment of herpes, it is strictly forbidden to use hormonal agents, and such improvised means as iodine and alcohol tincture can burn sensitive tissues in places where herpes appears.

Treatment of herpesvirus begins with the appearance of the first symptomatology.This approach reduces the likelihood of secondary infections. The course of drugs is prescribed only in consultation with a specialist and is conducted under his supervision.

Pink lichen (lichen Ziber): symptoms, treatment, causes

Versicolor pink has many names in medicine. It is called peeling roseola, Gibert’s disease, pityriasis pink. The disease belongs to the infectious-allergic category of dermatoses, is of an acute inflammatory nature with the appearance of spotty, papular, erythematous-squamous foci. They are located mainly on the body and on the surface of the limbs. The most common diagnosis of zhibert rosacea is in women between the ages of 20 and 40, as well as in adolescents. In other age categories of people, the disease is extremely rare. The peak of complaints occurs in the spring and autumn during the spread of acute respiratory diseases.

Information about pink lichen: causes, symptoms, manifestations

Medicine does not know the exact reasons for the development of Gibert’s lichen in men and women.Research is being carried out in the field of the influence of herpes viruses of types 6 and 7, but an unambiguous etiological agent has not yet been determined. The reasons for the appearance of pink lichen continue to be studied. It is only known that at any moment a weakened immune system can become a trigger mechanism. The causes of pink lichen lie precisely in a decrease in the body’s defenses due to bacterial and infectious diseases.

Symptoms and clinical picture of the disease

Due to colds, hypothermia, a difficult emotional state, stress, a rash may appear on the skin. Symptoms of pink lichen begin to manifest themselves with her. The classic clinical picture is the formation of the main focus in the form of a medallion with a diameter of 2 to 10 cm. Within 7-14 days after its appearance, the rash spreads in the form of plaques and papules of pink and yellow-brown color. They are smaller than the main focus – their diameter can be from 0.5 to 2 cm. In appearance, the rash can be confused with ringworm due to the scaly edge of the rash. A few days after the rash, the spots turn pale, wrinkle and the stratum corneum cracks.The central part of the plaques remains smooth. Symptoms of pink lichen can be accompanied by itching, fatigue, fever, general intoxication, and enlarged lymph nodes in the neck and chin.

Do you have symptoms of lichen rosacea?

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Types of disease

Lichen pink can have a classic appearance, when the clinical picture develops in stages in accordance with the generally accepted system – from the appearance of a “maternal” plaque to smaller rashes in the chest, back, abdomen, hips, on the flexor surfaces of the limbs. In the medical classification, several more forms of the disease are distinguished. Deprive Zhibert happens:

• urticarial – characterized by the presence of not plaques, but a rash in the form of blisters. There is severe itching. It resembles urticaria in appearance;
• vesicular – manifested by generalized rash of vesicles with severe itching. The diameter of bubbles with a transparent or turbid liquid is from 2 to 6 mm. They often form “rosettes”;
• papular – rare.It is characterized by the appearance of noncavity formations above the surface of the skin. Small papules 1-2 mm in diameter;
• hemorrhagic – there are punctate hemorrhages (hemorrhages), so the color of the plaques is darker than usual;
• follicular – the rash is grouped into round plaques of follicular papules, which can occur in parallel with the classic plaques;
• one-sided;
• hypopigmented – more often occurs in people with dark or dark skin. Inverse lichen is characterized by rashes in the axillary and groin areas and in the popliteal fossa;
• asbestos – is extremely rare, and manifests itself in the scalp in the form of gray plaques;
• Darya’s giant pink lichen – the formation of plaques, large in diameter, from 5-7 cm. In severe cases, they reach the size of the patient’s palm;
• Vidal’s ring-shaped ringed pink lichen has an atypical location – mainly in the groin or axillary region.The rash looks like a ring.

Gender and age

The onset of pink lichen affects women, adolescents and children. Different forms of the disease affect certain groups of people. For example, the vesicular form is diagnosed more often in children and adolescents. The papular form is diagnosed in most cases in pregnant women and young children. One-sided – occurs equally in adults and children.

How is the transmission of the disease

Research has not provided a definite answer to the question of contamination. In theory, lichen rosacea is transmitted through tactile contact, but this is extremely rare. There must be provoking factors for infection to occur. We are talking about low immunity, transferred viral and infectious diseases, colds. Relapse is possible in people with HIV, cancer and blood diseases.

What you need to know about diagnosis and treatment

The diagnosis of lichen pink is based on taking the patient’s history. To confirm or refute, to analyze complex cases, a number of laboratory tests are prescribed.They include a clinical study of blood and urine. It is necessary to exclude syphilis and mycosis, therefore, additional serological and microscopic examinations are carried out. If these methods do not provide enough information to verify the diagnosis, the patient is referred for a biopsy (histology biopsy).

Pink lichen treatment is not always required. The disease is prone to voluntary self-healing within 5 weeks. However, it is not worth considering dermatosis as harmless. First of all, antipruritic therapy is required.For this, topical glucocorticosteroid drugs, antihistamines are used externally. Ointments, gels, pastes cannot be used without the appointment of a dermatologist. Otherwise, the rash can enlarge the extent of the skin lesions, invading new areas. Of the drugs, antibiotics and antiviral agents can be prescribed, depending on the definition of the indications. Ultraviolet therapy has a good effect.

Help of a dermatologist in Moscow

Pink lichen diagnosis and treatment is the dermatologist’s field of activity.Depending on the form of the disease, the scale of the lesion of the skin, the patient is provided with recommendations. With deprivation, the emotional and psychological background of a person is important, therefore, the prompt formulation of the correct diagnosis allows you to quickly overcome the disease.

You can make an appointment with a dermatologist at Medicina JSC (Academician Roitberg’s clinic) by calling +7 (495) 775-73-60. Do not self-medicate. The reason is that according to external signs, skin rashes can turn out to be differential diseases, for example, toxidermia, psoriasis, mycosis, secondary syphilis.In these cases, the appointment of another therapy is required, taking into account the specific clinical picture and the patient’s history.

Frequently asked questions from patients

What is lichen rosacea from?

There is no definite answer to this question. Research is ongoing. Presumably, herpesvirus type 6 or 7 may be the cause. With a decrease in immunity, it is activated, which triggers the process of rashes of various types (plaques, vesicles, blisters).Stress, bad ecology, hormonal surges, chronic diseases can provoke the disease.

Is lichen rosacea contagious?

Rosa lichen in humans is considered non-infectious, but rare cases of the disease of entire families are known. Much depends on the state of immunity and the body’s defenses, capable of resisting viruses, bacteria and infections.

Is it possible to sunbathe with pink lichen?

One type of therapy for this dermatological disease is light therapy.Moderate exposure to ultraviolet radiation has a positive effect on the condition of the skin, stimulating its regeneration. Combustion must not be allowed. This will lead to increased itching in the area of ​​the blemishes.

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