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Shingles (Herpes Zoster)

What is Shingles (Herpes Zoster)?

Shingles or Herpes Zoster is a viral infection caused by the varicella-zoster virus, which also causes chickenpox. Varicella-zoster is part of a group of viruses known as herpes viruses. This is the same group that includes the viruses that cause genital herpes and cold sores. As a result, shingles is also known as herpes zoster. But the virus that causes chickenpox and shingles isn’t the same virus that causes cold sores or genital herpes,

which is a sexually transmitted infection.

Shingles occurs when the virus, which remains dormant in the body after a person has had chickenpox, becomes active again later in life. Shingles causes a painful rash with blisters, typically on one side of the face or body. Other symptoms can include fever, headache, and fatigue. It is more common in older adults and people with weakened immune systems. The risk of developing shingles can be reduced by receiving the shingles vaccine. If a person does develop shingles, antiviral medications can be used to shorten the duration of the illness and help prevent complications.

Symptoms of Shingles/ Herpes Zoster

The symptoms of shingles include a painful rash that typically appears as a stripe or band on one side of the face or body, along with fever, headache, chills, and an upset stomach. Other symptoms can include sensitivity to light, fatigue, and itching or tingling in the affected area. In some cases, shingles can also cause numbness, weakness, or a burning sensation in the affected area. In rare cases, shingles can lead to serious complications, such as pneumonia, encephalitis, or blindness. If you suspect that you have shingles, it is important to see a doctor as soon as possible for treatment.

Some patients of shingle also feel;

  • Fever
  • Headache
  • Fatigue
  • Sensitivity to Light

Causes of Shingles

Primarily varicella-zoster virus (VZV) causes chickenpox. After a person has had chickenpox, the virus remains dormant in their body and can reactivate later in life, causing shingles. The exact cause of reactivation is not fully understood, but it may be due to a weakened immune system. In some people, the virus does not reactivate after the chickenpox infection.

Varicella-zoster is part of a group of viruses known as herpes viruses. This is the same group that includes the viruses that cause  genital herpes and cold sores. As a result, shingles is also known as herpes zoster. But the virus that causes chickenpox and shingles isn’t the same virus that causes cold sores or genital herpes, which is a sexually transmitted infection.

Shingles are spread through direct contact with the fluid from the blisters caused by the virus. It is not as contagious as chickenpox and cannot be spread through casual contact. However, a person with shingles can spread the virus to someone who has never had chickenpox, causing them to develop chickenpox.

The reason for shingles is unclear. It may be due to lowered immunity to infections as people get older. Shingles is more common in older adults (aged more than 50 years) and in people who have weakened immune systems.

 

Risk Factors of Herpes Zoster

  1. Age: The risk of herpes zoster increases as a person gets older. It is more common in people over the age of 50.
  2. Weakened immune system: People with a weakened immune system, such as those with HIV/AIDS or cancer, are at a higher risk of developing herpes zoster.
  3. Chronic medical conditions: People with chronic medical conditions such as diabetes, heart disease, and lung disease are at a higher risk of developing herpes zoster.
  4. Medications: Certain medications, such as immunosuppressants, can increase the risk of herpes zoster.
  5. Previous chickenpox infection: Herpes zoster is caused by the reactivation of the varicella-zoster virus, which also causes chickenpox. Therefore, anyone who has had chickenpox in the past is at risk of developing herpes zoster.
  6. Exposure to the varicella-zoster virus: People who have been exposed to the varicella-zoster virus, either through close contact with someone with chickenpox or shingles, are at a higher risk of developing herpes zoster.
  7. Stress: People who are under a lot of stress or have had a recent physical or emotional trauma are at a higher risk of developing herpes zoster.
  8. Genetics: Some research suggests that there may be a genetic predisposition to developing herpes zoster.

When to See the Doctor?

It is recommended to see a doctor if you suspect you have Herpes Zoster (shingles) as soon as possible, as early treatment can help prevent complications and reduce the severity of symptoms. Symptoms of Herpes Zoster include a rash or blisters on one side of the face or body, along with pain, itching, or tingling in the affected area. If you experience any of these symptoms, it is important to see a doctor for diagnosis and treatment. Moreover, if you suspect Shingles in the following situations;

  • The pain and rash are close to the eye. Because it may completely damage the eye if left untreated or not treated timely.
  • You’re 50 or older and suspect Shingles. Because age increases your risk of complications.
  • Complications of shingles may increase if you or someone in your family has a weakened immune system. The immune system is generally weakened due to cancer, medications, and chronic illness.
  • The rash is widespread and causes pain.

Complications of Herpes Zoster

Herpes zoster, also known as shingles, can cause a variety of complications. Some of the most common complications include:

  1. Ramsay Hunt Syndrom: Ramsay Hunt Syndrome, also known as Herpes Zoster Oticus is a complication of Herpes Zoster, in which the infection proceeds to facial nerves near the ear.
  2. Postherpetic neuralgia: Postherpetic neuralgia (PHN) is a chronic pain condition that can occur after a person has had a case of herpes zoster, also known as shingles. Shingles is a viral infection caused by the varicella-zoster virus, the same virus that causes chickenpox. After a person has had chickenpox, the virus can remain dormant in the body and reactivate later in life, causing shingles.
  3. Impact on Eyes: One of the most common vision problems associated with herpes zoster is inflammation of the eye, known as herpes zoster ophthalmicus. This can cause symptoms such as redness, pain, and light sensitivity in the affected eye. In severe cases, it can lead to vision loss or even blindness.Other vision problems that can occur with herpes zoster include:
    • Optic neuritis: inflammation of the optic nerve, which can cause vision loss or changes in color vision
    • Retinitis: inflammation of the retina, which can cause floaters, blurred vision, and vision loss
    • Keratitis: inflammation of the cornea, which can cause pain, redness, and sensitivity to light

    It’s important to seek medical attention immediately if you experience any symptoms of vision problems after developing herpes zoster. Treatment may include antiviral medication and corticosteroids to reduce inflammation and prevent complications. In some cases, surgery may be necessary to repair damage to the eye.

