Is hydrocortisone cream safe to use on shingles rash. What are the recommended treatments for shingles. How can you manage shingles symptoms at home. When should you see a doctor for shingles.

Understanding Shingles: Causes and Symptoms

Shingles, also known as herpes zoster, is a viral infection caused by the reactivation of the varicella-zoster virus, the same virus responsible for chickenpox. This condition primarily affects people who have had chickenpox in the past, as the virus can remain dormant in nerve tissues for years before reactivating.

The hallmark symptom of shingles is a painful, blistering rash that typically appears on one side of the body or face. Other common symptoms include:

• Burning, tingling, or numbness in the affected area
• Sensitivity to touch
• Fever and chills
• Headache
• Fatigue

Why does shingles only affect one side of the body? The virus typically reactivates in a single nerve root, causing symptoms in the area of skin supplied by that nerve. This characteristic distribution pattern is known as a dermatome.

The Role of Hydrocortisone in Skin Conditions

Hydrocortisone is a corticosteroid medication commonly used to treat various skin conditions, including inflammation, itching, and allergic reactions. It works by reducing the production of inflammatory substances in the body, thereby alleviating symptoms associated with many dermatological issues.

Can hydrocortisone cream be used on shingles rash? Despite its effectiveness in treating many skin conditions, hydrocortisone cream is not recommended for use on shingles rashes. There is no evidence to suggest that hydrocortisone cream will help alleviate the pain or discomfort associated with shingles.

Why is hydrocortisone not recommended for shingles? Using corticosteroids like hydrocortisone on viral skin infections can potentially suppress the immune system’s response, potentially prolonging the infection or making it worse. Additionally, applying creams to the shingles rash may increase the risk of bacterial infection.

Recommended Treatments for Shingles

The preferred treatment for shingles involves antiviral medications taken orally. These medications help to shorten the duration of the infection, reduce the severity of symptoms, and lower the risk of complications. The most commonly prescribed antiviral drugs for shingles include:

1. Acyclovir
2. Valacyclovir
3. Famciclovir

How quickly should antiviral treatment be started? For optimal effectiveness, antiviral treatment should be initiated within 72 hours of the appearance of the shingles rash. Early treatment can significantly reduce the duration and severity of the outbreak.

Pain Management for Shingles

In addition to antiviral medications, pain management is a crucial aspect of shingles treatment. Over-the-counter pain relievers such as acetaminophen or ibuprofen can help alleviate discomfort. In some cases, doctors may prescribe stronger pain medications or nerve pain medications if the pain is severe.

Home Care for Shingles Rash

While antiviral medications are the primary treatment for shingles, there are several home care measures that can help manage symptoms and promote healing:

• Keep the rash clean and dry
• Apply cool, wet compresses to reduce pain and itching
• Take colloidal oatmeal baths to soothe the skin
• Wear loose-fitting, breathable clothing to avoid irritating the rash
• Avoid scratching or picking at the rash to prevent infection

Is it safe to apply calamine lotion to shingles rash? Yes, the American Academy of Dermatology Association recommends using calamine lotion for shingles. It can provide a cooling effect and help reduce itching. However, it’s important to avoid applying thick creams or ointments that could further irritate the skin.

Preventing the Spread of Shingles

Shingles itself is not contagious, but the virus that causes it can be transmitted to individuals who have never had chickenpox or have not been vaccinated against it. To prevent spreading the virus:

• Cover the rash with a non-stick dressing
• Avoid contact with individuals who have a weakened immune system, pregnant women, and newborns
• Wash hands frequently, especially after touching the affected area
• Avoid scratching or touching the rash

When is shingles no longer contagious? The shingles rash is contagious until all the blisters have scabbed over and are dry. This typically takes 7 to 10 days from the onset of the rash.

Complications of Shingles

While most cases of shingles resolve without long-term effects, some individuals may experience complications. The most common complication is postherpetic neuralgia (PHN), which is characterized by persistent pain in the affected area even after the rash has healed.

Other potential complications include:

• Vision problems if the rash occurs near or in the eye
• Hearing loss or balance problems if the inner ear is affected
• Skin infections
• Neurological complications in rare cases

How long can postherpetic neuralgia last? PHN can persist for months or even years after the initial shingles outbreak. Early treatment with antiviral medications can help reduce the risk of developing this complication.

When to Seek Medical Attention

While many cases of shingles can be managed at home with antiviral medications and self-care measures, certain situations warrant immediate medical attention:

• The rash is widespread or affects the face, especially near the eye
• You experience severe pain that is not relieved by over-the-counter pain medications
• You have a weakened immune system due to conditions like HIV/AIDS or cancer treatment
• The rash shows signs of infection, such as increased redness, warmth, or pus
• You develop fever, confusion, or other unusual symptoms

How quickly should you see a doctor after noticing shingles symptoms? It’s important to seek medical attention as soon as possible after noticing symptoms of shingles. Early treatment can significantly reduce the severity and duration of the outbreak, as well as lower the risk of complications.

