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Shingles – Herpes Zoster

The varicella-zoster virus (VZV) causes chicken pox. After the chicken pox clears the virus remains dormant in the nerve cells (dorsal root ganglia). Decades after the initial exposure the reactivation of varicella-zoster virus results in herpes zoster (shingles). Treatment is recommended to prevent complications including post herpetic neuralgia.

Signs and symptoms

The first sign of shingles is usually a burn, itch, or tingle. This usually occurs in a small area on 1 side of the body. Most people experience this for 1-3 days; however, it can last longer. A rash usually then develops as a group of clear blisters. Blisters turn yellow or bloody before the crust over and heal in 2-3 weeks. It is uncommon to have blisters without pain. Once the blisters heal, the pain tends to lessen. Pain can last for months after the blisters clear.

Treatment

Zoster usually clears on its own in a few weeks and seldom recurs. Pain relievers can help ease the discomfort as the blisters are clearing.

Topical medications: Corticosteroids may help to reduce inflammation, swelling and pain. Compound medications with anesthetic and/or anti viral medications. Calamine lotion, a mixture of zinc oxide with about 0.5% iron (III) oxide, may be used as an anti itch medication.

Oral antiviral medications works best when taken within 72 hours of initial symptoms and can prevent post-herpetic neuralgia (pain, numbness, itching, and tingling that last long after the rash clears.

Complications of herpes zoster

Post herpetic neuralgia The pain, numbness, itching and tingling can last for months or even years. Most common in older patients. Can be treated with anti-depressants, anti-seizure and antineuralgia medicines. Pain relievers and nerve blocks can help control pain

Bacterial infection A bacterial infection can develop in the blisters, which can delay healing

Occular Shingles If you suspect zoster in the eye seek medical attention immediately

Vaccination

A vaccine has been approved by the U.S. Food and Drug Administration (FDA) for persons aged 60 years and older who have never had zoster .One study showed decrease incidence of shingles by more than 50 %. It should not be given to people who have decreased immunity.Another vaccine has been approved to prevent chicken pox. This is typically given to children or adults who have never had chicken pox.