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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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.

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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.

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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.

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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.

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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.

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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.

How to spot a skin rash disease: symptoms and treatment

Find out how to spot a skin rash disease. Symptoms, causes and treatment of common skin conditions such as dermatitis, eczema, psoriasis and many more. Useful tips and tricks for healthy skin.

Skin rashes are a fairly common phenomenon that can be caused by a variety of reasons. Some of them do not pose a health risk, and some are a sign of serious illness. Often rashes lead to discomfort and unaesthetic, and in some cases can cause serious harm to health.

In this article, we’ll look at some of the symptoms that can accompany a skin rash, as well as make recommendations for treating various types of illnesses that can be associated with skin rashes.

If you have a skin rash and you do not know how to determine the cause of the disease, be sure to consult a specialist. Do not self-medicate and do not leave the disease unattended, as this can lead to negative health consequences.

Why is it important to identify a disease by a skin rash?

The skin is our first line of defense against the environment, so it’s important to keep it healthy and respond appropriately to any change. Skin rashes can be indicative of a variety of conditions, from mild allergic reactions to serious infections and life-threatening illnesses such as skin cancer.

Determination of the cause of skin rashes is very important in terms of treatment and further human health. Improper or missing treatment can lead to poor health and the development of serious complications.

Also, the correct definition of the disease helps to choose the appropriate type of treatment that will give an effective result and reduce the recovery time of the skin.

Finally, by knowing which diseases can cause skin rashes, you can prevent serious diseases and take preventive measures, such as using sunscreen and wearing protective clothing when working in the sun.

• In general, the correct identification of skin rashes is an important step in maintaining health, caring for the skin and preventing the development of serious diseases.

What diseases can be manifested through skin rashes?

Eruptions on the skin can be a manifestation of various diseases. Skin reactions can vary depending on age, gender, season, and many other factors. At the same time, many diseases have similar symptoms, which makes diagnosis quite difficult.

One of the most common causes of skin rashes are allergic reactions. They can be caused by food, drugs, cosmetics, or chemicals. The main symptoms of such reactions are itching, diaper rash, redness and hives.

Viral infections can also manifest as skin rashes. For example, chicken pox and shingles are manifested by rashes in the form of vesicles and spots, which then turn into crusts.

Autoimmune diseases such as psoriasis, eczema and rosacea can also cause skin rashes. Usually they are accompanied by itching, dryness and peeling of the skin.

In some cases, skin rashes can be a manifestation of dangerous diseases such as acute dermatitis and skin lymphoma. If you suspect these diseases, you should contact a specialist and undergo an appropriate examination.

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How do allergic rashes appear?

Allergic rashes can manifest themselves in several ways, depending on the type of allergy and individual characteristics of the organism. Here are some of the most common symptoms:

1. Redness of the skin: this is a typical sign of an allergy. The skin may become red and irritated at the site of contact with the allergen. Red spots can be of different sizes and shapes.
2. Swelling: Swelling can cause discomfort and pain, and sometimes even threaten a person’s life. It can appear in different parts of the body, from the eyes to the feet.
3. Itchy skin: this symptom can be very unpleasant as the itching can be severe and prolonged. This can lead to skin damage and infection.
4. Blisters: Allergic rash may often present as blisters. They can appear anywhere on the body where there has been contact with the allergen.

If you experience any of these symptoms, it is important to see a doctor who can conduct a thorough examination and find out the cause of the allergy. Treatment will depend on the type of allergy and may include antihistamines, skin creams, and other measures.

What are the symptoms of an infectious skin rash?

Infectious skin eruptions can take many forms and appear as blisters, red spots, hives or rashes that may be dry or wet. They can be very itchy, irritating and uncomfortable.

Common symptoms of infectious skin rashes are:

• Areas of redness – Depending on the type of infection, the skin may turn bright red or pink.
• Blisters and Blisters – Fluid blisters may appear on the skin, which may be small or large, and cause itching or pain. Blisters are hard growths on the skin that can also be noticeable.
• Moist plaques – In some infections, the skin can secrete fluid clots called vesicles, which can break apart and lead to the formation of weeping plaques.
• Rash – Infectious skin eruption may present as a rash that may be distributed evenly or randomly.

If you find yourself with some kind of infectious skin rash, it is recommended to consult a dermatologist who can prescribe an adequate treatment.