Shingles Vaccination: Prevention is Key

The most effective way to prevent shingles is through vaccination. The Centers for Disease Control and Prevention (CDC) recommends the shingles vaccine for adults 50 years and older. There are two types of shingles vaccines available:

1. Shingrix: A recombinant zoster vaccine, recommended as the preferred vaccine
2. Zostavax: A live zoster vaccine (no longer available for use in the United States as of November 18, 2020)

Who should get the shingles vaccine? The CDC recommends that healthy adults 50 years and older get two doses of Shingrix, separated by 2 to 6 months, to prevent shingles and its complications. The vaccine is also recommended for individuals who have previously had shingles or have received the older Zostavax vaccine.

Effectiveness of Shingles Vaccine

The Shingrix vaccine is highly effective in preventing shingles and its complications. Studies have shown that it reduces the risk of developing shingles by more than 90% in people 50 years and older. Even if a vaccinated person does develop shingles, the vaccine can help reduce the severity and duration of the outbreak.

Can you get shingles after being vaccinated? While the vaccine significantly reduces the risk of shingles, it is not 100% effective. Some individuals may still develop shingles after vaccination, but the symptoms are typically milder and the risk of complications is lower.

Alternative and Complementary Therapies for Shingles

While antiviral medications remain the primary treatment for shingles, some individuals may explore alternative or complementary therapies to manage symptoms. It’s important to note that these therapies should not replace conventional medical treatment, and you should always consult with your healthcare provider before trying any alternative remedies.

Some alternative approaches that have been explored for shingles management include:

• Acupuncture: May help relieve pain associated with shingles
• Transcutaneous electrical nerve stimulation (TENS): A non-invasive method that may help reduce pain
• Topical capsaicin: Derived from chili peppers, it may help alleviate PHN pain
• Tai chi: Some studies suggest it may boost immune function and reduce the risk of shingles in older adults
• Stress-reduction techniques: Such as meditation or yoga, which may help manage stress-induced shingles outbreaks

Are alternative therapies effective for shingles? While some individuals report benefits from alternative therapies, scientific evidence supporting their effectiveness for shingles is limited. It’s crucial to discuss any alternative treatments with your healthcare provider to ensure they don’t interfere with your primary treatment plan.

Dietary Considerations for Shingles

While there is no specific diet that can cure shingles, maintaining a balanced, nutrient-rich diet can support your immune system and potentially aid in recovery. Some dietary considerations for individuals with shingles include:

• Consuming foods rich in vitamin C, such as citrus fruits, berries, and leafy greens
• Including foods high in vitamin E, like nuts, seeds, and avocados
• Incorporating foods with lysine, an amino acid that may help fight viral infections (found in fish, chicken, and eggs)
• Staying hydrated by drinking plenty of water
• Limiting foods high in arginine, such as chocolate and nuts, as this amino acid may promote viral replication

Can dietary changes prevent or treat shingles? While a healthy diet can support overall immune function, there is no evidence that specific dietary changes can prevent or treat shingles. A balanced diet should be considered as part of an overall healthy lifestyle rather than a standalone treatment for shingles.

Long-term Management and Follow-up Care

For most individuals, shingles is a self-limiting condition that resolves within a few weeks. However, some people may experience lingering effects or complications that require ongoing management. Long-term considerations for shingles patients include:

• Regular follow-up appointments with your healthcare provider
• Monitoring for signs of postherpetic neuralgia
• Managing chronic pain, if present, through medication or other therapies
• Addressing any psychological impacts, such as anxiety or depression related to chronic pain
• Discussing strategies to prevent future outbreaks, including stress management and maintaining a healthy lifestyle

How often should you follow up with your doctor after a shingles outbreak? The frequency of follow-up appointments will depend on your individual case and any complications you may have experienced. Typically, your healthcare provider will schedule a follow-up visit a few weeks after the initial outbreak to assess your recovery and address any ongoing concerns.

In conclusion, while hydrocortisone cream is not recommended for treating shingles rashes, there are numerous effective treatments and management strategies available. Prompt antiviral treatment, proper home care, and appropriate pain management can help alleviate symptoms and promote faster healing. Additionally, vaccination remains the most effective method for preventing shingles and its complications. By understanding the nature of shingles and following proper treatment protocols, individuals can effectively manage this condition and minimize its impact on their quality of life.

Can I use hydrocortisone cream on shingles rash?

