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Herpes zoster (shingles): Treatment, symptoms, advice and help

About herpes zoster (shingles)

Herpes zoster (shingles) is a viral infection of the nerves which causes painful skin rashes along the nerve pathway. This is caused by varicella zoster virus which is also responsible for causing the chicken pox infection. Shingles usually results from reactivation of chicken pox virus in an individual who has a past history of chicken pox infection.

Herpes zoster (shingles): Incidence, age and sex

Herpes zoster infection is not an uncommon occurrence. It mainly afflicts an individual of more than 60 years of age. A past history of chicken pox infection, especially during infancy is considered to cause this infection. It has the same rate of incidence in both men and women.

Signs and symptoms of herpes zoster (shingles): Diagnosis

The clinical features of shingles include pain and tingling sensation of the skin which affects the body in a belt-like fashion extending from the spine to front of chest or abdomen. This is followed by reddish skin rash which may progress to form painful fluid filled blisters. These blisters eventually dry and form yellow crusts which usually fall within days. The skin lesions heal without scarring in most of the individuals. Occasionally it may affect the face and mouth. Other clinical features are non-specific and include temperature, muscle weakness and abdominal pain. Detailed history including past history of chicken pox infection along with characteristic skin rashes helps in diagnosis of shingles.

Causes and prevention of herpes zoster (shingles)

Shingles is caused by varicella zoster virus which also causes chicken pox. Individuals who have had chicken pox in infancy are more susceptible to this infection. The chicken pox virus after causing chicken pox does not get killed or eliminated. Instead, it remains in the roots of nerves in a dormant state. Certain triggering factors like weakened immunity may cause reactivation of virus years later to cause shingles. Usually a single attack of shingles confers a life long immunity. Herpes zoster infection can be effectively prevented with herpes zoster vaccine.

Herpes zoster (shingles): Complications

The most common and distressing complication of herpes include post herpetic neuralgia which is characterised by persistent pain in the affected area even after resolution of infection. Such pain may last for several months. Spread of infection to the eyes and the ears may hamper their function resulting in vision impairment and hearing loss respectively.

Herpes zoster (shingles): Treatment

The management of herpes zoster disease involves the skills of internist as well as that of ophthalmologist. Antiviral drugs (Acyclovir, Famcyclovir) may be prescribed to the affected individual. They can be taken orally as well along with antibiotic creams. Atropine eye drops which cause dilatation of pupils may also be considered to provide symptomatic relief. Diseased cells on surface of the cornea can be scraped off by an eye specialist to restore normal vision. Rarely, the cornea may get irreversibly damaged resulting in permanent scarring. Such cases may require corneal transplant to restore vision. But in most instances, herpes zoster may resolve completely with anti-viral treatment.