HERPES ZOSTER

(Shingles)

 Basic information

description

Herpes zoster is a condition that causes pain, rash, and blisters on the skin. You can get it only if you have had chickenpox in the past. It can affect all ages, including children, but is most common in adults over age 50.

FREQUENT SIGNS & SYMPTOMS

• It starts with pain, tingling, or burning on the skin.
• A rash appears a few days after the first symptoms begin. It appears as a band of reddened skin on one side of the chest, neck, or face. The rash turns into fluid-filled blisters. These may itch or be very painful. The blisters then begin to dry out and crust over within several days.
• Mild chills and fever.
• General ill feeling.
• Mild nausea, stomach ache cramps, or diarrhea.
• Chest pain, face pain, or burning pain in the skin of the stomach, depending on the affected area.

causes

Herpes zoster is caused by the varicella-zoster virus, the same virus that causes chickenpox. After a chickenpox infection, the virus remains inactive in nerve cells in the body. In some people, the virus becomes active again and causes zoster. Why this happens is unknown.

risk increases with

• Anyone who has had chickenpox.
• Adults over 50.
• Cancer.
• High stress situations.
• People who have a weak immune system due to drugs or illness.

PREVENTIVE MEASURES

A vaccine is available for ages over 60 to help prevent shingles. Ask your health care provider about its use.

expected outcomes

The rash usually clears in 14 to 21 days. The nerve pain may last for a month or longer. One attack usually provides immunity against herpes zoster, but a few persons have had more than one attack.

possible complications

• Skin infection may occur in the herpes zoster blisters.
• Chronic pain, especially in the elderly. It can last for months or years in the nerves where the blisters have been. This is called post-herpetic neuralgia.
• Spread of zoster over the body or to internal organs.
• If the face is affected, eye complications can occur.
• When blisters are present, herpes zoster patients can spread the virus and cause chickenpox in people who have never had it. Avoid physical contact with pregnant women, infants, and those with weak immune systems.

 diagnosis & treatment

general measures

• Your health care provider can usually diagnose the disorder by a skin exam of the affected area and asking questions about your pain symptoms. If the rash has not appeared, it is more difficult to diagnose. Medical tests may be done to confirm the diagnosis.
• Goals of treatment are to relieve the itching and the pain as much as possible. This is usually done with topical and oral drugs. The nerve pain that remains after the skin clears up is the most difficult to treat.
• For self-care:
  • When bathing, wash blisters gently.
  • Don't bandage the blistered area.
  • Try applying cool, moist compresses to help decrease the pain.
  • Soak in a tub of water to which cornstarch or an oatmeal product (such as Aveeno) has been added.

medications

• Use calamine lotion or capsaicin ointment for the blisters. For minor pain and discomfort, you may use drugs such as aspirin (not for children), acetaminophen, or ibuprofen.
• You may be prescribed one or more drugs to help treat the symptoms. Antiviral drugs can help if the disorder is diagnosed early. Injections of a nerve block may be recommended in severe and long-lasting cases.
• Other drugs for pain may be prescribed. Different types may need to be tried, as they are not always effective for every person.

activity

No limit, except those caused by the symptoms.

diet

Maintain a healthy diet.

 notify our office if

• You or a family member has symptoms of herpes zoster.
• Pain gets worse, despite treatment.
• New symptoms develop. Drugs may have side effects.

Special Notes: