Herpes Zoster

Herpes Zoster
Medical Subjects: Skin

What Is Herpes Zoster

What is shingles?

Herpes zoster is an infectious disease caused by the latent varicella zoster virus in the body.

Shingles and chickenpox are the same virus. People who haven't had chickenpox will not have shingles after contacting shingles. They may have chickenpox or they may not have obvious manifestation. It is called recessive infection in medicine. The populations at high risk of infection are infants and those not receiving the varicella vaccine.

Herpes zoster typically presents as patches of red skin with blisters on it. These skin rashes are distributed along the innervation area on the skin surface and are usually in the form of strips, hence the name herpes zoster.

Herpes zoster is commonly known as "snake winding waist", "snake sore", "fire Dan wrapped waist", etc. Another feature is severe neuropathic pain, which seriously affects the quality of life.

Shingles have self-healing, that is, can be cured without treatment, generally in the onset of 2 to 3 weeks gradually scab cured. However, it may leave behind severe neuralgia with a long duration, especially in the elderly and weak. The elderly can prevent the onset of herpes zoster vaccine injection in advance.

Is herpes zoster common?

More common.

And the older you are, the more you get sick. The incidence rate of young people is about 1‰, and that of people over 50 years old can reach more than 5‰, while that of people over 65 years old can reach as high as 4 ‰–12 ‰. In terms of gender ratio, the ratio of men to women is approximately 3: 2.


What Is The Cause Of Herpes Zoster

How is shingles produced?

The majority of patients (about 70%) have had chickenpox at an early age, while about 30% of patients have been infected with varicella-zoster virus but have not had chickenpox, which is medically known as "recessive infection".

The virus can enter the sensory nerve endings and "walk up" the sensory nerves, reaching the sensory ganglia and lurking.

After varicella cure, there are still some latent in the sensory ganglia (where nerve cell aggregates) virus exists in the dormant state in the body.

At ordinary times because the human body has a good resistance, dormant virus is not easy to be activated.

However, when the body's resistance drops, the virus can be activated in the ganglia and grow and reproduce again, damaging the nerves of the body, leading to severe neuralgia, and moving to the skin along the nerve fibers, causing strong inflammation in the affected nerves and skin and herpes zoster.

Why can zoster happen? What conditions can cause shingles to occur?

  • Resistance decline is an important factor causing herpes zoster, such as long-term use of glucocorticoids, mental stress, fatigue, long-term stay up late and work overtime, etc.
  • Older people get shingles more easily than younger people.
  • Some patients with immunodeficiency diseases such as leukemia, bone marrow transplantation, HIV infection/AIDS, and cancer are prone to herpes zoster.

Why can postherpetic neuralgia produce?

Some adverse factors can make people more prone to post-herpetic neuralgia.

Including those over 50 years of age, herpes zoster rash and severe pain with other chronic conditions such as diabetes, herpes zoster on the face or trunk (chest, back, or waist and abdomen), and delayed treatment of herpes zoster (treatment takes place 72 hours after the rash develops). These factors may make it difficult to reverse or repair damaged nerves.

What are the mechanisms of postherpetic neuralgia?

The pathogenesis of postherpetic neuralgia is still not very clear at present. In general, its mechanism is divided into two aspects, i.e., peripheral mechanism and central mechanism:

  • Peripheral mechanism: it is usually said that nerves are destroyed by viruses.
  • Central mechanism: It is mainly the result of central sensitization. In short, it is the body in the persistent herpes zoster pain stimulation, the pain signal amplification. For example, under normal circumstances, stroking the skin will not cause pain, but for patients with post-herpetic neuralgia, stroking the affected skin will cause severe pain.

Can shingles be contagious?

It can be said to be contagious or not.

Shingles is caused by varicella zoster virus. A first infection with the virus may go without and may develop chickenpox. After that, the virus can be latent in the body and the herpes zoster only appears when the resistance is reduced and the disease reoccurs.

Therefore, people who have not been infected with the varicella-zoster virus before or have not been vaccinated with the varicella vaccine may only develop varicella after coming into contact with patients with herpes zoster, but not herpes zoster.

People who have been infected with the varicella zoster virus before are not re-infected after contacting patients with herpes zoster.

People who have received varicella vaccine before basically won't be infected with varicella, but they may have breakthrough infection in some cases, manifesting as slight varicella.

For people who have never had chickenpox or have not been vaccinated against chickenpox, do not touch the rash of the patient, especially where it is broken and porous, as this may cause chickenpox.


What Are The Symptoms Of Herpes Zoster

What are the manifestations of shingles?

  • Pain: The skin at the diseased part feels burning, sharp or severe pain. Like electric shock, slight touch can also cause obvious pain (called pain sensitivity). Pain can occur with the rash or before or after the rash.
  • Erythema and blisters: The skin will generally have patches of redness, with blisters on the surface that will gradually become larger.
  • Scab: The rash usually lasts for 2–3 weeks. The scab will appear in the later stage when the blister dries up. The complete shedding of the scab indicates that the herpes zoster is cured.

Where does herpes zoster grow easily?

The most common site of herpes zoster is chest and back, about 55%. This was followed by the head and face (15%), waist and abdomen (14%), neck (12%), sacral region (above hip) (3%) and other regions (1%).

The rash of herpes zoster is arranged along a nerve strip and occurs on one side of the body, usually no more than the midline of the body.

What is neuralgia after zoster?

Post-herpetic neuralgia is neuralgia left by herpes zoster.

This sequela is to point to commonly herpes zoster after rash abate still have pain more than a month. Manifested as local paroxysmal or persistent burning pain, sharp pain, knife cut pain, affect the rest, sleep and mental state.

After suffering from herpes zoster, the occurrence of post-herpetic neuralgia, three-quarters of the people are over 50 years of age in the elderly.


How To Check For Herpes Zoster

What is the difference between shingles and chickenpox?

Varicella and herpes zoster are two related but different diseases. The two are related because they are infected with the same virus, varicella zoster virus, and the same principle applies to the selection of antiviral drugs for treatment.

However, they are two different diseases. The primary infection of varicella zoster virus is varicella, and the latent virus develops into herpes zoster after activation. They are not the same infectious, varicella infectious. Furthermore, they behave differently, and patients with chickenpox do not have as much neuralgia as patients with herpes zoster.

How should zoster be diagnosed?

Doctors generally according to:

  • Patients have predisposing factors (e.g., aging, long-term use of hormonal drugs, fatigue, etc.);
  • Clinical manifestations: Crowds of blisters on sheets of red skin. The blisters were distributed in bands along one side of the peripheral nerve and did not exceed the midline. Generally accompanied by severe pain.

What disease should zoster differentiate with?

Herpes zoster is sometimes harder to diagnose and may have similarities to the following conditions.

  • Herpes simplex: It occurs at the junction of skin and mucosa (such as the corner of mouth and lip), with irregular distribution. The blister is small and easy to break. The pain is relatively mild and it is easy to relapse.

  • Contact dermatitis: There is contact with special substances. The rash has nothing to do with the nerve distribution and corresponds to the substance contacted. There may be a burning sensation or pruritus without neuralgia.

  • In a period of time before the onset of herpes zoster (prodromal stage) or herpes zoster without rash (suffering from herpes zoster but without visible rash), if neuralgia is obvious, it is easy to be misdiagnosed as internal diseases such as intercostal neuralgia, pleurisy and acute appendicitis. The identification of these diseases requires the doctor to ask the medical history in detail and do the examination of relevant diseases to identify.


How To Prevent Shingles

Can shingles be prevented?


Shingles vaccines have been marketed to reduce the risk of, and symptoms of, shingles. It is recommended that the elderly over the age of 50 be vaccinated.

How to avoid producing postherpetic neuralgia.

As the mechanism of post-herpetic neuralgia is complex and the treatment is difficult, post-herpetic neuralgia should be avoided as much as possible. Although post-herpetic neuralgia may not be completely preventable, the following measures may be helpful:

  • The emergence of herpes zoster immediately carry out regular antiviral treatment, do not miss the best treatment time due to delay, this is the most important, many patients because of acute phase has not been dealt with in time and become post-herpetic neuralgia.
  • Regular treatment methods are adopted for treatment, including comprehensive treatment such as antiviral and analgesic treatment.

How To Treat Herpes Zoster

Shingles see what department?

Usually see dermatology, severe pain can see pain department.

Can herpes zoster be cured by oneself?

Herpes zoster does heal spontaneously, but prompt medical treatment is still recommended.

The self-cure of herpes zoster is only for the rash. For the rash of the disease, there was a process of erythema-blister-scab-desquamation, and the changes on the skin were self-healing. However, herpes zoster can lead to neuralgia in addition to rash. Children and young people may have no pain or the pain is very mild, but the pain is severe in the elderly and weak.

Timely treatment after herpes zoster can shorten the duration and reduce the severity of neuralgia. Therefore, the early treatment of herpes zoster is very important, especially in the more serious illness, the elderly and weak crowd.

