What foods should you avoid when experiencing shingles. How can your diet support recovery from shingles. Which nutrients are beneficial for managing shingles symptoms. Can certain foods worsen shingles outbreaks. What dietary changes can help alleviate shingles discomfort.

Understanding Shingles: A Brief Overview

Shingles, also known as herpes zoster, is a viral infection caused by the reactivation of the varicella-zoster virus, which initially causes chickenpox. According to the Centers for Disease Control and Prevention (CDC), while more than 99% of American adults born before 1980 have had chickenpox, only about one in three adults develop shingles in their lifetime. The risk of developing shingles increases with age.

Shingles typically manifests as a painful rash on one side of the body or face. The CDC reports that the rash usually develops blisters that scab over within 7 to 10 days. While there is no cure for shingles, dietary choices can play a significant role in supporting recovery and managing symptoms.

Foods to Avoid During a Shingles Outbreak

During a shingles outbreak, it’s crucial to avoid foods that may impair immune function or exacerbate inflammation. Here are some categories of foods to steer clear of:

High Glycemic Carbohydrates

High glycemic carbohydrates rapidly break down in the body, causing a spike in blood sugar levels. This sudden increase triggers the release of inflammatory molecules and free radicals, potentially compromising the immune system and increasing inflammation. Even a single high glycemic meal can promote increased inflammation.

Examples of high glycemic foods to avoid include:

• Candies and sweets
• Cakes and baked goods
• Sugary drinks
• Sugary cereals
• Sugary sauces
• Ice cream
• White bread
• White rice

Highly Processed Foods

Highly processed foods often contain high levels of salt, added sugars, and omega-6 fatty acids, which can trigger inflammation and weaken the immune system. While omega-6 fatty acids are essential, most people consume an excessive amount in their diet. Omega-6 fatty acids promote inflammation, while omega-3 fatty acids inhibit it.

Research suggests that excessively high salt intake may impair the immune system. A 2015 study found that participants consuming 12 grams of salt per day had higher levels of monocytes (a type of white blood cell) in their blood, along with elevated levels of IL-23 and IL-6, and lower levels of IL-10. These markers collectively indicate excessive inflammation and immune response.

Examples of highly processed foods to avoid include:

• Sweetened cereals
• High-fat chips and snack foods
• Sugary energy drinks and sodas
• Cookies, cakes, pies, and pastries
• High-fat, low-fiber breads and crackers
• Deep-fried foods

Alcohol

Alcohol has the potential to impair almost every aspect of health, including immune function. While most medications used to treat shingles don’t contain specific alcohol warnings, it’s generally advisable to avoid mixing alcohol and medications as much as possible during recovery.

Nutrient-Dense Foods to Support Shingles Recovery

Incorporating nutrient-dense foods into your diet can help support your immune system during a shingles outbreak. Focus on foods rich in the following nutrients:

Lysine

Lysine is an amino acid thought to inhibit the replication of the varicella-zoster virus. While more research is needed to confirm its effectiveness, including lysine-rich foods in your diet may be beneficial.

Foods high in lysine include:

• Lean meats (chicken, turkey, beef)
• Fish (particularly cod and sardines)
• Eggs
• Cheese (particularly parmesan)
• Soybeans and tofu
• Spirulina
• Fenugreek seeds

Zinc

Zinc plays a crucial role in immune function and wound healing. Ensuring adequate zinc intake may help support your body’s defense against the shingles virus.

Good sources of zinc include:

• Oysters
• Beef
• Crab
• Lobster
• Pork chops
• Baked beans
• Fortified breakfast cereals

Vitamins for Immune Support During Shingles

Several vitamins play essential roles in supporting immune function and may help alleviate shingles symptoms:

Vitamin A

Vitamin A is crucial for maintaining the health of skin and mucous membranes, which act as barriers against infections. It also supports the production and function of white blood cells.

Foods rich in vitamin A include:

• Sweet potatoes
• Carrots
• Spinach
• Kale
• Apricots
• Eggs
• Fortified milk

Vitamin B12

Vitamin B12 is essential for nerve health and may help alleviate the nerve pain associated with shingles. It also plays a role in the production of red blood cells and DNA synthesis.