Medically reviewed by Carmen Pope, BPharm. Last updated on Aug 25, 2022.

Hydrocortisone cream is not recommended to put on a shingles rash and there is no evidence that hydrocortisone cream will help treat the pain of a shingles rash. The preferred treatment for shingles are antiviral medicines that you take by mouth, such as acyclovir, valacyclovir and famciclovir. These require a prescription from your doctor.

It is best to keep the rash clean and dry and not put anything on the rash if possible. Cover the rash with a nonstick dressing to prevent the virus that causes shingles being passed onto other people. The shingles rash is contagious until all the blisters have scabbed over and are dry. If the blisters are covered with a dressing, it is unlikely that the virus will pass on to others.

In general, it is best to avoid applying lotions or creams (eg, moisturizer) to the affected area, as this can further irritate the skin. If you do want to put something on your shingles rash, then the American Academy of Dermatology Association recommends using calamine lotion for shingles. Calamine lotion has a cooling effect and can help reduce itching. Other topical treatments for shingles include wet compresses and colloidal oatmeal baths.

But oral antiviral treatment remains the preferred treatment for shingles and this will help the rash heal faster, reduce shingles pain, and reduce the risk of postherpetic neuralgia (long-lasting nerve pain in an area of skin previously affected by shingles) developing. Oral antivirals are most effective when started within 72 hours after the shingles rash appears. The three antiviral drugs used to treat shingles are:

• Acyclovir
• Famciclovir
• Valacyclovir.

Other oral treatments include acetaminophen or ibuprofen for pain relief. Sometimes, oral corticosteroids may be prescribed alongside oral antivirals if inflammation is severe.

References

1. Centers for Disease Control and Prevention (CDC). Treating Shingles. July 1, 2019. Available at: https://www.cdc.gov/shingles/about/treatment.html. [Accessed May 2, 2022].
2. Santee JA. Corticosteroids for herpes zoster: what do they accomplish? Am J Clin Dermatol. 2002;3(8):517-524. https://doi.org/10.2165/00128071-200203080-00001.
3. Patient education: Shingles (Beyond the Basics) Updated Feb 15, 2022. Up to Date. https://www.uptodate.com/contents/shingles-beyond-the-basics
4. Shingles: Diagnosis and Treatment. American Academy of Dermatology Association. 2022. https://www.aad.org/public/diseases/a-z/shingles-treatment

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How to choose the best cream for shingles

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Was this helpful?

Shingles causes an itchy, painful, and blistering rash that typically affects one side of the body. Several creams are available that can reduce itching and discomfort from these rashes.

Anyone who has had chickenpox can develop shingles. Following chickenpox, the varicella-zoster virus remains in the person’s nerves. Shingles occurs when the virus finds its way back to the skin.

Most people only have one instance of shingles in their lifetime, but some may develop it more than once. A person who develops a shingles rash cannot spread shingles to another person. However, they can spread chickenpox to anyone who is unvaccinated or has never had chickenpox.

A doctor may recommend antiviral medications, pain relievers, and over-the-counter (OTC) self-care creams to help ease the symptoms on the skin.

Several creams and ointments are available in local drug stores or online for managing shingles. This article reviews the best shingles creams and offers a few options.

Quick links

• DermaChange Natural Shingles Treatment and Relief Cream
• Shingbase Shingles Cream
• Terrasil Shingles Treatment Cream
• Humco Calamine Lotion
• Aloderma Organic Pure Aloe Vera Gel
• Aveeno Anti-Itch Concentrated Lotion

Many OTC creams contain natural ingredients. Though this may be appealing to some, it is important to keep in mind that the Food and Drug Administration (FDA) does not regulate these products. Studies on the effectiveness and safety of natural ingredients may also be lacking.

However, some creams contain ingredients that may help reduce shingles symptoms, such as lidocaine.

Shingles creams could provide temporary relief from symptoms such as pain and itchiness.

Before starting self-care for shingles at home, a person should talk with their doctor and get a formal diagnosis. In some cases, untreated shingles can lead to permanent nerve damage or vision loss, so a person should always seek medical treatment from a doctor before trying self-care creams.

When looking for topical, OTC shingles creams, a person may want to consider the following:

• Active ingredients: Some products only use natural ingredients, while others use low doses of medication.
• Effectiveness: Not all ingredients have strong, empirical evidence backing them up. A person may need to look at the experiences of other users.
• Cost: Some creams are more expensive than others. A person should pay attention to the total cost and the amount of cream each product contains to estimate its value.