What are the characteristics of rashes caused by parasites on the skin?

Skin eruptions caused by parasites often have a peculiar character and unique features. When infected with worms, fleas, ticks or other parasites, the affected skin is saturated with different types of rashes, which are characterized by unique properties.

One of the features of such eruptions is their location. Parasites often choose certain areas of the skin where they begin to multiply. For example, fleas and ticks prefer places where the skin is thin and soft, such as the inner thighs, knees, or elbows.

Another feature is the shape and size of the lesions. Rashes caused by parasites can be small and scaly, red or pink, blistered, blistered, hives, or round nodules. They can look very similar to other skin conditions, so medical advice and tests are needed for an accurate diagnosis.

Itching and skin irritation are also common symptoms of parasite rashes. However, the intensity of itching can vary depending on the type of parasite and the stage of the infection.

• Worms may cause itching and redness around the anus or vagina, as well as other skin manifestations.
• Ticks and fleas may cause small blisters on the skin which may then bleed or itch. Itching may persist for some time after the bite.
• Scabies is a disease caused by a mite that penetrates the skin, causing an allergic reaction and itching. Rashes are usually located in places where a person tickles the skin more intensively. Also, scales can be picked up from a sick person, pets and through linen and things.

In any case, if you have an unexpected skin rash accompanied by itching, redness or other symptoms, you should consult a dermatologist for diagnosis and treatment.

What is eczema and how is it detected?

Eczema is a skin disease that manifests itself in the form of rashes on the skin. Eczema is one of the most common skin conditions and can appear on various areas of the skin.

Eczema can be identified by the following symptoms:

• Frequent rashes, which can be of various sizes and shapes;
• Skin may be dry, flaky and itchy;
• Skin may be red, swollen and swollen;
• Skin may develop blisters or blisters that may fill with fluid;

Although rashes can appear anywhere on the skin, eczema most commonly occurs on the face, hands, elbows and knees.

If you notice any of the above symptoms, you should consult a dermatologist. Treatment for eczema depends on the type of eczema and may include ointments, creams, tablets, and other medications.

In addition, with eczema, it is necessary to follow the rules of personal hygiene and avoid contact with possible allergens in order to prevent an aggravation of the disease. It is also important to monitor the condition of the skin and apply moisturizers and protective products to reduce dryness and itching.

What skin diseases are manifested by herpes?

Herpes is a viral disease that can appear on the skin in the form of blisters that cluster in certain areas. However, herpes can be associated not only with the common cold, but also with other skin diseases.

Shingles is one of the most common skin diseases with herpes symptoms. Manifestations of the disease are blisters on the skin that are difficult to distinguish from the manifestations of herpes. Shingles can be caused by the Varicella-Zoster virus, which remains in the body after chickenpox and can manifest itself as shingles after a few years.

Also, herpes can manifest itself with eczema, which is a chronic skin disease that manifests itself in the form of dryness, itching and redness of the skin. Patients with eczema may have an increased risk of contracting herpes.

In addition, herpes may be associated with skin diseases such as dermatitis herpetiformis and herpetic folliculitis. Dermatitis herpetiformis manifests itself in the form of herpes rashes on the skin, which can lead to the formation of ulcers. Herpetic folliculitis is an inflammation of the hair follicles that can cause blisters on the skin.

In general, when herpes appears on the skin, it is necessary to consult a qualified dermatologist to determine the exact cause of the rash and establish the correct diagnosis. Treatment for skin conditions that present with herpes depends on the type and may include antiviral medications, creams, and ointments.

What is the difference between psoriasis and eczema?

Psoriasis and eczema are two different skin conditions. What makes them different?

First, the causes. Psoriasis is an autoimmune disease where the immune system mistakenly attacks healthy skin cells, causing them to overgrow and form breakouts. Eczema occurs due to an allergic reaction to irritants such as food, pollens, bacteria, etc.

Second, the symptoms. In psoriasis, the skin becomes red, often with silvery scales, and the limbs may swell. In eczema, the symptoms can be similar, but most often the skin becomes very itchy, inflamed and flaky. In both diseases, shiny, lumpy lesions occur, but in the case of eczema, they can become moist and prone to infections.

Thirdly, treatment. Different diseases require different approaches to treatment. For psoriasis, silica ointments or tar are used, while for eczema, anti-inflammatory drugs and creams are mainly used to alleviate the symptoms. Antiallergic drugs are also often required in cases of eczema.