Good sources of vitamin B12 include:

• Beef liver
• Clams
• Fish (salmon, trout, tuna)
• Fortified cereals
• Milk and dairy products
• Eggs

Vitamin C

Vitamin C is a powerful antioxidant that supports immune function and may help reduce the severity and duration of shingles symptoms.

Foods high in vitamin C include:

• Citrus fruits (oranges, grapefruits, lemons)
• Strawberries
• Bell peppers
• Broccoli
• Brussels sprouts
• Kiwi fruit
• Papaya

Vitamin E

Vitamin E is another antioxidant that supports immune function and may help protect cells from damage caused by free radicals.

Good sources of vitamin E include:

• Sunflower seeds
• Almonds
• Avocados
• Spinach
• Butternut squash
• Olive oil
• Wheat germ

The Role of Omega-3 Fatty Acids in Managing Shingles

Omega-3 fatty acids have anti-inflammatory properties that may help reduce inflammation associated with shingles. Additionally, they support overall immune function.

Foods rich in omega-3 fatty acids include:

• Fatty fish (salmon, mackerel, sardines)
• Flaxseeds
• Chia seeds
• Walnuts
• Soybeans
• Canola oil
• Fortified eggs

Hydration: A Key Factor in Shingles Recovery

Staying well-hydrated is crucial during a shingles outbreak. Proper hydration supports overall health, helps flush toxins from the body, and may aid in reducing the severity of symptoms.

To ensure adequate hydration:

• Drink plenty of water throughout the day
• Consume hydrating foods like cucumbers, watermelon, and zucchini
• Opt for herbal teas, particularly those with anti-inflammatory properties like chamomile or ginger
• Consider coconut water for added electrolytes

Creating a Balanced Diet Plan for Shingles Recovery

When dealing with shingles, it’s essential to create a balanced diet plan that incorporates immune-boosting nutrients while avoiding foods that may exacerbate symptoms. Here’s a sample meal plan to consider:

Breakfast

• Oatmeal topped with berries and ground flaxseeds
• Greek yogurt with a drizzle of honey
• Green tea

Lunch

• Grilled chicken salad with spinach, avocado, and pumpkin seeds
• Whole grain bread
• Orange slices

Dinner

• Baked salmon with roasted sweet potato and steamed broccoli
• Brown rice
• Mixed berries for dessert

Snacks

• Carrot sticks with hummus
• Handful of almonds
• Apple slices with almond butter

Remember to consult with a healthcare professional or registered dietitian before making significant changes to your diet, especially if you have any underlying health conditions or are taking medications.

Additional Lifestyle Factors to Support Shingles Recovery

While diet plays a crucial role in managing shingles, other lifestyle factors can also contribute to a faster recovery and reduced symptom severity:

Stress Management

Stress can weaken the immune system and potentially exacerbate shingles symptoms. Incorporate stress-reducing activities into your daily routine, such as:

• Meditation or mindfulness practices
• Gentle yoga or tai chi
• Deep breathing exercises
• Journaling
• Engaging in hobbies or relaxing activities

Adequate Sleep

Quality sleep is essential for immune function and overall health. Aim for 7-9 hours of sleep per night and establish a consistent sleep schedule. Create a relaxing bedtime routine and ensure your sleeping environment is comfortable and conducive to rest.

Gentle Exercise

While it’s important to avoid strenuous activity during a shingles outbreak, gentle exercise can help boost circulation and support overall health. Consider low-impact activities such as:

• Walking
• Swimming (once blisters have healed)
• Gentle stretching
• Stationary cycling

Always consult with your healthcare provider before starting any exercise routine during a shingles outbreak.

