Herpes zoster is a skin rash, which occurs when a virus (varicella-zoster virus) in the nerve cells becomes active again later in life
The varicella zoster virus is the same virus that causes chickenpox. Once you had chickenpox, varicella zoster virus remains in your body’s nerve tissues, never really going away. It can be reactivated later in life, causing herpes zoster
It is not sure how why the varicella zoster virus reactivate, but it is believed that once your immune systems response to the virus weans over the years after the childhood chickenpox.
When the virus reactivate, it travels through the nerves, often causing a burning or tingling sensation in the affected areas. Two or three days later when the virus reaches the skin, the blisters appear. These are grouped and usually occur along the affected one side of the body.
Hives will not last beyond a few days and will last for a maximum of six weeks.
Triggers of acute hives include infections, drugs, insect stings (bees, wasps, ants) and food allergy and physical contact with certain agents.
Food associated urticaria appears within 30 minutes of eating the food and the foods most likely to cause it include milk, cake, other nuts, soy wheat, fish, and shellfish, Physical contact with certain plans of fruits, vegetables and can also cause Urticaria in certain individuals.
The list is not all inclusive.
If you have had chickenpox, you are at risk is developing shingles . However, the virus does not recover reactivate in everyone who has had chickenpox. Shingles mostly appears in people who are older than 50 years and people with weak immune system such as patients having treatment for cancer, HIV patients, etc.
Your chances of getting shingles increases as you get older.
Although in this disease can occur in any age and shingles appear in children which is uncommon, it is usually very mild.
Shingles usually begins with a burning sensation, mild itching or tingling or shooting pain, usually located one side of the chest, abdomen, face or a portion of arm and leg.
Skin may be extremely sensitive so that you may not be able to stand clothing, touching or rubbing that area
And about five days later, the skin becomes red and mildly swollen, and a rash appears
Small blisters, which may cluster in patches or form a continuous line, roughly follows the path of the infected nerve
The blisters maybe painful or itchy, may continue to appear as 2 to 7 days and eventually break to form crust
Shingles can also cause fatigue, low grade fever and mild muscle aches
Post herpetic neuralgia -About 10% of the adults get shingles experience long-term pain in the area of the skin where the blister occurred, even after the rashes heal completely. This condition which may last for months, or very rarely, years. Severe pain is most common in older patients, often accompanied by extreme sensitivity to heat and cold in the affected area of the skin.
Herpes zoster ophthalmicus - This occurs when shingles involoves the eye. Herpes zoster ophthalmicus can affect your vision, even causing blindness and severe pain.
Ramsay Hunt syndrome can cause hearing loss
Bell’s Palsy - Paralysis of the facial nerve, leading to facial symmetry and deformity
Consult your dermatologist immediately if you’re experiencing symptoms of shingles. Early treatment may help prevent long-term complications.
Shingles can be very difficult to diagnose before visible signs of the disease appear. Once the rash and blisters appear, your dermatologist will probably diagnose based on your symptoms and appearance of your skin. No laboratory test are usually needed for the diagnosis.
When the diagnosis is less certain, the doctor may scrape tissue collect cells from the affected skin and examine under microscope to check for the cellular changes consistent with herpes zoster infection.
If your skin condition is diagnosed within 72 hours after the rash appears, a dermatologist may prescribe oral anti-viral medications.
Anti-viral medications help to reduce the risk of developing chronic pain in shingles.
The skin rash and blister should be rinsed gently once twice a day with cold water, and the doctor may suggest that you use antibiotic or ointment on the rash.
Because the pain that accompany the shingles may be intense, your dermatologist may also prescribe pain medication.
For post herpetic neuralgia, the neurologist or the dermatologist prescribe pain medications for the pain, which lingers long after the rashes gone away.
When shingles affects the eyes and ophthalmologist should be consulted immediately.
Shingles usually last 7 to 10 days to run its course, although the blister may take several weeks to disappear completely, but within four weeks, the appearance of your skin was likely to return to normal. Some people are left with some dark spots in the skin.
The duration of pain is highly variable. In most people pain decreases within 2 to 3 months. About 10% of people have pain for many months and 2% of pain longer than a year.
Most people recover completely after acute episode with no pain and skin returns to normal. Once you’ve had shingles it’s unusual for the condition to return. Shingles comes back only in 2% of the patients but in up to 20% of patients with AIDS.
Long-term complications from shingles is post herpetic neuralgia characterised by shooting pain along the nerve that is continues for months to years. However, if shingles is treated adequately with appropriate antivirals, incidence of nerve pain is less.
Disease may cause varying degree of skin, risk, colouration, darkening, and scarring
A vaccine is recommended for people over 50 to help prevent shingles and decrease the risk of post herpetic neuralgia, if shingles does occur. The ingredient in the vaccine of the same as the ones in the chickenpox vaccine for children, but the dose is 14 times stronger.
The standard chickenpox vaccine for children is too new to determine how effective it is to prevent shingles later in life.
Disclaimer: This article is only for general patient information and is not intended for self medication. There is no legal liability of IADVL arising out of any adverse consequence to the patient. Subsequent to its use for self treatment of the disease images adjust for the depiction of the condition and is not to be used for any other purpose.
Explore articles in this section to gain a deeper understanding of various skin diseases and conditions. Each article provides detailed information on symptoms, causes, and treatment options, helping you to manage and address these dermatological issues effectively.
Psoriasis is a skin condition where new skin forms at a faster rate, showing up as red rashes with whitish scales, commonly over elbows, knees, and other body parts.
Dandruff is a common scalp condition in which small pieces of dry skin flake off from the scalp and is usually associated with itching. The exact cause of Dandruff and Seborrhoeic Dermatitis is unknown.
Dermatophyte infection is a superficial fungal infection of skin, hair and nails. It is also known as ringworm. In Hindi it is termed as Daad and in Marathi it is termed as Gachkaran.