Understanding the symptoms, possible causes, and treatment options can help you understand the differences between psoriasis and eczema and help you choose the right treatment.

How does lichen manifest itself?

Ringworm is an infectious skin disease caused by various viruses, fungi and bacteria. Symptoms may vary depending on the type of lichen:

• Pink lichen – round or oval spots appear on the skin, red, pink or brown. There may be peeling in the center of the spot.
• Lichen fungus – round spots with a bright border appear on the skin, covered with small white scales. Spots can move to other areas of the skin.
• Lichen planus – small pink plaques appear on the skin, very itchy. May appear on any part of the body, including the mucous membranes of the mouth and genitals.
• Lichen warts – rough, bumpy nodules appear on the skin, calculated on a few millimeters. Most often, nodules appear on the arms and legs.

Lichen is treated individually, depending on its type and severity. Usually, the doctor prescribes topical treatment (creams, ointments) or prescribes antibiotics. In some cases, hospitalization may be required.

What is a boil and how is it treated?

Furuncle (or carbuncle) is an infectious inflammation of the hair follicle. The causative agents can be various types of bacteria, most often – staphylococci. With a boil, redness and swelling appear on the skin, in which a purulent plaque forms. In some cases, there may be an increase in body temperature and lymph nodes in the parotid region.

Self-treatment of a boil is not recommended. In case of illness, you should consult a dermatologist or therapist. Often, to quickly get rid of a boil, an urgent incision and removal of the contents of a purulent constipation is required. Medicated ointments and antibiotics may be used to reduce pain and speed up recovery.

In addition, to prevent recurrence, skin hygiene, avoid injury to hair follicles and do not use other people’s personal belongings. An important step to prevent the spread of infection is the general processing of things and places where the sick person has passed.

• Clean and dry-brush leather;
• Apply orthopedic isolation ointment to the skin;
• Nail clippers, razors, bathtubs, pillows and other items may be contaminated. Do not allow others to use such objects until they are left subjected to the same treatment as the surfaces on which the sick person was.

How to properly treat chicken pox?

Chickenpox is an infectious disease caused by the Varicella Zoster virus. The main symptoms are rashes on the skin, on top of which a small bubble with liquid forms. The most important thing in treatment is to prevent the risk of recurrence and reduce symptoms during treatment.

The first step in treating chickenpox is to keep the skin clean and avoid shaving the body to minimize the risk of infection in cuts and other open sores on the skin. Warm manganese baths are recommended to reduce itching and irritation. Do not rub the skin, remove crusts or squeeze out blisters to avoid infection.

Antiviral, antibiotic, and pain medication drips are recommended for pain relief. Also, other treatments may be considered depending on the individual needs of each patient.

It is important to understand that treatment for chickenpox should only be started under the supervision of a physician who will make recommendations based on the patient’s symptoms and general condition. Good hygiene and access to medical care are two important ingredients for successful chickenpox control.

What is the difference between varicose eczema and thrombophlebitis?

Varicose eczema and thrombophlebitis are two different diseases that affect the human venous system. Although these diseases may have similar symptoms, they have different causes and treatments.

Varicose eczema is a condition in which there is inflammation of the skin, usually in the legs. This is due to post-ecstatic hyperemia, when blood stagnates in incompetent vein valves. In this case, the skin can become dry, tight and itchy, and a rash appears. The treatment for varicose eczema is to treat the varicose veins and relieve symptoms such as itching and inflammation.

Thrombophlebitis is a disease in which a blood clot forms in the veins, usually in the lower extremities. In this case, the patient may experience soreness, swelling and redness. Treatment for thrombophlebitis may include anticoagulants and antibiotics, as well as compressing the venous system with compression stockings and providing increased rest for the limbs.

In both cases, it is important to see a doctor if symptoms develop. He will be able to make the correct diagnosis and give recommendations for treatment in order to avoid the development of complications.

Can skin cancer show up through rashes?

Yes, skin cancer can manifest itself through skin rashes. The rash can be of various shapes and colors, which can make it difficult to diagnose this dangerous disease.

• One type of skin cancer that manifests itself through rashes is basalioma.
• This type of skin cancer usually appears as ulcers, crusty sores that do not heal and may bleed.
• Another type of skin cancer, melanoma, can also appear as a rash.
• Melanoma may appear as large patches of skin, with various shades of black and gray, sometimes with a rough, uneven surface and irregular shape.