Proper Skin Care

Taking care of the affected skin can help alleviate discomfort and promote healing. Follow these tips:

• Keep the rash clean and dry
• Apply cool compresses to reduce pain and itching
• Use calamine lotion or other soothing topical treatments as recommended by your doctor
• Wear loose-fitting, breathable clothing to avoid irritation

When to Seek Medical Attention

While dietary and lifestyle changes can support recovery from shingles, it’s crucial to seek medical attention if you experience any of the following:

• Severe pain that doesn’t respond to over-the-counter pain relievers
• A rash that spreads to your eyes or near your eyes
• A rash that covers a large area of your body
• Fever, chills, or other flu-like symptoms
• Signs of infection, such as increased redness, warmth, or swelling around the rash
• Confusion or difficulty thinking clearly

Early treatment with antiviral medications can help reduce the severity and duration of a shingles outbreak. Your healthcare provider can also recommend appropriate pain management strategies and monitor for potential complications.

By combining a nutrient-rich diet, lifestyle modifications, and proper medical care, you can support your body’s natural healing processes and manage the symptoms of shingles more effectively. Remember that recovery times can vary, and it’s essential to be patient and consistent with your self-care routine throughout the healing process.

Foods to Avoid During a Shingles Attack & What Foods May Help

Foods to Avoid During a Shingles Attack & What Foods May Help

• Health Conditions
  • Featured
    • Breast Cancer
    • IBD
    • Migraine
    • Multiple Sclerosis (MS)
    • Rheumatoid Arthritis
    • Type 2 Diabetes
  • Articles
    • Acid Reflux
    • ADHD
    • Allergies
    • Alzheimer’s & Dementia
    • Bipolar Disorder
    • Cancer
    • Crohn’s Disease
    • Chronic Pain
    • Cold & Flu
    • COPD
    • Depression
    • Fibromyalgia
    • Heart Disease
    • High Cholesterol
    • HIV
    • Hypertension
    • IPF
    • Osteoarthritis
    • Psoriasis
    • Skin Disorders and Care
    • STDs
• Discover
  • Wellness Topics
    • Nutrition
    • Fitness
    • Skin Care
    • Sexual Health
    • Women’s Health
    • Mental Well-Being
    • Sleep
  • Product Reviews
    • Vitamins & Supplements
    • Sleep
    • Mental Health
    • Nutrition
    • At-Home Testing
    • CBD
    • Men’s Health
  • Original Series
    • Fresh Food Fast
    • Diagnosis Diaries
    • You’re Not Alone
    • Present Tense
  • Video Series
    • Youth in Focus
    • Healthy Harvest
    • No More Silence
    • Future of Health
• Plan
  • Health Challenges
    • Mindful Eating
    • Sugar Savvy
    • Move Your Body
    • Gut Health
    • Mood Foods
    • Align Your Spine
  • Find Care
    • Primary Care
    • Mental Health
    • OB-GYN
    • Dermatologists
    • Neurologists
    • Cardiologists
    • Orthopedists
  • Lifestyle Quizzes
    • Weight Management
    • Am I Depressed? A Quiz for Teens
    • Are You a Workaholic?
    • How Well Do You Sleep?
  • Tools & Resources
    • Health News
    • Find a Diet
    • Find Healthy Snacks
    • Drugs A-Z
    • Health A-Z
• Connect
  • • Breast Cancer
    • Inflammatory Bowel Disease
    • Psoriatic Arthritis
    • Migraine
    • Multiple Sclerosis
    • Psoriasis

Medically reviewed by Kathy W. Warwick, R.D., CDE, Nutrition — By Daniel Yetman — Updated on March 31, 2023

Eating nutrient-dense foods when you have shingles may support your body’s immune function. You may want to avoid processed foods and other foods that cause inflammation.

Shingles, sometimes called herpes zoster, is the reactivation of the varicella-zoster virus that causes chickenpox.

According to the Centers for Disease Control and Prevention (CDC), more than 99 percent of American adults born before 1980 have had chickenpox, but only about 1 in 3 adults develop shingles in their lifetime. The chance for developing shingles increases as you get older.

Shingles typically causes a painful rash on one side of your body or face. The CDC says the rash contains blisters that scab over after 7 to 10 days.

Avoiding foods that impair your body’s immune system may help you shorten the duration of your shingles outbreak.

Some believe that increasing your intake of the amino acid lysine and decreasing your intake of arginine may also help your body clear the virus faster, though more research is needed.

Keep reading to find out which foods you should avoid eating if you’re having a shingles outbreak.

If you’re experiencing shingles, it’s a good idea to avoid foods that can impair your immune function.

