What is shingles and how does it differ from chickenpox. Who is at risk for developing shingles. How can shingles be prevented and treated effectively. What are the potential complications of shingles.

The Nature and Origin of Shingles

Shingles, medically known as herpes zoster, is a viral infection that manifests as a painful skin rash. It is caused by the varicella-zoster virus (VZV), the same virus responsible for chickenpox. After an individual recovers from chickenpox, the virus remains dormant in the body’s nerve tissues. Years or even decades later, it may reactivate, leading to the development of shingles.

The reactivation of the virus typically occurs in older adults or those with compromised immune systems. While shingles itself is not contagious, the virus can be transmitted to individuals who have never had chickenpox, potentially causing a primary VZV infection.

Key Characteristics of Shingles

• Painful, blistering rash
• Usually appears on one side of the body or face
• Caused by reactivation of the varicella-zoster virus
• More common in older adults and immunocompromised individuals

Risk Factors and Vulnerable Populations

While anyone who has had chickenpox can develop shingles, certain factors increase the likelihood of its occurrence. Age is a significant risk factor, with individuals over 50 being more susceptible. This increased risk is attributed to the natural decline in immune function that comes with aging.

People with weakened immune systems are particularly vulnerable to shingles. This includes individuals with:

• HIV/AIDS
• Certain types of cancer
• Autoimmune disorders
• Organ transplant recipients taking immunosuppressive medications

Stress and certain infections can also temporarily weaken the immune system, potentially triggering the reactivation of the varicella-zoster virus.

Can stress cause shingles?

While stress itself does not directly cause shingles, it can weaken the immune system, making it more likely for the dormant virus to reactivate. Prolonged periods of stress, whether physical or emotional, can compromise the body’s ability to keep the virus in check, potentially leading to a shingles outbreak.

Recognizing the Symptoms of Shingles

The onset of shingles is often characterized by a distinctive set of symptoms that typically progress in stages. Understanding these symptoms is crucial for early detection and prompt treatment.

Early Warning Signs

Before the characteristic rash appears, individuals may experience:

• Tingling or burning sensations in a specific area of skin
• Sensitivity to touch
• Itching or pain in the affected area
• Flu-like symptoms such as fever, headache, and fatigue

Development of the Rash

The hallmark symptom of shingles is a painful, blistering rash that typically appears on one side of the body or face. The rash often follows the path of a nerve, forming a stripe or belt-like pattern. As the infection progresses, the blisters fill with fluid, eventually crusting over and healing within 2-4 weeks.

Is shingles always painful?

While pain is a common symptom of shingles, the intensity can vary significantly among individuals. Some people may experience mild discomfort, while others may suffer from severe, debilitating pain. In rare cases, individuals may develop a condition called zoster sine herpete, where they experience the pain associated with shingles without developing the characteristic rash.

Diagnosis and Testing for Shingles

Diagnosing shingles typically involves a combination of clinical evaluation and, in some cases, laboratory tests. Healthcare providers often rely on the distinctive appearance of the rash and the patient’s medical history to make a diagnosis.

Clinical Examination

During a physical examination, the doctor will assess the appearance, distribution, and characteristics of the rash. They will also inquire about any accompanying symptoms and the patient’s history of chickenpox or shingles vaccination.

Laboratory Tests

In cases where the diagnosis is uncertain, or if the patient is at high risk for complications, the following tests may be conducted:

• Viral culture: A sample from the rash is tested to confirm the presence of the varicella-zoster virus.
• Polymerase chain reaction (PCR) test: This highly sensitive test can detect VZV DNA in skin lesions or cerebrospinal fluid.
• Tzanck smear: A scraping from the rash is examined under a microscope for characteristic cell changes.

How long does it take to diagnose shingles?

In most cases, a healthcare provider can diagnose shingles based on the appearance of the rash and the patient’s symptoms during a single visit. However, if laboratory tests are required, it may take a few days to receive the results and confirm the diagnosis.

Treatment Options and Management Strategies

While there is no cure for shingles, prompt treatment can help reduce the severity and duration of symptoms, as well as prevent potential complications. The management of shingles typically involves a multi-faceted approach.