Medical News Today chooses skin care products that meet the following criteria:

• Price: Products are available for a wide range of budgets.
• Ingredients: Products list all ingredients clearly.
• Skin concerns: Products target a specific skin concern.
• Safety: Products contain ingredients that are safe for topical use.
• Reputable: Products are from businesses that adhere to industry best practices.

Was this helpful?

Please note that the writer of this article has not tried these products. All information presented is purely research-based and correct at the time of publication.

DermaChange Natural Shingles Treatment and Relief Cream

DermaChange offers a cream that claims to contain only natural ingredients, including:

• aloe vera
• manuka honey
• coconut oil
• shea and cocoa butter

The product claims to provide instant cooling relief and states that manuka honey has several studies supporting its use. However, no study looks directly at its effect on shingles rashes and pain.

Aloe vera may help with reducing inflammation from a shingles rash. According to a 2019 study, aloe vera has several potential healing effects, including reducing inflammation.

The product claims to be safe for everyone, but a person should talk with their doctor before using it.

Users on Amazon give an average rating of 4.2 out of 5 stars, with over 4,500 reviews.

SHOP NOW

Shingbase Shingles Cream

Shingbase uses lidocaine and menthol to help with shingles pain and itchiness.

Evidence suggests that lidocaine can be part of an effective treatment for shingles-related pain. This product contains 4% lidocaine, which could contribute to pain relief.

In addition, it also contains aloe vera and other natural ingredients that may help with inflammation and itchiness.

The product has an average of 4.2 out of 5 stars from over 300 users on Amazon.

SHOP NOW

Terrasil Shingles Treatment Cream

Terrasil shingles cream may provide relief from itchy and painful shingles rashes.

It contains all-natural ingredients that may appeal to people looking to avoid putting synthetic chemicals on their skin. In addition to cottonseed oil and beeswax, it contains activated minerals.

There are claims the minerals can help clear the skin, but there is no evidence of this. Of nearly 1,700 users on Amazon, the product earns a 4.3 out of 5 star rating, with many users indicating that the product works well for them.

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Humco Calamine Lotion

The American Academy of Dermatology Association recommends using calamine lotion for shingles. Calamine lotion can create a cooling sensation to help with itching from conditions such as chickenpox.

In addition, it contains zinc oxide. This active ingredient may reduce inflammation, which can help relieve itching and pain from shingles.

A person can find calamine lotion on Amazon, where it has a rating of 4.4 out of 5 stars from over 2,000 reviews.

SHOP NOW

Aloderma Organic Pure Aloe Vera Gel

This gel claims only to contain aloe vera.

The company also claims to be eco-friendly and does not test on animals.

The American Academy of Dermatology Association notes that aloe vera can relieve pain from shingles.

SHOP NOW

Aveeno Anti-Itch Concentrated Lotion

Aveeno Anti-Itch Concentrated Lotion contains a combination of calamine and oatmeal. The two ingredients can soothe itchy skin from shingles.

The product specifically mentions chickenpox rashes and claims to be safe for most people to use.

The product has a 4. 8 out of 5 star rating from over 10,000 users on Amazon.

SHOP NOW

A person can take other steps aside from applying medication to feel more comfortable while dealing with shingles. Steps include:

• seeing a doctor within 72 hours of developing a rash
• cleaning the rash daily
• protecting the rash with a thin layer of petroleum jelly
• covering the rash with a sterile bandage
• easing discomfort by applying a cool washcloth several times per day
• soaking in an oatmeal bath
• using calamine lotion after the blisters scab over
• wearing loose-fitting clothes

Not only should a person with shingles try to keep the skin rash as comfortable as possible, they should also take steps to fight the virus itself, including:

• getting plenty of rest
• eating a nutrient-rich diet
• drinking plenty of water
• avoiding stress

Shingles can cause an uncomfortable, itchy rash. Applying shingles cream can temporarily reduce the itching and pain from the disease. Some creams contain all-natural products, but others include medications.

Some shingles creams will work better than others. It is best to talk with a doctor for treatment and advice on the best shingles creams.

Shingles (Herpes zoster) – treatment in adults and children, symptoms, is it contagious, prevention, which doctor treats

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Shingles (Herpes zoster): causes, symptoms, diagnosis and treatment.

Herpes zoster is an infectious disease whose causative agent (herpesvirus type 3) also causes chicken pox.

Since the virus, penetrating into sensitive nerve endings, is integrated into the genetic apparatus of nerve cells, it is impossible to remove it from the body. In those who have had chickenpox, the virus goes into a latent (inactive) state.

When the immune system is weakened, the virus is activated, affecting the skin. The disease often develops in the elderly and in immunocompromised individuals.