High glycemic carbohydrates

High glycemic carbohydrates quickly break down in your body and create a rapid spike in your blood sugar. Spikes in your blood sugar trigger the release of inflammatory molecules and free radicals, which can stress out your body.

Including too many high glycemic carbohydrates in your diet can potentially compromise your immune system and increase inflammation. Even a single high glycemic meal can promote increased inflammation.

Some examples of high glycemic foods include:

• candies and sweets
• cakes and baked goods
• sugary drinks
• sugary cereals
• sugary sauces
• ice cream
• white bread
• white rice

Highly processed foods

Highly processed foods are often high in salt, added sugars, and omega 6 fatty acids that may trigger inflammation and weaken your immune system.

Omega-6 fatty acids are essential, but most people get an excessive number in their diet. Omega-6 fatty acids promote inflammation, while omega-3 fatty acids inhibit it.

There’s some research that excessively high salt intake may impair your immune system. In a 2015 study, a group of six men ate:

• 12 grams of salt for 50 days
• 9 grams of salt for 50 days
• 6 grams of salt per day for 50 days
• 12 grams of salt for the final 30 days

The researchers found that, when the participants ate 12 grams of salt per day, they had higher levels of a type of white blood cell called monocytes in their blood. They also had high levels of IL-23, IL-6 and lower IL-10. Altogether, these markers indicate excessive inflammation and immune response.

Examples of highly processed foods include:

• sweetened cereals
• high-fat chips and snack foods
• sugary energy drinks and sodas
• cookies, cakes, pies, and pastries
• high-fat, low-fiber breads and crackers
• deep-fried foods

Alcohol

Alcohol has the potential to impair almost every aspect of your health, including your immune system.

Most medications used to treat shingles don’t contain specific alcohol warnings. But it’s still a good idea to avoid mixing alcohol and medications as much as possible.

Nutrient-dense foods, especially foods high in zinc and vitamins A, B12, C, and E, can help support your immune system. Consuming lysine may also help inhibit the virus.

Lysine

Lysine is an amino acid that’s thought to inhibit the growth of some viruses, including herpes zoster.

Some people think eating a diet high in lysine may help treat shingles and other herpes viruses. At this time, there’s not enough evidence showing that increasing your intake of this amino acid can improve shingles symptoms.

More research is needed to understand the effects of lysine on shingles.

Foods high in zinc and vitamins A, B12, C, and E

Eating a well-balanced diet can help you prevent nutrient deficiencies that might weaken your immune system.

The following are particularly important for maintaining a healthy immune system:

• zinc
• vitamin A
• vitamin B12
• vitamin C
• vitamin E

Here are some good sources for each nutrient.

Complex carbohydrates

Switching simple carbohydrates for complex carbohydrates can potentially help you lower inflammation and improve your overall health.

Complex carbohydrates contain more fiber. And whole grains provide more nutritional value.

Some forms of complex carbohydrates include:

• whole grain bread
• brown rice
• barley
• quinoa
• sweet potato
• whole oats
• whole grain pasta
• whole grain couscous

There’s no cure for shingles. Usually, it’s treated with antiviral medications.

The following home remedies may help you manage symptoms:

• Cold compress. Soak a cloth or towel in cool water and put it against your rash to help relieve itching and inflammation.
• Oatmeal bath. An oatmeal bath may help soothe itchy patches and moisturize dry skin. Try mixing 1 cup of oat powder with lukewarm water, and soak in it for about 10 to 15 minutes.
• Essential oils. You can try mixing about 15 drops of an essential oil with soothing properties — like chamomile, eucalyptus, or tea tree oil — with 1 tablespoon of a carrier oil — like coconut oil. Then apply it to your skin. Alternatively, you can add a few drops of essential oils to a warm bath.
• Witch hazel. Witch hazel may help you reduce itchiness and inflammation. Witch hazel comes in different forms, like creams, gels, and sprays.
• Calamine lotion. The CDC recommends applying calamine lotion to your rash to help manage shingles pain and itchiness.

Shingles is a reactivation of the virus that causes chickenpox. It causes an itchy rash that’s typically on one side of your body or face.