Antiviral Medications

Antiviral drugs are the cornerstone of shingles treatment. These medications work by inhibiting viral replication, thereby reducing the severity and duration of the infection. Common antiviral drugs prescribed for shingles include:

• Acyclovir
• Valacyclovir
• Famciclovir

These medications are most effective when started within 72 hours of the rash’s appearance.

Pain Management

Managing pain associated with shingles is crucial for patient comfort and quality of life. Treatment options may include:

• Over-the-counter pain relievers (e.g., acetaminophen, ibuprofen)
• Topical anesthetics or analgesics
• Prescription pain medications for severe cases
• Nerve blocks or local anesthetics for intense, localized pain

Supportive Care

Additional measures to alleviate symptoms and promote healing include:

• Applying cool compresses to the affected area
• Wearing loose-fitting clothing to minimize friction on the rash
• Maintaining good hygiene to prevent secondary bacterial infections
• Getting adequate rest to support the immune system

How long does shingles treatment typically last?

The duration of shingles treatment can vary depending on the severity of the infection and the individual’s response to therapy. Antiviral medications are usually prescribed for 7 to 10 days. However, pain management and supportive care may continue for several weeks or even months in cases of persistent pain (postherpetic neuralgia).

Prevention Strategies and Vaccination

Preventing shingles is a crucial aspect of public health, particularly for older adults and those at higher risk. Vaccination plays a pivotal role in reducing the incidence and severity of shingles outbreaks.

Shingles Vaccines

Two vaccines are currently available for the prevention of shingles:

1. Shingrix (Recombinant Zoster Vaccine): This is the preferred vaccine, recommended for adults 50 years and older. It is a two-dose series that is more than 90% effective in preventing shingles.
2. Zostavax (Zoster Vaccine Live): While no longer available for use in the United States as of November 18, 2020, this vaccine was previously used for adults 60 years and older.

Who should get the shingles vaccine?

The Centers for Disease Control and Prevention (CDC) recommends Shingrix for adults 50 years and older, including those who:

• Have previously had shingles
• Have received the Zostavax vaccine in the past
• Are unsure if they have had chickenpox

The vaccine is particularly important for individuals with chronic medical conditions or weakened immune systems, as they are at higher risk for shingles and its complications.

Additional Prevention Measures

While vaccination is the most effective way to prevent shingles, other strategies can help reduce the risk of outbreaks:

• Maintaining a healthy lifestyle to support immune function
• Managing stress through relaxation techniques or counseling
• Avoiding close contact with individuals who have active shingles or chickenpox if you have never had chickenpox or been vaccinated

Can you prevent shingles naturally?

While natural methods cannot guarantee prevention of shingles, certain lifestyle choices may help support overall immune function, potentially reducing the risk of virus reactivation. These include:

• Eating a balanced, nutrient-rich diet
• Engaging in regular physical activity
• Getting adequate sleep
• Practicing stress-reduction techniques such as meditation or yoga

However, it’s important to note that these measures should not replace vaccination or medical advice for those at risk of shingles.

Complications and Long-Term Effects of Shingles

While many cases of shingles resolve without significant long-term effects, some individuals may experience complications that can have lasting impacts on their health and quality of life.

Postherpetic Neuralgia (PHN)

The most common complication of shingles is postherpetic neuralgia, a condition characterized by persistent pain in the area where the shingles rash occurred. PHN can last for months or even years after the rash has healed.

Risk factors for developing PHN include:

• Advanced age
• Severe pain during the acute phase of shingles
• Extensive rash
• Presence of prodromal pain (pain before the rash appears)

Other Potential Complications

Depending on the location and severity of the shingles outbreak, additional complications may occur:

• Vision problems: Shingles affecting the eye (ophthalmic shingles) can lead to temporary or permanent vision loss.
• Hearing issues: If the infection involves the ear, it may cause hearing loss or balance problems.
• Skin infections: Secondary bacterial infections can occur if the rash is not properly cared for.
• Neurological complications: In rare cases, shingles can lead to encephalitis, facial paralysis, or other neurological issues.

Can shingles recur?

