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HomeHealthHerpes zoster - treatment of the virus and pain

Herpes zoster - treatment of the virus and pain

Herpes zoster, commonly known as herpes zoster, is a viral infection caused by the varicella-zoster virus (VZV). This virus is also responsible for causing chicken pox. After a person recovers from chicken pox, the virus remains latent in his nervous system, specifically in the sensory ganglia near the spinal cord or cranial nerves. Shingles has a treatment. It can and should be treated with specific medications.

What is Herpes Zoster? Symptoms appear when the varicella-zoster virus reactivates years later. Usually the cause is a weakened immune system or aging. The reactivated virus travels along the nerve fibers and causes a painful rash or blisters in a localized area of the skin. In most cases, this happens on one side of the body or face. The rash usually follows the path of a single nerve known as a dermatome.

Some of the symptoms are a painful rash, sensitivity to light

woman and candlelight

Photo source Freepik

The main symptom of herpes zoster is a painful rash (often in chest area), which may be preceded or accompanied by other symptoms such as fever, headache, fatigue, and sensitivity to light. The rash usually develops in clusters of fluid-filled blisters. They gradually heal within two to four weeks. The pain associated with shingles can be severe and may persist even after the rash has healed. The condition is known as postherpetic neuralgia.

How is the herpes virus transmitted?

Shingles is contagious to people who have not had chickenpox or who have not received the chickenpox vaccine. However, it takes direct contact with the rash or blisters to contract the virus, not through respiratory droplets like with chickenpox. It is recommended that people with shingles avoid close contact with people at risk. These are, for example, pregnant women, newborns and people with a compromised immune system (transplanted, HIV patients, etc.).

Treatment for shingles usually includes antiviral medications to reduce the severity and duration of the infection. Pain relievers, anti-inflammatory medications, and topical creams or ointments also work. They relieve discomfort and speed up healing.

The varicella-zoster virus vaccine is registered in the EU. It can also be used in people aged 50 and over to prevent or reduce the severity of shingles.

medicine pills

Treatment is mainly with antiviral drugs

Treatment for shingles aims to reduce the severity of the infection, relieve symptoms and speed healing. The main treatment options for shingles include antiviral medications, pain management, and supportive care. Here are the main medications that are used:

Antiviral drugs: Prescription antiviral medications are commonly used to treat shingles. These drugs, such as acyclovir, valacyclovir, and famciclovir, help inhibit the replication of the varicella-zoster virus. They reduce the severity and duration of the infection.

Such medications work best when started within 72 hours of the onset of the rash. Therefore, it is important to seek medical attention immediately. Antiviral treatment is usually administered orally for a certain duration determined by a doctor.

Pain relievers: The pain associated with shingles can be quite intense. It can persist even after the rash has healed. The condition is known as postherpetic neuralgia (PHN). Therefore, patients are often prescribed over-the-counter pain relievers such as:

  • acetaminophen (Tylenol);
  • non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen.

In rarer cases, stronger pain medications, including opioids, may be prescribed. Also, certain medications such as tricyclic antidepressants or anticonvulsants can help manage nerve-related pain.

Skin care for herpes zoster

skin cream

Supportive Care: Several measures can be taken to provide supportive care and promote healing during a shingles infection. Keeping the affected area clean is very important. Washing the rash carefully with mild soap and water helps prevent secondary infections.

Applying soothing lotions or creams: Calamine lotion, over-the-counter hydrocortisone creams, or antiviral creams are recommended to relieve itching and discomfort.

Using cool compresses: Applying cool, moist compresses to the rash relieves pain and reduces inflammation.

Avoiding irritants: It is important to avoid tight or rough clothing that may rub against the rash. This causes additional discomfort or irritation.

Maintain good hygiene: To prevent the virus from spreading, people with shingles should cover the rash with a sterile, non-stick dressing. Wash your hands thoroughly after touching the affected area.
Do not delay an examination with a doctor, infectious disease specialist or dermatologist, for an accurate diagnosis and appropriate treatment recommendations. They can assess the severity of the infection, take into account your overall health.

What are the possible complications if herpes zoster is not treated in time?

If herpes zoster (herpes zoster) is not treated promptly or effectively, several complications can occur. Most cases of shingles resolve without major complications. Some people, especially those with weakened immune systems or older age, are at higher risk. Here are some possible complications that can occur:

Postherpetic neuralgia (PHN): This is the most common complication of herpes zoster. PHN refers to persistent pain in the area affected by shingles, even after the rash has healed. The pain can be severe and debilitating, lasting months or even years. This happens when damaged nerves continue to send pain signals to the brain. Older adults are more susceptible to PHN and the risk increases with age.

Vision problems: If the shingles rash affects the area around the eyes, it can lead to various eye-related complications. These may include conjunctivitis (inflammation of the outermost layer of the eye), keratitis (inflammation of the cornea), uveitis (inflammation of the uvea) or even optic neuritis (inflammation of the optic nerve). Prompt medical attention is critical to preventing vision loss or other long-term eye problems.

Do not underestimate the risk of bacterial infections

Bacterial skin infections: Open sores and blisters caused by shingles can create an opportunity for bacterial infections. Scratching the rash or poor hygiene practices can further increase the risk of infection. Bacterial infections can cause additional pain, redness, swelling, and may require antibiotics to treat.

Neurological complications: In rare cases, the varicella-zoster virus can affect the central nervous system, leading to complications such as meningitis (inflammation of the membranes around the brain and spinal cord) or encephalitis (inflammation of the brain). These complications can cause severe headaches, confusion, seizures, and other neurological symptoms. Immediate medical attention is critical if these complications are suspected.

Organ damage: In people with weakened immune systems, such as those with HIV/AIDS or undergoing immunosuppressive treatment, shingles can potentially affect internal organs. This can lead to pneumonia, hepatitis or other organ complications. Such cases require urgent medical intervention.

It is important to remember that early diagnosis, appropriate treatment and management can greatly reduce the risk of complications associated with shingles. If you suspect you have shingles or are experiencing symptoms consistent with the infection, it is recommended that you seek medical attention to receive appropriate care and minimize potential complications.

Author Ina Dimitrova

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