Eating a balanced diet that’s low in high glycemic carbohydrates and processed foods can help your immune system fight off the virus.

There’s some research that decreasing arginine intake and increasing your lysine intake may help inhibit growth of the virus, but more research is needed.

Last medically reviewed on June 14, 2021

How we reviewed this article:

Healthline has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. We avoid using tertiary references. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.

• About shingles (herpes zoster). (2019).
  cdc.gov/shingles/about/index.html
• Chi C, et al. (2015). Interventions for prevention of herpes simplex labialis (cold sores on the lips).
  ncbi.nlm.nih.gov/pmc/articles/PMC6461191/
• Iddir M, et al. (2020). Strengthening the immune system and reducing inflammation and oxidative stress through diet and nutrition: Considerations during the COVID-19 crisis.
  doi.org/10.3390/nu12061562
• Mailoo VJ, et al. (2017). Lysine for herpes simplex prophylaxis: A review of the evidence.
  ncbi.nlm.nih.gov/pmc/articles/PMC6419779/
• Yi B, et al. (2015). Effects of dietary salt levels on monocytic cells and immune responses in healthy human subjects: A longitudinal study.
  doi.org/10.1016/j.trsl.2014.11.007

Our experts continually monitor the health and wellness space, and we update our articles when new information becomes available.

Current Version

Mar 31, 2023

Written By

Daniel Yetman

Edited By

Roman Gokhman

Jun 14, 2021

Written By

Daniel Yetman

Edited By

Roman Gokhman

Medically Reviewed By

Kathy Warwick, RD, LD

Copy Edited By

Jen Anderson

Share this article

Medically reviewed by Kathy W. Warwick, R.D., CDE, Nutrition — By Daniel Yetman — Updated on March 31, 2023

Read this next

• What to Eat When You Have Chickenpox — and What to Avoid

  By Cecilia Snyder, MS, RD

  Having chickenpox can be extremely uncomfortable at times, and managing symptoms through diet can be beneficial. This article highlights which foods…

  READ MORE

• Can You Use L-lysine Supplements to Treat Shingles?

  Medically reviewed by Alan Carter, Pharm.D.

  Lysine is a necessary part of a balanced diet. This amino acid may be able to reduce or prevent cold sores, but what about shingles? Learn what the…

  READ MORE

• 6 Ways to Use Papain

  Medically reviewed by Gregory Minnis, DPT

  Papain is a popular folk remedy to reduce pain and improve digestion, but does it actually work? Here’s what you need to know.

  READ MORE

• Understanding What Causes Shingles to Activate

  Medically reviewed by Alana Biggers, M.D., MPH

  Shingles happens when the chickenpox virus, varicella-zoster, reactivates in your body. It can be painful and last for up to a month.

  READ MORE

• Is Shingles Contagious? Plus, How It Spreads

  Medically reviewed by Shilpa Amin, M.D., CAQ, FAAFP

  Shingles is a condition related to chickenpox. It mostly affects older adults. Learn the causes and how to avoid getting or spreading the virus that…

  READ MORE

• Can I Have Shingles Without a Rash?

  Medically reviewed by Debra Sullivan, Ph.D., MSN, R.N., CNE, COI

  Shingles without a rash is uncommon, but it can occur. It’s also difficult to diagnose because the usual shingles rash isn’t present. This condition…

  READ MORE

• When Does Shingles Pain Peak?

  Medically reviewed by Angelica Balingit, MD

  Shingles pain can last for a few days to up to a month or longer. We’ll discuss why.

  READ MORE

• Your FAQs Answered: Activities to Avoid with Shingles

  Medically reviewed by Avi Varma, MD, MPH, AAHIVS, FAAFP

  Learn what activities you should avoid when you have shingles and when to prioritize rest.

  READ MORE

• Air Pollution Linked to Heart Disease, COPD, Cancer, and Other Health Concerns

  Air pollution can reach dangerous levels during wildfire seasons or become hazardous over time from vehicle emissions or agricultural practices…

  READ MORE

Senior Living Communities & Care Options

Senior Living Communities & Care Options | Seasons Retirement Communities

It’s Better Together

Why live alone when you could join a Seasons Retirement Community and be surrounded by staff and neighbours who genuinely care?