While it is possible to develop shingles more than once, recurrence is relatively uncommon. Studies suggest that the risk of recurrence is about 6% within 5 years of the initial outbreak. Individuals with weakened immune systems are at higher risk for recurrent shingles. Vaccination can help reduce the risk of recurrence, even in those who have previously had shingles.

Living with Shingles: Coping Strategies and Support

Dealing with a shingles outbreak can be challenging, both physically and emotionally. Implementing effective coping strategies and seeking appropriate support can significantly improve the experience and recovery process.

Managing Daily Activities

During an active shingles outbreak, it’s important to:

• Rest and avoid strenuous activities to support healing
• Wear loose, comfortable clothing to minimize irritation of the affected area
• Adapt daily routines to accommodate any limitations caused by pain or discomfort
• Use assistive devices if necessary, especially for individuals experiencing postherpetic neuralgia

Emotional Well-being

The pain and discomfort associated with shingles can take a toll on mental health. Consider the following strategies:

• Practice stress-reduction techniques such as deep breathing or meditation
• Engage in gentle exercises or activities that promote relaxation
• Seek support from friends, family, or support groups
• Consult with a mental health professional if experiencing persistent anxiety or depression

Dietary Considerations

While there is no specific diet for shingles, maintaining proper nutrition can support overall health and potentially aid in recovery:

• Consume foods rich in vitamins A, B12, C, and E to support immune function
• Increase intake of foods with lysine, such as fish, chicken, and eggs
• Stay hydrated by drinking plenty of water
• Consider consulting a nutritionist for personalized dietary advice

How can caregivers support individuals with shingles?

Caregivers play a crucial role in supporting individuals with shingles. They can provide assistance by:

• Helping with daily tasks and personal care
• Ensuring medications are taken as prescribed
• Assisting with the application of topical treatments
• Providing emotional support and companionship
• Monitoring for signs of complications or worsening symptoms
• Encouraging rest and facilitating a comfortable environment

It’s important for caregivers to also practice good hygiene and take precautions to avoid potential transmission of the virus, especially if they have never had chickenpox or been vaccinated.

Shingles | Herpes Zoster | MedlinePlus

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What is shingles?

Shingles (herpes zoster) is an infection that causes a painful rash. It is caused by the varicella-zoster virus (VZV). This is the same virus that causes chickenpox. After you have chickenpox, the virus stays in your body. It may not cause problems for many years. But as you get older, the virus may become active again and cause shingles.

Is shingles contagious?

Shingles is not contagious. You cannot get shingles from someone else. But you can catch chickenpox from someone with shingles if you have direct contact with fluid from their shingles rash.

The risk of spreading the virus is low if the shingles rash is kept covered. People with shingles cannot spread the virus before their rash blisters appear or after the rash crusts.

Who is at risk for shingles?

Anyone who has had chickenpox can get shingles. But the risk of shingles goes up as you get older. Shingles is most common in people over age 50.

People with weakened immune systems are at higher risk of getting shingles. This includes those who:

• Have immune system diseases such as HIV
• Have certain cancers
• Take medicines that weaken their immune system, such as steroids and medicines you take after organ transplant

Your immune system may be weaker when you have an infection or are stressed. This can raise your risk of shingles.

It is rare, but possible, to get shingles more than once.

What are the symptoms of shingles?

Early signs of shingles include burning or shooting pain and tingling or itching. It is usually on one side of the body or face. The pain can be mild to severe.

Up to several days later, you will get a rash. It consists of blisters that typically scab over in 7 to 10 days. The rash is usually a single stripe around either the left or the right side of the body. In other cases, the rash is only on one side of the face. In rare cases (usually among people with weakened immune systems), the rash may be more widespread. It might look similar to a chickenpox rash.

Some people may also have other symptoms:

• Fever
• Headache
• Chills
• Upset stomach

What other problems can shingles cause?

Shingles can cause other problems (complications):

• Postherpetic neuralgia (PHN) is most common complication of shingles. It causes severe pain in the areas where you had the shingles rash. It usually gets better in a few weeks or months. But some people can have pain from PHN for many years, and it can interfere with daily life.
• Vision loss can happen if shingles affects your eye. It may be temporary or permanent.
• Hearing or balance problems are possible if you have shingles within or near your ear. You may also have weakness of the muscles on that side of your face. These problems can be temporary or permanent.

