What is Herpes Zoster: Everything You Should Know

Herpes zoster is a painful rash caused by the varicella-zoster virus, the same microbe responsible for causing chickenpox. While many associate chickenpox with childhood, the herpes zoster virus can lie dormant in the nervous system for decades before reactivating and causing a painful outbreak later in life. 

This blog will inform you about everything you need to know about herpes zoster, including its symptoms, causes, risk factors, complications, and treatment options. 

What is Herpes Zoster?

Herpes Zoster, commonly called shingles, is a viral infection caused by the varicella-zoster virus. Think of it like a one-two punch of infections since it typically follows a previous episode of chickenpox, often occurring decades earlier.

Both conditions occur due to the same virus – varicella zoster. This virus can remain dormant in the nerve tissues near the spinal cord and brain after an initial episode of chickenpox.

Chickenpox appears as itchy blisters starting on the back, chest, and face, eventually spreading across the body. On the other hand, herpes zoster occurs as a rash accompanied by shooting pain, typically on one side of the body in a specific area.

Initially, a herpes zoster rash appears as a cluster of small bumps with different colors on different skin tones. On darker skin, they may be pink, grayish, purple, or brown, while on lighter skin, the bumps appear red. These lumps then develop into fluid-filled blisters, which vary in color depending on the individual’s skin tone. The blisters typically dry out and form crusts within 7 to 10 days.

Herpes Zoster Symptoms

The early signs and symptoms of herpes zoster include:

  • Swollen lymph nodes
  • Clusters of tiny blisters that unexpectedly burst
  • A sharp or shooting pain
  • A tingling or burning sensation in or beneath the skin
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If you suspect any of these signs and symptoms, consult a doctor quickly. While there is no cure for herpes zoster, treatment on time can reduce the risk of complications, such as persistent pain after the rash disappears, known as postherpetic neuralgia.

Herpes Zoster Causes

The varicella-zoster virus initially causes chickenpox, a disease commonly associated with childhood but can also affect adults. After the chickenpox episode, the virus remains dormant in nerve tissues near the spinal cord and brain. 

For unknown reasons, the virus can reactivate years later, traveling along nerve fibers to the skin and causing herpes zoster.

Herpes Zoster Risk Factors

Now that you know herpes zoster causes, let’s understand its risk factors.

Several factors can trigger the reactivation of the virus, leading to herpes zoster. These include:

  • Age (being 50 or older)
  • Experiencing high-stress levels
  • Having conditions such as cancer or HIV that weaken the immune system
  • Suffering a severe physical injury
  • Taking immune-suppressing medications
  • Not receiving the chickenpox vaccine or shingles vaccines (although eligible)

However, it’s essential to note that many individuals who develop herpes zoster may not fall into these risk categories.

Complications of Herpes Zoster

If not treated on time, herpes zoster can lead to lasting complications, even after the rash disappears. These may include:

  • Brain inflammation
  • Facial paralysis
  • Eye problems or vision loss
  • Postherpetic neuralgia – a persistent pain affecting up to 1 in 5 herpes zoster patients

Is Herpes Zoster Contagious?

No, herpes zoster is not contagious, but the varicella-zoster virus can be transmitted to those who have never had chickenpox or received the vaccine. Affected individuals can spread the infection until all sores have crusted over. During this period, it’s essential to avoid contact with pregnant women, individuals with weakened immune systems, and newborns.

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Herpes Zoster Diagnosis

Diagnosing herpes zoster involves considering medical history and symptoms and conducting a physical examination. Additionally, doctors may test a small fluid sample from the blisters for confirmation.

Treatment for Herpes Zoster

While there’s no cure for herpes zoster, antiviral drugs such as Acyclovir, Famciclovir, and Valacyclovir can accelerate healing and reduce the risk of complications if administered within the first three days of rash appearance. 

Pain management strategies may involve:

  • Anticonvulsant medicines
  • Cool compresses
  • Medicated lotions
  • Numbing medications, including lidocaine
  • Over-the-counter medicines like ibuprofen or acetaminophen
  • Prescription painkillers (codeine)

Herpes Zoster Vaccine

The Shingrix vaccine is highly effective, with over 90% efficacy. The CDC recommends two doses for healthy adults aged 50 and older, as well as those 18 years and older who are immunodeficient or immunosuppressed. The vaccine is crucial even for individuals who have previously had herpes zoster or received the now-discontinued Zostavax vaccine.

Understanding herpes zoster, its symptoms, causes, risk factors, complications, and available treatments and preventive measures is crucial for effective management and reducing the risk of complications associated with this viral infection.