Causes of disease

The virus is transmitted from a patient with chicken pox or herpes zoster by contact or airborne droplets. The person who becomes infected primarily (most often a child) gets chickenpox. Penetrating through the mucous membranes into the blood and lymph, the virus reaches the nerve cells, where it begins to multiply. After recovery, the virus remains in the body for life, often being in an inactive state. The awakening of the infection is associated with weakened immunity caused by hypothermia, long-term use of steroid hormones, immunosuppression (after transplantation), chemotherapy and radiation therapy, as well as a general decrease in immunity in patients with blood diseases, oncological and viral diseases. Shingles is very severe in HIV-infected patients.

Classification of herpes zoster

The clinical picture of herpes zoster consists of skin manifestations and neurological disorders. There are typical and atypical forms of the disease. With an atypical form, an erased course of the disease is possible, in which papules develop in the foci of hyperemia, which do not transform into vesicles.

In herpes zoster, the spread of the pathological process corresponds to a certain area of ​​the skin and does not cross the anatomical midline of the trunk. In most patients, the rash is preceded by a burning or itching sensation in a specific area of ​​the skin, as well as pain, which can be stabbing, throbbing, shooting, paroxysmal or constant. In a number of patients, the pain syndrome is accompanied by general systemic inflammatory manifestations: fever, malaise, myalgia, and headache.

Infection of the central nervous system and involvement of the meninges can produce meningeal, encephalic (symptoms suggest virus involvement of the brain and/or spinal cord and meninges), or mixed forms of herpes zoster. If the infection spreads along the optic nerve, ophthalmic herpes develops.

When a rash appears over the entire surface of the skin and on parenchymal organs (eg, liver, kidneys), a generalized form of herpes zoster develops. Another type of shingles is hemorrhagic. A characteristic feature is the bloody fluid inside the vesicles.

Symptoms of herpes zoster

The onset of the disease is accompanied by general intoxication, malaise and fever. Nausea and vomiting are possible. Lymph nodes are enlarged.

There are pronounced pains along the affected nerve, which can be permanent, but more often they are paroxysmal itchy in nature, intensifying at night.

As a rule, they are provoked by any irritants: touching the skin, cold, movement. Some patients complain of loss of sensation in certain areas of the skin, which may be combined with increased pain response. Sometimes the pain syndrome in the absence of skin rashes can resemble angina pectoris, myocardial infarction, renal colic, or pancreatitis. The period of neuralgia preceding the rash lasts up to 7 days. Then nodules appear on one side of the body, from which bubbles form with transparent contents, which gradually become cloudy. After 3-7 days, most of the bubbles dry up with the formation of yellow-brown crusts. When the bubbles are injured, bright red sores are exposed. After the sores heal, small scabs or scars remain on the skin.

Most often, rash and pain are noted in the region of the ribs, lower back and sacrum, less often along the branches of the trigeminal, facial and ear nerve and on the extremities.

In rare cases, the mucous membranes are affected.

Herpes zoster diagnostics

It is possible to make a diagnosis after examining and questioning the patient. The doctor pays attention to the nature of the rash (localized and unilateral), the type of vesicles and complaints of itchy burning pain. It is more difficult to identify the atypical form of herpes zoster. With an erased form, pain and other neurological symptoms may be absent. In case of neurogenic disorders before the appearance of rashes, the diagnosis can be made on the basis of the results of laboratory tests. In this case, a histological examination is used, and the virus is isolated in cell culture. The Zanck test helps to quickly confirm the herpetic nature of the rashes: giant multinucleated cells are found in the scraping of the material taken from the base of the vesicle. However, this test does not make it possible to determine the type of herpes. The methods of enzyme immunoassay and indirect immunofluorescent reaction are also used. Recently, the diagnosis of viral infections is carried out using the polymerase chain reaction (PCR).

Antibodies of the IgG class to the Varicella-Zoster virus (Varicella-Zoster Virus IgG, anti-VZV IgG, antibodies of the IgG class to the varicella-zoster virus and shingles)

Synonyms: Blood test for antibodies to the chickenpox virus; Chicken pox; Human herpes virus type 3; HBV-3 type; varicellae-zoster virus; Herpes zoster.

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Antibodies of the IgM class to the Varicella-Zoster virus (Varicella-Zoster Virus IgM, anti-VZV IgM, antibodies of the IgM class to the varicella-zoster virus and herpes zoster)

Synonyms: Blood test for antibodies to the chickenpox virus; Chicken pox; Human herpes virus type 3; HBV-3 type; varicellae-zoster virus; Herpes zoster.

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Which doctors to contact

Depending on the primary symptoms, patients with herpes zoster may see different specialists. However, first of all, you should go to
therapist for examination and referrals for tests. If limited, localized skin rashes appear and there are no pain symptoms, it is necessary to contact a dermatologist for differential diagnosis of erysipelas (caused by bacteria), eczema, etc. In case of severe pain syndrome, movement disorders, consultation is necessary
neurologist. In case of damage to the eyes, pain when moving the eyeballs, an ophthalmologist’s consultation is required. The generalized form of herpes often requires hospitalization and the combined efforts of an immunologist, a neurologist, and a dermatologist.

Herpes zoster treatment

With any localization of rashes, antiviral agents are first prescribed (the drug, the frequency of administration and dosage are determined by the attending physician!).

Their action is especially effective in the first 72 hours from the onset of clinical manifestations.

In the presence of a strong pain syndrome, the doctor may recommend anti-inflammatory therapy. However, contraindications must be taken into account (for example, chronic diseases such as arterial hypertension, diabetes mellitus, erosive lesions of the intestine, peptic ulcer of the stomach and duodenum). If analgesics don’t work, your doctor may prescribe central analgesics (often prescription drugs) and nerve blocks. External (topical) treatment is necessary to eliminate inflammation and prevent infection of the skin by other agents (eg, bacteria). With erosive forms of herpes zoster, creams and ointments with antibacterial action are applied to the affected areas.

Your doctor may also recommend treatments to improve immunity, such as taking vitamins (particularly B vitamins).

Complications

When the vesicles open, a secondary infection (bacterial infection of the skin) is possible, which is accompanied by fever and general intoxication.

Typical complications of herpes zoster include neuritis, paresis and paralysis of sensory and motor nerves.

Postherpetic neuralgia is difficult to treat.

The ocular form of herpes can lead to keratitis (inflammation of the cornea), less often to iritis (inflammation of the iris) or glaucoma (increased intraocular pressure). In addition, the development of optic neuritis is possible, sometimes with its subsequent atrophy and blindness. With the defeat of the branch of the oculomotor nerve, ptosis develops (drooping of the upper eyelid). Sometimes patients complain of hearing loss, damage to the vestibular apparatus, in severe cases – paralysis and paresis of the oral cavity. In addition, patients may report tinnitus or increased sensitivity to sounds. Damage to the lumbosacral nerve nodes sometimes leads to urinary retention, constipation or diarrhea. In patients with significantly weakened immunity (with HIV infection, oncological diseases), herpes zoster often occurs in a generalized form and is complicated by meningitis, encephalitis, or meningoencephalitis.

Shingles prevention

Since shingles is caused by the same pathogen as varicella, prevention of the disease will be based on the same measures as with chickenpox.

To prevent the spread of infection, isolation of the patient is necessary, which lasts up to 5 days from the moment the last element of the rash appears.

Persons who have been in contact with a patient with chickenpox are observed for 21 days. Active (vaccination) and passive (immunoglobulin administration) immunization are used as emergency prophylaxis. Vaccination is carried out for children older than 12 months and adults with no contraindications in the first 72-96 hours after probable contact with a person with chickenpox or shingles. Passive immunization with anti-varicella immunoglobulin is indicated for people with low immunity who have contraindications to vaccinations, pregnant women, children under 12 months of age and newborns whose mothers fell ill with chicken pox within 5 days before the birth of the child. The introduction of immunoglobulin is also carried out within 72-96 hours after contact with a patient with chicken pox or herpes zoster.

References

1. Herpes zoster: Clinical guidelines. Ministry of Health of the Russian Federation. 2016.
2. Decree of the Chief State Sanitary Doctor of the Russian Federation dated February 5, 2018 No. 12 on the approval of SP 3.1.3525-18 “Chickenpox and Shingles Prevention”. 2018.

IMPORTANT!

The information in this section should not be used for self-diagnosis or self-treatment. In case of pain or other exacerbation of the disease, only the attending physician should prescribe diagnostic tests. For diagnosis and proper treatment, you should contact your doctor.
For a correct assessment of the results of your analyzes in dynamics, it is preferable to do studies in the same laboratory, since different laboratories may use different research methods and units of measurement to perform the same analyzes.

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Herpes zoster – causes, symptoms, treatment in adults

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Effective treatment of herpes zoster and postherpetic neuralgic pains in Hadassah Medical Clinic. All analyzes and consultations in one place for the convenience of patients. The selection of an individual treatment plan and a multidisciplinary approach make it possible to successfully cure the infection even in immunocompromised patients.

Shingles (herpes zoster) is a viral infection that affects the skin and nervous system. It is caused by the causative agent Varicella zoster (VZV) – type 3 herpesvirus. The disease is manifested by blisters along the nerves and burning pains that bother a person for several months. Herpes zoster is dangerous not only with subjective symptoms, but also with complications from the brain and sensory organs.