Discover Life at Seasons.

Book a Personal Visit Today.

Quality Care at Seasons

Seasons offers a range of care options to meet our residents’ varied and evolving needs. We believe in a flexible approach to care that supports our residents’ preferences. Before moving in, we will assess a resident’s needs and recommend the appropriate, bundled care package that best reflects their individual preferences.

Lifestyle Options for Ontario

See All

Lifestyle Options for Alberta

See All

Services & Features at Seasons

Live Life Your Way

Active living is vital to health and happiness, which is why we offer countless ways for residents to get involved in our communities. Everyone is different; the choice is theirs, whether someone prefers to catch up on a book in their suite, take part in a fitness class, volunteer, or join an excursion. Quiet or involved, relaxed or busy – it’s up to you.

Your Food is Our Passion

We know food plays a significant role in how our residents feel about living at Seasons Retirement Communities, so they must enjoy the food we prepare for them. We hire skilled chefs who love food just as much as our residents do. Our dining service teams know what it takes to ensure healthy and well-balanced meals without compromising taste and presentation.

Health & Wellness

Physical activity is an integral part of maintaining a healthy lifestyle and feeling one’s best.  Seasons supports residents in their journey to becoming as healthy and active as possible, regardless of their fitness level. All residents are welcomed and encouraged to participate in daily classes to the best of their abilities.

Discover Life at Seasons. Book a Personal Visit Today.

To view current job opportunities, or to apply today, click to visit our Careers page

Learn More

Tel
289-291-5999

Fax
289-291-0999

Shingles

How is herpes zoster related to herpes zoster? Why can you get chickenpox from it? What to do to not get sick? We tell in detail in our article.

Shingles or herpes zoster is an acute viral disease. Its characteristic feature is unilateral skin rashes with severe pain.

Shingles is caused by the Varicella Zoster virus, a member of the herpesvirus family. The one that causes chicken pox.

Varicella zoster virus causes two diseases: chicken pox (varicella) and shingles (zoster).

The herpes simplex virus also belongs to the same family of herpes viruses – the cause of the “cold” on the lips.

These viruses are different. And the diseases they cause are different.

All herpesviruses are able to go into a latent state, and then (sometimes years later) reactivate.

Clinically, in the case of herpes simplex, it looks like relapses of rashes that appear periodically in the same places. For example, an annoying “cold” on the lips, which worries us every winter (and some more often), but then suddenly behaves decently for years.

With shingles, everything is different.

Shingles is a secondary disease that occurs when the varicella zoster virus reactivates after chickenpox.

Varicella zoster virus infection causes chickenpox. Children usually get sick with it, but in rare cases, if a person first met him when he was already grown up, an adult can also get sick. After recovery, the virus remains in the body in a latent state and waits in the wings. By the way, can’t wait!

But in the case of severe stress, immune suppression, severe illness and other similar provocations, the Varicella Zoster virus reactivates, causing the formation of characteristic vesicles on the skin, similar to chicken pox rashes.

Shingles develops in 10-20% of patients who have previously had chickenpox.

Since the virus begins to multiply and migrate to the peripheral nerves during the reactivation process, skin lesions occur on the corresponding parts of the body. It is the participation of nerves in the development of the disease that is the cause of the pronounced pain syndrome.

The characteristic signs of herpes zoster are a unilateral lesion and severe pain.

Cases of adult infection from patients with herpes zoster are rare. Children who have not previously had chickenpox, after contact with patients with herpes zoster, can get chickenpox.

The onset of the disease is preceded by symptoms of general malaise: tingling, itching, paresthesia, pain along the nerve, and sometimes fever. Pain is especially pronounced when the rash is localized in the area of ​​\u200b\u200bthe branches of the trigeminal nerve (on the face).

On the 2-5th day after the onset of pain in the lesion, skin changes appear: redness and swelling of the skin, grouped nodules that transform into round or oval vesicles with transparent contents. Most of the vesicles shrink into crusts, and some open with the formation of erosions and their subsequent epithelialization.