Very rarely, shingles can also lead to pneumonia, brain inflammation (encephalitis), or death.

How is shingles diagnosed?

Usually your health care provider can diagnose shingles by taking your medical history and looking at your rash. In some cases, your provider may scrap off tissue from the rash or swab some fluid from the blisters and send the sample to a lab for testing.

What are the treatments for shingles?

There is no cure for shingles. Antiviral medicines may help to make the attack shorter and less severe. They may also help prevent PHN. The medicines are most effective if you can take them within 3 days after the rash appears. So if you think you might have shingles, contact your provider as soon as possible.

Pain relievers may also help with the pain. A cool washcloth, calamine lotion, and oatmeal baths may help relieve some of the itching.

Can shingles be prevented?

There is a vaccine, called Shingrix, to help prevent shingles and its complications. The Centers for Disease Control and Prevention recommends that healthy adults 50 years and older get the vaccine. Your provider might also recommend the vaccine if you are over 19 and have a weakened immune system. The vaccine is given in two doses.

If you have shingles, you can help prevent spreading the virus to others by:

• Staying away from:
  • People with weakened immune systems
  • People who have not had chickenpox or the chickenpox vaccine, especially if they are pregnant
  • Premature or low birth weight babies
• Keeping the rash covered
• Not touching or scratching the rash
• Washing your hands often

Centers for Disease Control and Prevention

• Shingles

  (National Institute on Aging)

  Also in Spanish

• Shingles (Herpes Zoster)

  (Centers for Disease Control and Prevention)

• Shingles Transmission

  (Centers for Disease Control and Prevention)

  Also in Spanish

• What Everyone Should Know about Shingles Vaccine (Shingrix)

  (Centers for Disease Control and Prevention)

• Herpes Zoster Oticus

  (National Institute of Neurological Disorders and Stroke)

• Postherpetic Neuralgia

  (Mayo Foundation for Medical Education and Research)

  Also in Spanish

• Ramsay Hunt Syndrome

  (Mayo Foundation for Medical Education and Research)

• Photos of Shingles

  (Centers for Disease Control and Prevention)

• Shingles (Zoster)

  (VisualDX)

• Shingles: Signs and Symptoms

  (American Academy of Dermatology)

• ClinicalTrials. gov: Herpes Zoster

  (National Institutes of Health)

• ClinicalTrials.gov: Neuralgia, Postherpetic

  (National Institutes of Health)

• Article: Causal association between inflammatory bowel disease and herpes virus infections: a. ..

• Article: Prevention of Shingles in Dermatology Patients on Systemic Medications.

• Article: The incidence of herpes zoster in China: A meta-analysis and evidence. ..

• Shingles — see more articles

• Find a Dermatologist

  (American Academy of Dermatology)

• National Institute of Allergy and Infectious Diseases

• National Institute of Neurological Disorders and Stroke

  Also in Spanish

• Shingles (For Parents)

  (Nemours Foundation)

  Also in Spanish

• Get the Shingrix Vaccine if You Are 50 or Older

  (Centers for Disease Control and Prevention)

Shingles – Symptoms & causes

Overview

Shingles is a viral infection that causes a painful rash. Shingles can occur anywhere on your body. It typically looks like a single stripe of blisters that wraps around the left side or the right side of your torso.

Shingles is caused by the varicella-zoster virus — the same virus that causes chickenpox. After you’ve had chickenpox, the virus stays in your body for the rest of your life. Years later, the virus may reactivate as shingles.

Shingles isn’t life-threatening. But it can be very painful. Vaccines can help lower the risk of shingles. Early treatment may shorten a shingles infection and lessen the chance of complications. The most common complication is postherpetic neuralgia. This is a painful condition that causes shingles pain for a long time after your blisters have cleared.

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Symptoms

Shingles symptoms usually affect only a small section on one side of your body. These symptoms may include:

• Pain, burning or tingling
• Sensitivity to touch
• A red rash that begins a few days after the pain
• Fluid-filled blisters that break open and crust over
• Itching

Some people also experience:

• Fever
• Headache
• Sensitivity to light
• Fatigue

Pain is usually the first symptom of shingles. For some people, the pain can be intense. Depending on the location of the pain, it can sometimes be mistaken for problems with the heart, lungs or kidneys. Some people experience shingles pain without ever developing the rash.

Most commonly, the shingles rash develops as a stripe of blisters that wraps around either the left or right side of the torso. Sometimes the shingles rash occurs around one eye or on one side of the neck or face.

Shingles

Shingles is characterized by pain or a tingling sensation in a limited area on one side of the face or torso, followed by a red rash with small, fluid-filled blisters.

When to see a doctor

Contact your health care provider as soon as possible if you suspect shingles, especially in the following situations:

• The pain and rash occur near an eye. If left untreated, this infection may lead to permanent eye damage.
• You’re 50 or older. Age increases your risk of complications.
• You or someone in your family has a weakened immune system. This may be due to cancer, medications or chronic illness.
• The rash is widespread and painful.

Causes

Shingles is caused by the varicella-zoster virus — the same virus that causes chickenpox. Anyone who’s had chickenpox may develop shingles. After you recover from chickenpox, the virus enters your nervous system and stays inactive for years.

Sometimes the virus reactivates and travels along nerve pathways to your skin — producing shingles. But not everyone who’s had chickenpox will develop shingles.

The reason for shingles is unclear. It may be due to lowered immunity to infections as people get older. Shingles is more common in older adults and in people who have weakened immune systems.

Varicella-zoster is part of a group of viruses called herpes viruses. This is the same group that includes the viruses that cause cold sores and genital herpes. As a result, shingles is also known as herpes zoster. But the virus that causes chickenpox and shingles isn’t the same virus that causes cold sores or genital herpes, which is a sexually transmitted infection.

Shingles affects the nerves

The shingles rash is associated with an inflammation of nerves beneath the skin.

Are you contagious?

A person with shingles can pass the varicella-zoster virus to anyone who isn’t immune to chickenpox. This usually occurs through direct contact with the open sores of the shingles rash. Once infected, though, the person will develop chickenpox rather than shingles.

Chickenpox can be dangerous for some people. Until your shingles blisters scab over, you are contagious. Avoid physical contact with anyone who hasn’t yet had chickenpox or the chickenpox vaccine. That includes people with weakened immune systems, pregnant women and newborns.

Risk factors

Anyone who has ever had chickenpox can develop shingles. Most adults in the United States had chickenpox when they were children. That was before the availability of the routine childhood vaccination that now protects against chickenpox.

Factors that may increase your risk of developing shingles include:

• Age. The risk of developing shingles increases with age. Shingles typically occurs in people older than 50. And people over the age of 60 are more likely to experience more-severe complications.
• Some diseases. Diseases that weaken your immune system, such as HIV/AIDS and cancer, can increase your risk of shingles.
• Cancer treatments. Radiation or chemotherapy can lower your resistance to diseases and may trigger shingles.
• Some medications. Drugs that prevent rejection of transplanted organs can increase your risk of shingles. Long-term use of steroids, such as prednisone, may also increase your risk of developing shingles.

Complications

Complications from shingles can include:

• Postherpetic neuralgia. For some people, shingles pain continues long after the blisters have cleared. This condition is known as postherpetic neuralgia. It occurs when damaged nerve fibers send confused and exaggerated messages of pain from your skin to your brain.
• Vision loss. Shingles in or around an eye (ophthalmic shingles) can cause painful eye infections that may result in vision loss.
• Neurological problems. Shingles may cause inflammation of the brain (encephalitis), facial paralysis, or problems with hearing or balance.
• Skin infections. If shingles blisters aren’t properly treated, bacterial skin infections may develop.

Prevention

A shingles vaccine may help prevent shingles. People who are eligible should get the Shingrix vaccine, which has been available in the United States since its approval by the Food and Drug Administration in 2017. The Zostavax vaccine is no longer available in the U.S., but other countries may still use it.

Shingrix is approved and recommended for people age 50 and older, whether they’ve had shingles or not. People who’ve had the Zostavax vaccine in the past or don’t know whether they’ve had chickenpox may also receive the Shingrix vaccine.