Herpes zoster is the blister on the skin cured this disease cured?

Not exactly.

Early treatment of patients with herpes zoster is very important, not only improving the quality of life of patients, but more importantly, if no measures are taken to treat pain in the acute phase, the nerves damaged by the virus cannot be effectively repaired, which will make the course of the disease longer. If post-herpetic neuralgia develops, the nerve damage cannot be repaired basically, and the treatment is very difficult.

Therefore, early treatment of pain is very important. Similarly, a patient with herpes zoster cannot be considered as cured if only the erythema and blisters on his skin disappear and the neuralgia persists; On the contrary, as long as its neuralgia exists, it should be actively dealt with.

How should zoster treat?

Herpes zoster is caused by varicella zoster virus, should be timely medical treatment, avoid by all means delay, especially the elderly are easy to leave behind neuralgia (skin lesions subsided after intermittent or continuous attack of pain). Treatment includes:

  • Antiviral treatment: At present, the commonly used anti-varicella-zoster virus drugs include acyclovir, valacyclovir, and famciclovir.
  • Analgesics: ibuprofen, pregabalin, gabapentin, lidocaine patch, and even tramadol.
  • Nerve block therapy is one of the measures for the treatment of herpes zoster neuralgia.

What is the effect of herpes zoster treatment? Can it be cured?

The treatment of herpes zoster, the vast majority of patients curative effect is very obvious, especially for patients who see a doctor in time, cure quickly. For patients who develop postherpetic neuralgia, the therapeutic effect is often not as good as that in the acute phase.

What treatment method does neuralgia have after zoster?

The treatment of postherpetic neuralgia is still a difficult problem so far, and the commonly used methods include:

  • Analgesic drug therapy: ibuprofen, pregabalin, gabapentin, amitriptyline, lidocaine patch and even tramadol.
  • Local treatment: local physiotherapy, local intradermal injection, etc.
  • Interventional therapy: such as nerve block and radio frequency.
  • Other: Psychotherapy is also an important part.

Why is the remedial effect after zoster neuralgia unsatisfactory?

Post-herpetic neuralgia is a difficult problem because the pathogenesis, treatment, and efficacy are much more complex and difficult than those of acute herpes zoster.

To date, there is no very effective treatment. Although post-herpetic neuralgia occurs and the pain is often relieved to a certain extent in the later stage, many patients cannot completely relieve the pain.

Shingles is a disease lifetime immunity? Can shingles recur?

Long-term immunity was previously thought to arise from a single illness, including some books.

However, recently we have found in clinical work that there are individual patients with herpes zoster who will develop the disease again, and there are patients whose time interval of two onset is more than ten years, and the two onset are not in the same place, which indicates that this type of patients do develop herpes zoster twice.

Although the overall number of patients with recurrent herpes zoster is currently small, it cannot be assumed that patients who have had herpes zoster are 100% immune for life.


What Should Shingles Patient Notice In Life

What are the precautions for patients with herpes zoster diet? Do you need any taboos?

Many herpes zoster patients who come to see a doctor are very concerned about the problem of diet. Some patients even think that after suffering from herpes zoster, they can't eat many things and can only eat light vegetables and radishes.

This is actually a misunderstanding. Herpes zoster is an infectious disease caused by viral infection and does not need to be avoided blindly. On the contrary, pay attention to a balanced diet on the recovery of herpes zoster should be beneficial, light to eat green vegetables radish is not conducive to improve the patient's nutrition, is not conducive to the recovery of the disease.

What precautions do herpes zoster patients have in life?

Once herpes zoster is diagnosed, in addition to the need for active treatment, the following items should be noted:

  • Avoid overwork, overwork is the inducing factor of herpes zoster, similarly, if overwork after the onset of disease will affect the patient's rehabilitation.
  • Blisters can be covered with clothing as much as possible. Avoid contact with infants, especially in the acute phase of herpes zoster should avoid contact with infants, because infants have the potential risk of infection.
  • Reasonable arrangement of work and rest, try not to participate in heavy physical labor, ensure adequate sleep.
  • Try to keep your mind at ease, which is positive for recovery.
  • The condition was closely observed during treatment in order to take active countermeasures.

How does the skin of zoster patient nurse?

Hair after herpes zoster, because there are blisters on the skin, very let the attention of patients, in general, the skin should pay attention to the main are:

  • Keep your skin clean and don't apply any ointments to your skin, especially those that contain hormones.
  • Keep the skin intact and do not pick out the blister with the needle.
  • If the pain is severe, avoid rubbing the skin.

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