Drying, formation and falling off of crusts with herpes zoster last an average of 2-3 weeks.

In the case of herpes zoster, you do not need to self-medicate or wait for it to “go away on its own”. You should see a doctor as soon as possible. In the treatment of this disease, special antiviral and analgesic drugs are used, which quickly alleviate the patient’s condition, allow you to fully recover in the shortest possible time.

The treatment of herpes zoster is more effective the earlier it is started.

In conclusion, it should be noted that modern epidemiologists (see “MP 3.1.0224-20. 3.1. Prevention of infectious diseases. Epidemiological surveillance of infection caused by the Varicella Zoster virus. Guidelines”) consider herpes zoster as uncontrolled, secondary to varicella smallpox endogenous infection. Approaches to its specific prevention are only being developed.

Considering the connection of this disease with a weakened immune system, for the prevention of herpes zoster, it is advisable to adhere to universal, non-specific methods of preventing infections: lead a healthy lifestyle, eat rationally, find time for rest, spend enough time outdoors, avoid contact with patients with infectious diseases.

Take care of yourself and be healthy!

Herpes zoster: causes, symptoms and recommendations for the treatment of the disease. Dr. Peter

• Directory of diseases

August 8, 2022

Shingles is the reactivation of chickenpox viruses remaining in the body after an infection in childhood. Typical of shingles is a belt-shaped rash of patches of redness and blisters that can be very painful and affect almost any part of the body. The contents of the blister are contagious.

Source:

iStockphoto

Shingles occurs mainly in immunocompromised people and in old age. Early treatment is important to prevent persistent nerve pain, so-called postherpetic neuralgia, or other complications. For this purpose, drugs are available that suppress the reproduction of the virus, and painkillers. Shingles vaccination with an inactivated vaccine is recommended for people over 60 years of age, for some risk groups even from 50 years of age.

Causes

The cause of shingles (herpes zoster) is infection with the varicella zoster virus (chickenpox). This virus belongs to the herpes virus family and can cause two distinct clinical presentations.

Varicella (chickenpox), a disease that most people suffer during childhood, may develop. When the chickenpox rash disappears, like other herpes viruses, it persists for life in the human body and settles in the cranial nerves and nerve roots of the spinal cord – the spinal and cranial ganglia.

Under certain circumstances, such as age and weakening of the immune system, varicella-zoster viruses begin to multiply again, migrate outward along the nerves to the skin. Herpes zoster develops in the zone of innervation of certain nerves into which viruses have previously penetrated. All parts of the body, the face, as well as such eyes, ears or brain may be affected.

The varicella-zoster virus (herpes zoster) occurs worldwide. Humans are the only known reservoir for these viruses. Chickenpox is highly contagious and spreads quickly. Viruses are transmitted by airborne droplets. In addition, the pathogen can be transmitted through contact with the virus-containing filling of blisters and crusts (contact route).

The virus only becomes active again under certain circumstances. This is especially true of temporary or disease-related immunodeficiency, as well as old age, which is also associated with a decrease in the protective functions of the immune system. Trauma, stress, UV radiation, and medications that weaken the immune system can also contribute to shingles. Sometimes shingles occurs spontaneously in young healthy people.

Herpes zoster symptoms

Signs of the disease appear locally. While chickenpox affects the entire body, the manifestations of lichen are belt-like, but one-sided, that is, asymmetrical, only on the area of ​​​​the skin innervated by the affected cranial or spinal nerve.

Source:

iStockphoto

The first signs of the disease (prodromal symptoms) are usually malaise, possibly a slight increase in body temperature and one-sided, limited, sometimes burning pain in the corresponding area of ​​the skin. Sometimes itching may also occur. About 80 percent of all patients with herpes zoster experience unilateral pain before typical skin changes appear.

In a limited area of ​​the skin, redness first appears, then small bubbles appear on the reddened background, which appear in groups, and sometimes in the form of rosettes, sometimes they can be filled with blood. After a few days, the blisters burst and crust over. Sometimes they also leave scars and areas of discolored skin (pigmentation or depigmentation). It may take up to a month for the symptoms of shingles to disappear completely.