Shingrix is also recommended for people who are 19 years of age and older who have weakened immune systems due to disease or medication.

Shingrix is a nonliving vaccine made of a virus component. It’s given in two doses, with 2 to 6 months between doses. The most common side effects of the shingles vaccine are redness, pain and swelling at the injection site. Some people also experience fatigue, headache and other side effects.

The shingles vaccine doesn’t guarantee that you won’t get shingles. But this vaccine will likely reduce the course and severity of the disease. And it will likely lower your risk of postherpetic neuralgia. Studies suggest that Shingrix offers protection against shingles for more than five years.

Talk to your health care provider about your vaccination options if you:

• Have had an allergic reaction to any component of the shingles vaccine
• Have a weakened immune system due to a condition or medication
• Have had a stem cell transplant
• Are pregnant or trying to become pregnant

The shingles vaccine is used only as a way to prevent shingles. It’s not intended to treat people who currently have the disease.

More Information

Shingles (herpes) – causes, symptoms, diagnosis, treatment of lichen in Moscow

• Signs of herpes zoster
• Lichen forms
• Causes
• Incipient disease
• Eruption period
• Crust
• Diagnosis of herpes zoster
• How to treat infection?
• What are antivirals used for?
• Possible consequences of herpes
• Is shingles contagious?
• When lichen is transmitted
• Disease prevention
• Which doctor to contact with herpes zoster

Shingles , also known as herpes zoster or herpes zoster, is a viral disease that occurs as a result of reactivation of the herpes simplex virus type 3. It is characterized by inflammation of the skin, on which a large number of vesicles appear, as well as inflammation of the nervous tissue surrounding the posterior roots of the spinal cord and ganglia of peripheral nerves. This condition usually occurs in a specific area of ​​the skin known as the “dermatome” and has vivid and painful symptoms.

Most often, the disease is detected in the elderly. Unfavorable ecology contributes to the development of infection in young people with weak immunity. Shingles often develops against the background of oncological processes, especially in people with weakened immune systems (after chemotherapy, for example).

Signs of herpes zoster

The onset of the disease is quite pronounced – there is a burning sensation and soreness of a certain area of ​​\u200b\u200bthe skin. Often these areas coincide with the location of the trigeminal facial nerve, affect the forehead, back of the head, neck, and can be located in accordance with the course of the nerves.

Lichen forms

The disease can be typical and atypical.

With an atypical form, the symptoms may be mild:

• In the abortive form, rashes are absent or there is a single focus;
• Bullous form – multiple vesicles with a clear liquid;
• Hemorrhagic form – vesicles with bloody fluid, in place of which scars remain.
• The gangrenous form leaves hard-to-heal ulcers and rough scars.

Causes

Infections that are present in the body in a dormant state are activated. The following factors provoke the development of the process:

• Immunosuppressive drugs;
• Heavy workload, stress;
• Cancer processes;
• Radiation therapy;
• HIV;
• Organ transplant.

Repeated episodes require special attention, as rashes are often localized at the site of the tumor. The development of shingles goes through certain stages.

Early disease

From the incubation to the active period takes about four days. At this time there is:

• Malaise, weakness. chills;
• Pain;
• Temperature increase;
• Burning and itching;
• Enlarged lymph nodes;
• Possible disorders of the organs and systems of the body.

Subsequently, the disturbances subside.

Eruption period

The type of rash depends on the severity of the disease. At the initial stage, the rash looks like small pink spots located on healthy skin.

If the process develops typically, then the next day they are replaced by bubbles with a clear liquid – grouped vesicles. After 3 days, their contents become cloudy. Rashes occur in jerks, with interruptions of several days.

If a severe gangrenous form develops, then the filling of the vesicles may be mixed with blood. It seems that the bubbles move to another place, located around the body.

If the form of inflammation is mild, the manifestation of the disease can only be neurological in nature, when the patient feels pain, but there is no rash. This is herpetic neuralgia.

Crust

As a rule, after 2-3 weeks from the onset of rashes, crusts form. The areas of rashes turn pale and dry up. In place of the fallen crusts, a slight pigmentation remains.