In any case, if you have rashes on your skin that do not disappear after a few weeks and cause concern, you should consult a dermatologist.

Only a qualified specialist can correctly diagnose and prescribe the necessary treatment. Remember that early diagnosis and treatment of skin cancer can save lives.

What are the causes of fungal infections of the skin and how can they be treated?

Fungal infections of the skin are caused by fungi that can affect various areas of the skin, such as nails, hands, face, body. Manifestations of a fungal infection can be different, depending on the type of fungus and the site of the lesion.

The most common type of fungal skin infection is dermatophytosis, which causes redness, itching, scaling and blistering. Fungal infections can be transmitted through contact with an infected skin surface, as well as through public places and personal belongings of a person.

Antimycotic drugs are used to treat fungal infections of the skin and may be for topical or internal use. In case of itching and skin irritation, topical antifungal creams and ointments can be applied. In more complex cases, systemic treatment with tablets or capsules may be required.

• Prevention of fungal infections of the skin consists in observing the rules of hygiene, using individual personal items and underwear, as well as regular examination of the skin and timely access to a doctor.
• You should never wear shared shoes in swimming pools, saunas and other public places, so as not to infect your feet with a fungus.
• Also do not use someone else’s sharp objects, which can damage the skin and be a way for the fungus to penetrate under the damaged layer of the skin.
• Fungal infections of the skin should be treated as soon as possible to avoid complications and spread of the infection to other areas of the skin.

Is there a link between stress and skin rashes?

Stress is a tense psychological state that can cause many physiological changes in the human body. One of these changes may be a rash on the skin.

When a person is under stress, their body produces more hormones such as cortisol and adrenaline. These hormones can increase the activity of the sebaceous glands, which can lead to the formation of skin rashes such as pimples.

In addition, stress can worsen existing skin problems such as eczema or psoriasis. Some of these problems can be caused by stress itself, which creates a vicious circle.

If you notice skin rashes after stressful situations, consult a dermatologist. Treatment may be needed to avoid complications and improve quality of life.

It is also important to remember that stress prevention can be an effective way to prevent skin rashes and other physiological changes. Regular meditation, yoga, and other relaxation techniques can help manage stress.

How is skin disease diagnosed through rashes?

Diagnosis of skin diseases through rashes begins with an examination of the skin and identification of the characteristics of the rash: shape, size, color, location, etc. The main task of a dermatologist is to determine the nosological unit – that is, to identify skin diseases based on clinical manifestations.

If necessary, the doctor may perform additional research, including microscopy, biopsy, or analysis of the skin for the presence of pathogenic microorganisms.

Some skin conditions characterized by rashes, such as dermatitis, eczema, herpes zoster, rosacea and many others, may have similar clinical manifestations. Therefore, for diagnosis, it is necessary to undergo an examination and consultation with an experienced specialist.

• Examination of the skin and identification of the characteristics of rashes
• Establishment of a nosological unit
• Additional examination if necessary
• Correct and timely diagnosis is the key to successful treatment

Q&A:

How to properly treat various types of skin rashes?

Dermatitis:

Topical preparations such as hydrocortisone creams or ointments are recommended for the treatment of dermatitis to help reduce inflammation and itching. In addition, it is important to avoid irritants such as chemical dyes, soaps or hard water and apply mild moisturizers to prevent skin dryness.

Acne:

Acne is treated with topical preparations such as creams, ointments or gels containing benzoyl peroxide or retinoids to help unclog pores and prevent new pimples from forming. In severe cases, systemic medications such as antibiotics or isotretinoin may be required.

Eczema:

For the treatment of eczema, it is recommended to use mild moisturizers such as petroleum jelly or glycerin to prevent dry skin. You may also need topical medications, such as creams or ointments based on calcipotriol or topical calcineurin inhibitors, which help reduce inflammation and itching.

Fungal infections of the skin:

Fungal infections of the skin can be treated with topical preparations, such as ointments or creams based on azole preparations or terbinafine, which help eliminate the fungus. If the infection spreads to large areas of the skin, systemic antifungals may be required.

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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 the 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.

Herpes zoster symptoms

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 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.

chickenpox; Human herp…

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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, the 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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