Herpes Zoster Definition, Reason, Symptoms, Treatment & Prevention

Herpes Zoster Definition, Reason, Symptoms, Treatment & Prevention

Understanding

Herpes zoster, also known as shingles, is an infection caused by varicella zoster, a virus that also causes chickenpox

When treating chickenpox, this virus is not completely resolved. The virus settles at the base of the skull or spine. 

Once chickenpox is cured, the virus becomes active again at a later date. This is what is called shingles.

Symptoms

The symptom of shingles is a burning feeling like a burning sensation. These sensations are often accompanied by other symptoms of shingles, such as headaches, sensitivity to light, and fever.

A few days after these symptoms are felt, a rash appears. Next, the rash will turn into very itchy water-filled blisters, similar to chicken pox rashes. After a few days the blisters will dry up.

In contrast to chickenpox, the symptoms of shingles will only appear on one side of the body according to the nerves that are infected.

Generally, the rash appears in the middle of the back to the chest. The rash can also appear on the face in the area of ​​one eye and in more than one location on the body.

The following are the stages of the appearance of the symptoms of herpes zoster.

1. Prodromal (Before the Rash Appears)

Symptoms that sufferers generally experience include:

  • Pain, tingling, or even numbness occurs at the location of the infected nerve a few days or even weeks before the rash appears. The discomfort is usually felt in the chest, back, stomach, head or neck
  • Have flu-like symptoms (usually without fever), such as chills, stomach pain, or  diarrhea
  • Lymph nodes feel slightly swollen

2. Active Level (Rashes and Blisters Appear)

Symptoms of herpes zoster in the active stage include:

  • A rash appears which can be located anywhere on the body but only on one side, right or left. Then, the rash becomes blisters filled with fluid. Some sufferers do not experience a rash or have a rash but are mild in nature
  • Rash may appear on the forehead, cheeks, nose, or around the eyes (Herpes Zoster Ophthalmicus)
  • Pain that feels like being pricked by a needle
  • The blisters will open, ooze, and dry up. Usually lasts 5 days. The rash may disappear completely after 2-4 weeks

Herpes zoster is often misdiagnosed as another disease that has similar symptoms. The rash or blisters are often mistaken for an infection caused by the herpes simplex virus or impetigo.

Reason

Most people usually have chickenpox in childhood. After recovering, apparently the virus that causes chickenpox can still settle at the base of the skull or spine.

This happens because the immune system makes the virus inactive. However, later in life, when chickenpox has healed, the virus can become active again.

Why the virus can be active again until now is not known with certainty. However, in most cases, the cause of shingles is due to a lowered immune system. The body is also susceptible to infection.

Stress is also thought to play a role in the reactivation of the varicella-zoster virus.

Risk Factors

Several risk factors for herpes zoster include:

  • Age. Herpes zoster is more common in those over 50 years of age. This happens because the immune system decreases with age. Even so, it doesn’t mean that those who are young cannot get shingles
  • Physical and emotional stress When experiencing stress, the body releases chemicals. These chemicals affect the function of the immune system
  • Immune system problems, such as  HIV /AIDS
  • Have recently undergone a medical procedure that is quite severe, for example undergoing chemotherapy or after undergoing organ transplant surgery

Diagnosis

The diagnosis of herpes zoster can be established through medical interviews and physical examinations. Doctors can usually immediately identify shingles when they see the location and shape of the rash. 

If the diagnosis is still uncertain, the doctor will perform a Tzanck test. In this test, the doctor will take a rash skin sample or fluid sample for analysis in the laboratory.

Chickenpox and shingles are caused by viral infections. This means herpes zoster skin disease can heal by itself.

The drugs given are only intended to relieve the symptoms that arise and reduce the risk of complications.

If there is prolonged pain, such as pain for more than 1 month after the dry rash, the doctor will usually diagnose post-herpetic neuralgia ( postherpetic neuralgia) . 

The most common complication of shingles can cause pain for months or even years.

Treatment

There is no specific treatment or treatment for shingles. Handling is done to speed healing and reduce the risk of complications. 

1. Home Treatment

Also, do some of these treatments at home as part of how to treat shingles:

  • Keeping the rash and blisters clean will reduce the risk of the rash getting a bacterial infection
  • Use loose clothing and made of soft material
  • Do not use topical antibiotics because it will slow down the healing process

If the rash feels itchy, you can use calamine lotion to relieve it. If the fluid in the rash leaks out, apply cold compresses for 20 minutes several times a day to keep it clean.

Generally, herpes zoster is handled by a general practitioner or a skin specialist.

In addition, medications that are often used for shingles include:

2. Antiviral drugs

The doctor will give antiviral drugs to reduce the severity of the disease, speed up healing, and reduce the risk of complications.

Antiviral medications are most effective when taken within 72 hours of the first rash appearing. Generally, antiviral drugs are consumed for 2-7 days.

Examples of herpes zoster drugs that are commonly given are acyclovir and valacyclovir

Treatment of herpes zoster with antivirals is prioritized for sufferers over 50 years of age or have the following conditions:

  • The symptoms of shingles affect one eye
  • Have a low immune system
  • Moderate or severe pain
  • Moderate or severe rash

If a person with the herpes zoster virus is pregnant, the doctor will discuss the case with an obstetrician to consider the most appropriate treatment. Herpes zoster has no effect on the fetus that is being conceived.

Antiviral drugs are generally not needed for children with sufferers. This is because children usually have milder symptoms than adults.

In addition, the child’s risk factor for complications of herpes zoster is also small. However, if a child sufferer has a low immune system, the doctor will refer him for antiviral treatment in the form of intravenous fluids.

3. Painkillers

To relieve the painful symptoms of shingles, your doctor may recommend pain relievers, such as acetaminophen or ibuprofen.

Prevention

To reduce the risk of exposure to this disease, it is highly recommended to vaccinate against shingles. Especially if you are over 50 years old. 

Vaccines cannot completely prevent shingles. However, this can at least reduce the severity of symptoms and speed up the healing process.

Herpes Zoster is not a contagious disease. However, varicella zoster, which causes herpes, is a highly contagious virus. 

You can do a number of things to avoid the spread of the varicella virus:

  • Do not scratch skin rashes
  • Routinely wash your hands with running water and soap
  • Cover blisters or sores so they don’t contaminate the surrounding environment
  • Avoid direct contact with people who have never been exposed to varicella before or high-risk groups such as the elderly, pregnant women, or people with low immunity.

Complications

Herpes zoster can cause complications. The risk of complications will increase in patients who have a low immune system or are elderly.

Some serious complications of shingles include:

1. Postherpetic Neuralgia

Post-herpetic neuralgia generally occurs in the age group of 60 years and over. Neuralgia is characterized by pain that can last for months or even years after the rash has healed.

2. Bacterial Infection in the Rash

Bacterial infection can occur if the cleanliness of the rash is not maintained. Avoid scratching the rash to prevent bacterial infection.

The shingles rash can cause damage to skin pigment which will look like scars.

3. Vision Disorders

The eyes can experience inflammation, pain, or even blindness as a result of shingles that occur in the eye.

4. Syndrome Ramsay-Hunt

Ramsay-Hunt syndrome is characterized by paralysis of the facial nerve so that the sufferer looks like a grin.

Other symptoms that can be caused are ringing in the ears, spinning dizziness, and earache to hearing loss.

When to See a Doctor? 

Immediately consult a doctor if the characteristics of herpes zoster arise as mentioned above. 

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