  4. Brain infections: Brain infections refer to any type of infection that affects the brain and central nervous system. These infections can be caused by bacteria, viruses, fungi, or parasites. Some common types of brain infections include meningitis, encephalitis, and brain abscesses. In rare cases, herpes zoster can also affect the brain, causing a condition called herpes zoster encephalitis. Symptoms of herpes zoster encephalitis can include confusion, seizures, and difficulty with coordination or speech.
  5. Skin infections: The rash and blisters can become infected if they are not kept clean and dry, leading to skin infections. They can become infected and lead to cellulitis or impetigo.
  6. Secondary bacterial infections: One of the complications of shingles is secondary bacterial infections. The rash and blisters associated with shingles can become infected with bacteria, leading to skin and soft tissue infections such as cellulitis and impetigo. These infections can cause redness, swelling, and pain and can lead to more serious complications if left untreated.Secondary bacterial infections can occur in people of any age, but they are more common in older adults and people with weakened immune systems. People with shingles should keep the affected area clean and dry and avoid scratching or picking at the blisters to reduce the risk of infection. They should also seek medical attention if they develop signs of infection, such as increased pain, redness, or swelling around the rash or blisters.
  7. Autoimmune disorders: Shingles can trigger or exacerbate autoimmune disorder like Lupus, Rheumatoid arthritis, or Multiple Sclerosis.

It’s important to see a doctor if you think you have shingles as early treatment can help prevent complications and lessen symptoms.

Diagnosis of Herpes Zoster

Shingles/ Herpes Zoster is a viral infection that is caused by the varicella-zoster virus (VZV), the same virus that causes chickenpox. It is diagnosed through a physical examination of the rash and symptoms and is sometimes confirmed through a blood test or viral culture. The most common symptom of shingles is a painful rash that develops on one side of the face or body, often in a band-like pattern. Other symptoms can include fever, headache, and fatigue. If you suspect you have shingles, it is important to see a healthcare provider for a proper diagnosis and treatment.

Tests to diagnose Shingles

There are several tests that can be used to diagnose shingles, including:

  1. Visual inspection: A doctor can often diagnose shingles by simply looking at the rash and any blisters.
  2. Tzank smear: A sample of fluid from a blister can be taken and examined under a microscope to confirm the presence of the virus that causes shingles.
  3. Polymerase chain reaction (PCR) test: A sample of fluid from a blister can be taken and tested for the genetic material of the virus.
  4. Blood tests: Antibody tests can be used to detect if a person has been infected with the virus.

It’s worth noting that a diagnosis of shingles can often be made based on a person’s symptoms and a physical examination without the need for any specific tests.

 

Treatment of Herpes Zoster

There is no specific treatment for Shingles / Herpes Zoster. Typical antiviral medicines are prescribed to accelerate the healing, and reduce the risk of plausible complications. Moreover, your healthcare provider may prescribe some anti-inflammation and pain reducers to relieve the patient, as this infection causes severe pain and itching. Some common medications are as under;

  1. Antiviral medications: These medications can help to shorten the duration of shingles and reduce the severity of symptoms. They can also lower the risk of complications. Examples include acyclovir, valacyclovir, and famciclovir.
  2. Topical creams and ointments: Topical creams or ointments containing a local anesthetic, such as lidocaine, can help to relieve pain and itching associated with shingles.
  3. Cool compresses: Applying cool compresses to the affected area can help to reduce pain and itching.
  4. Rest and relaxation: Getting plenty of rest and taking it easy can help to reduce stress and promote healing.
  5. Avoiding triggers: Avoiding triggers that may worsen symptoms, such as exposure to heat or sunlight, can help to reduce pain and discomfort.
  6. Vaccination: The shingles vaccine can help to lower the risk of developing shingles and reduce the severity of symptoms if you do get the virus.

As shingles causes severe pain and inconforts, therefore, your healthcare provider will prescribe pain delivers along side the treatment.

Pain relief medications: Over-the-counter pain relievers such as ibuprofen and acetaminophen can help to reduce pain associated with shingles. Prescription medications such as gabapentin or pregabalin may also be prescribed for more severe pain.

It is important to consult with a healthcare provider for proper diagnosis and treatment. They may prescribe medication, pain relief, and other treatments to help manage symptoms.

Difference Between Herpes and Shingles (Herpes Zoster)

Shingles and herpes are two different viral infections that can cause skin rashes and other symptoms.

Shingles, also known as herpes zoster, is caused by the varicella-zoster virus, which is the same virus that causes chickenpox. After a person has had chickenpox, the virus can remain dormant in the nerve cells and reactivate later in life to cause shingles. Shingles typically causes a rash on one side of the body, along with pain, itching, and burning. It can also cause fever, headache, and fatigue.

Herpes, on the other hand, is caused by the herpes simplex virus (HSV). There are two types of herpes simplex virus: HSV-1 and HSV-2. HSV-1 typically causes oral herpes (cold sores) while HSV-2 typically causes genital herpes. Herpes can cause blisters and sores on the skin, as well as itching and burning sensations.

While shingles and herpes are both viral infections that can cause skin rashes, they are caused by different viruses and can have different symptoms. It is important to consult a healthcare professional for proper diagnosis and treatment.