Herpes zoster diagnosis

With a pronounced manifestation of skin forms of the disease, it is not difficult to make a diagnosis. Errors occur at the initial stage, when angina pectoris, pulmonary infarction, pleurisy, acute appendicitis are mistakenly diagnosed.

Laboratory confirm the diagnosis using a microscope or immunofluorescent method. In general practice, laboratory diagnostics is not used.

How to treat an infection?

If young people who do not have chronic diseases are sick, then treatment is not carried out. The disease will completely disappear within a month. To eliminate the pain of herpes, the doctor may prescribe painkillers. With intense pain, painkillers are used along with antiviral drugs. It is possible to use non-steroidal drugs. Assign antiherpetic drugs in tablets, creams, ointments or intramuscular injections.

What are antivirals used for?

The goal is to avoid the development of complications. Antiherpetic treatment helps the rapid healing of ulcers and improves the patient’s condition.

The course of treatment and dosage of drugs is determined by the doctor, taking into account the general condition of the patient. On average, the treatment time does not exceed 10 days.

If a gangrenous form develops with a bacterial infection, antibiotics, immunomodulators, physiotherapy and vitamins are prescribed.

As for the treatment of rashes, there are different opinions about the use of drying agents. In any case, they should be used with caution so as not to worsen the condition of the skin with a burn.

Do not use hormonal drugs, as they suppress the immune system.

Treatment of the disease in elderly patients is not always successful, since antiviral drugs do not justify themselves.

Possible consequences of herpes

• Paralysis of the facial or other nerves.
• Reduced vision.
• Violations of the internal organs.
• Disabling meningoencephalitis.
• For bacterial infections, treatment is delayed for months.

Is shingles contagious?

Most often, cases of the development of the disease are recorded in the off-season. If a person has previously had chickenpox and has good immunity, then the likelihood of contracting infection through contact with a patient is minimal.

If immunity to the herpes virus is weakened or not formed, then there is a chance of getting sick upon contact, including again.

When lichen is transmitted

• A sick person can infect those who have not had chickenpox – adults and children.
• In the presence of strong immunity and good health, the probability of getting infected is zero.
• Most often children get sick.
• Almost anyone can get shingles if their defenses are weakened.
• Viral during the formation of fresh blisters. During the formation of crusts, there is no danger of infection.

Disease prevention

It is necessary to isolate the sick, avoid contact with the sick (applies to those who have not had chickenpox), observe hygiene rules, and take measures to strengthen immunity.

Which doctor to contact with herpes zoster

You should first contact a therapist, then an infectious disease specialist or a dermatologist. If the form of herpes is severe, the help of a neurologist is needed, if the eyes are affected, an ophthalmologist.

We recommend making an appointment at the neurological department of the clinic of the Russian Academy of Sciences (Moscow). You will be examined by the best doctors, they will study the signs of the disease, determine the causative agent of the infection, make a diagnosis, consult, give clinical recommendations and prescribe an effective treatment.

Don’t put off going to a specialist! Specialists of the Neurological Department of the NCC No. 2 (CCH RAS) in Moscow remind you that any symptoms that disturb you are a reason for consulting a neurologist. In this case, the doctor will be able to recognize and stop the disease at an early stage, until the situation worsens and becomes irreversible. You can make an appointment with a neurologist by calling the clinic, as well as using the form on the website.

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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Benefits of treatment at the Hadassah Clinic

Rapid diagnostics

Analyzes are carried out 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 health condition requires it.

Personalized therapy program

Our doctors follow the principle of “treat the patient, not the disease”, therefore, 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 restoring the patient’s full life, eliminating 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.

Rashes 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 a 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

Most people come into contact with the pathogen in childhood, when they fall ill with classic chickenpox 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 states;
• receiving immunosuppressive, antibacterial therapy.

One of the most important predisposing factors is 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.

Diagnostics

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

for detection of 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 multinucleated giant 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.

Shingles Treatment at Hadassah Clinic

Therapy is carried out in two directions: etiotropic medicines 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 post-herpetic neuralgia, which can occur even with the right 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.

Such 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 verified by an expert doctor

Zhukova
Daria Grigorievna

Allergist-immunologist, Ph.D.

Work experience: 14 years

Published: June 27, 2022

Updated: June 27, 2022

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.