Some people develop persistent pain after prodromal symptoms, but no skin symptoms or blisters. In these cases, it is difficult to diagnose shingles, and then the doctor also thinks about other acute diseases, such as a heart attack, stomach ulcer, or herniated disc. They should be excluded with appropriate research.

Possible complications and risks

Although the varicella-zoster virus mainly affects the nerves of the thoracic and lumbar spine, and often also the nerves of the face, especially in the elderly, any other areas can be affected. In rare cases, severe forms of the disease occur. This occurs, in particular, with damage to the cranial nerves and the development of, for example, herpes zoster of the eyes (zoster ophthalmicus with eye damage) or ear (zoster oticus).

If the cornea or iris of the eye or, above all, the optic nerve is affected, permanent visual impairment and even blindness can occur. Shingles in the ear often leads to facial paralysis. This facial paralysis, along with possible other symptoms such as nerve pain, hearing loss, and dizziness, is also known as Ramsey-Hunt syndrome. Such paralysis of facial muscles sometimes occurs with herpes zoster in the neck. According to the latest data, with herpes zoster, a stroke may develop.

If the immune system is severely weakened, shingles can also spread to the entire skin and internal organs (disseminated lichen) and cause life-threatening complications. In very rare cases, inflammation of the meninges and brain develops (shingles meningitis and shingles encephalitis).

Diagnosis

Medicines that stop the varicella-zoster virus from multiplying work best when given early. Therefore, if you suspect shingles, you should not hesitate, but immediately consult a doctor who specializes in skin diseases. A doctor can usually diagnose shingles by asking the person (history) and identifying typical symptoms.

In unclear cases, laboratory tests are required to reliably detect varicella-zoster virus. With the help of such a laboratory method as PCR – polymerase chain reaction – in the vesicular or cerebrospinal fluid (CSF), even tiny amounts of the genetic material of the pathogen can be detected.

If there is a suspicion that the eye or ear is affected, it is also wise to consult an appropriate specialist (ophthalmologist or otolaryngologist) in order to prevent possible complications such as hearing or visual impairment.

It is also important to clarify what led to the onset of the disease. If there are no obvious causes, it may be worth looking for diseases that do not initially cause any symptoms of their own, but nevertheless cause immunodeficiency, such as infection with the human immunodeficiency virus (HIV). HIV infection should be excluded in patients with herpes zoster under 50 years of age.

How to treat shingles

Painkillers, drying and antiseptic solutions applied to the affected areas of the body can relieve the symptoms of shingles. Almost always, special drugs are needed to suppress the reproduction of the virus. The drugs can be administered as tablets or as an infusion through a vein.

These so-called antiviral drugs, for example with the active ingredients acyclovir, famciclovir, valaciclovir or brivudine, provide faster healing of blisters and may reduce the risk of post-herpetic neuralgia.

These drugs should be started within two to three days of the onset of symptoms in addition to pain relief and topical therapy. In patients younger than fifty who have only very mild symptoms of herpes zoster, such as in the chest area, antiviral therapy can sometimes be dispensed with. In elderly patients with zoster, especially in the head (zoster ophthalmicus with eye involvement and zoster oticus), as well as in patients with a weakened immune system, antiviral therapy through a vein is always preferable, since severe pain can be quickly controlled and complications avoided.

Early and adequate analgesic therapy is especially important to prevent the development of postherpetic neuralgia. Depending on the severity of the pain, treatment is initially given, such as paracetamol, ibuprofen, or opioids. However, if persistent nerve pain occurs as a result of shingles, active ingredients such as pregabalin, gabapentin, desipramine, or amitriptyline, which are not actually painkillers, but belong to the group of antiepileptics or antidepressants, may help. This does not mean that people who take these drugs have epilepsy or depression. Postherpetic neuralgia has been found to be relatively well prevented and treated with these drugs.

Attention!

The information on this website is not a guide to self-medication. All materials are for reference only and do not replace a visit to the doctor. If any symptoms appear, you should contact a specialist.

References:

1. Robert Koch-Institut: Herpes-zoster-Impfung. Online: https://www.rki.de/DE/Content/Infekt/Impfen/Materialien/Faktenblaetter/Zoster.