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Zhukova
Daria Grigoryevna

Allergist-immunologist, Ph.D.

Work experience: 14 years

Cost of admission: from 9000 ₽

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Zaitseva
Galina Valerievna

Allergist-immunologist

Work experience: 10 years

Cost of admission: from 6500 ₽

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Benefits of treatment at the Hadassah clinic

Rapid diagnosis

Analyzes are performed in our own laboratory, which is equipped with modern equipment and test systems for all types of research.

Multidisciplinary approach

Herpes zoster will be treated by neurologists, infectious disease specialists, immunologists and other specialists, if the patient’s medical condition so requires.

Personalized therapy program

Our doctors follow the principle of “treat the patient, not the disease”, so they are attentive to each situation and take into account the characteristics of a particular person when choosing a therapeutic program.

Evidence-based medicine

In our work, we use only generally recognized clinical protocols, international recommendations, and the results of randomized trials.

Original medicines

The clinic cooperates with leading pharmaceutical companies, which makes it possible to purchase certified and high-quality medicines.

Rehabilitation

We pay great attention to the restoration of a full life of the patient, the elimination of residual pain and other symptoms that interfere with normal activities.

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Symptoms of herpes Zoster

Up to 80% of cases of the disease begin with a prodromal period. Patients experience moderate pain, itching and tingling in the area of ​​one dermatome – where a rash appears after 3-4 days. It is also characterized by fever, malaise, headaches.

Eruptions have characteristic features:

• initially pink spots 3-5 cm in diameter with indistinct edges appear;
• a day later, small blisters form in their place, similar to a rash with chickenpox;
• vesicles are usually located on the chest or abdomen, which corresponds to the course of one of the sensory nerves;
• the appearance of signs of herpes on the back, neck, limbs is typical for the generalized form of the disease and is mainly associated with immunodeficiencies;
• rashes gradually shrink into crusts that fall off after a few weeks, leaving behind unstable pigmentation on the skin.

The acute period is always accompanied by intense burning pains in the area of ​​the affected nerve. Pain is aggravated by touch. They can be permanent or paroxysmal in nature, some patients describe the symptoms as “electric shock”.

You can see a photo of what shingles looks like, but do not use the information as a way for self-diagnosis and self-treatment. This is a dangerous disease that should be treated under the supervision of an infectious disease specialist and a neurologist.

Causes of occurrence

Most people come into contact with the pathogen in childhood, when they fall ill with classic chicken pox or endure it in an erased form. After the initial infection, the virus does not disappear from the body anywhere. It remains in the nerve ganglia and can remain there in a latent state for decades. Under adverse conditions, it again manifests itself, causing shingles.

VZV reactivation occurs when the body’s immune defenses decrease due to the following factors:

• hypothermia or overheating;
• chronic stress;
• excess ultraviolet exposure;
• unbalanced diet, beriberi;
• acute respiratory diseases;
• injuries, surgical operations;
• acute and chronic diseases of internal organs;
• secondary immunodeficiency conditions;
• taking immunosuppressive, antibiotic therapy.

One of the most important predisposing factors is called HIV infection. When the level of CD4-lymphocytes falls below 500 cells per μl, the body’s resistance to latent infection is sharply reduced, and symptoms of herpes zoster appear.

Diagnosis

The diagnosis of herpes zoster is usually based on pathognomonic lesions and pain. Herpes simplex virus (HSV) can cause nearly identical lesions, but unlike herpes zoster, HSV tends to recur and is not dermatomal (associated with a specific nerve). Before treating herpes zoster, the doctor must be completely sure of the diagnosis, so clarifying examinations are prescribed:

PCR test

to identify the genetic material of the pathogen;

ELISA

to detect antibodies to herpesvirus;

Clinical blood test

in which the specialist is interested in the level of leukocytes and the ratio of different fractions of white blood cells;

Microscopy of impression smears from affected areas of the skin

to detect giant multinucleated cells.

It is important to clarify what led to the manifestation of the disease. If there are no obvious causes, it is worth looking for a disease that initially does not cause independent symptoms, but reduces immunity (cancer or infection with the human immunodeficiency virus). Exclusion of HIV infection is necessary in all patients under 50 years of age.

Methods of treatment of herpes zoster in the Hadassah clinic

Therapy is carried out in two directions: etiotropic drugs to fight a viral infection and painkillers to alleviate a person’s condition. The best clinical results can be achieved with the start of pharmacotherapy in the first 72 hours from the appearance of rashes. The main drugs for the treatment of herpes zoster in adults are representatives of the acyclovir group, which are used according to an individual scheme.

All patients are prescribed analgesics in tablets and injections; local anesthetics are also used for postherpetic pain. With intense pain syndrome, the treatment of herpes Zoster is supplemented with centrally acting medicines: antidepressants, tranquilizers, anticonvulsants. According to indications, methods of physiotherapy are used.

Blisters on the skin contain a large number of viral particles that pose an epidemiological hazard to others. Herpes zoster itself is not transmitted because it is associated with the reactivation of an existing infection, but the patient can become a source of chickenpox for children and previously healthy adults. Since a person with skin manifestations of shingles is contagious to others, it is recommended to limit close contact with family members and others who have not yet encountered chickenpox.

Why the disease is dangerous

One of the main problems is postherpetic neuralgia, which can occur even with properly selected drugs for the treatment of herpes zoster in adults. The frequency of complications increases in direct proportion to age – more than 50% of patients over 60 suffer from this disease. Pain phenomena at the site of the rash persist for several months, in 10-15% of cases the symptoms last for six months.

Other negative effects of the infection are much less common, but are a serious health hazard. These include:

• transverse myelitis – inflammation of the segments of the spinal cord located close to the affected dermatome;
• meningitis, encephalitis – inflammation of the membranes and substance of the brain;
• ophthalmic herpes – damage to the eyeball, which is fraught with decreased vision and the development of glaucoma;
• pyoderma – suppuration of rash areas due to the addition of a secondary bacterial infection.

These manifestations are more common in elderly patients, people with weakened immune systems, patients who have recently undergone serious illness or surgery.

To reduce the risk of dangerous complications from the nervous system, it is necessary to consult a doctor in a timely manner, who knows how to treat herpes zoster according to modern protocols from the standpoint of evidence-based medicine.

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Disease prevention

In people who have recovered from chickenpox, preventive measures are aimed at preventing VZV reactivation in regional nerve structures. For this purpose, it is recommended to strengthen the immune system and health-improving procedures, which include:

• balanced and fortified nutrition;
• prolonged sleep;
• avoidance of mental and physical overwork;
• timely treatment of somatic diseases, metabolic disorders;
• practicing safe sex to prevent HIV infection.

The only way to specifically protect against the Varicella Zoster virus is timely vaccination before the person has come into contact with the virus. Children are usually vaccinated to protect them from infection. However, immunization according to strict indications is also carried out for the elderly and debilitated people who are at high risk of developing symptoms of herpes zoster. Vaccination helps build immunity against infection and prevent it from reactivating.

For effective and evidence-based treatment of herpes zoster in adults, contact the Hadassah clinic in Moscow. Our doctors will conduct a comprehensive diagnosis and select a personal treatment plan. Specialists also treat postherpetic neuralgia and other complications, helping the patient return to a full life after illness.

Text checked by an expert doctor

Zhukova
Daria Grigorievna

Allergist-immunologist, Ph.D.

Work experience: 14 years

Published: 06/27/2022

Updated: 06/27/2022

The information provided on the site is for reference only and cannot serve as a basis for making a diagnosis or prescribing treatment. Internal consultation of the expert is necessary.

SOURCES

• Herpes zoster. Clinical recommendations of the All-Russian public organization “Russian Society of Dermatovenerologists and Cosmetologists”. – 2020.
• Isakov DV, Isakov VA Herpes simplex and herpes zoster (clinic, treatment and prevention). – 2021.
• Cairo A. N., Lavrov V. F. Herpes zoster: epidemiological features of incidence in 2019 // Epidemiology and vaccine prevention. – 2020. – T. 19. – No. 5. – S. 93-97.
• Ryumin AM et al. Neurological manifestations of herpes zoster virus reactivation //Journal of Infectology. – 2022. – T. 14. – No. 1. – S. 31-42.
• Ignatovsky AV Herpes zoster – modern approaches to diagnosis and treatment //Doctor/Vrach. – 2022. – T. 33. – No. 10.
• Avdeeva M.G., Alikeeva G.K., Antonova M.V. etc. Infectious diseases. National leadership. Ed. N.D. Yushchuk, Yu.Ya. Vengerov. M.; GOETAR; 2018.
• Polyakova D.M., Nikiforov V.V., Shakhmardanov M.Z. Immunity and vaccination in adults with infection caused by the Varicella zoster virus. Epidemiology and infectious diseases. 2019; 24(2): 84-7.
• Dooling K.L., Guo A., Patel M., Lee G.M., et al. Recommendations of the advisory committee on immunization practices for use of herpes zoster vaccines // Centers for disease control and prevention. — 2018; 67(3):103-108.
• Lavrov V. F., Svitich O. A., Casanova A. S. et al. // Varicella zoster virus infection: immunity, diagnostics and modeling in vivo. J. microbiol. 2019; 4:82–89.

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