Herpes Zoster (Shingles)

Herpes Zoster

The same virus that causes chicken pox causes herpes zoster or shingles. Once the virus is contracted, it remains in the nerve cells in what is called a resting phase. When there is a recurrent outbreak, the virus manifests itself as herpes zoster or shingles. You cannot get herpes zoster without having had chicken pox. The first outbreak will always be in the form of chicken pox and subsequent outbreaks will be in the form of shingles. It is estimated that about 20 percent of the population with the virus will experience episodes of outbreaks during their lifetime.

What are the symptoms of herpes zoster?

Initial symptoms are similar to other strains of the herpes virus, tingling and/or burning type soreness on a specific part of the body. These symptoms are followed by redness and a chicken pox like rash that blisters and causes significant discomfort. Episodes tend to last more than ten days and as long as a few weeks. The blisters eventually dry up, crust and heal the same way cold sores do. Redness and lingering pain can last well beyond the healing phase. This is known as post-herpetic neuralgia, and most often occurs with immunosuppressed individuals and the elderly.

What part of the body does herpes zoster affect?

Unlike other strains of herpes, shingles tends to develop mostly on the trunk and buttocks, but it can occur and spread anywhere on the body. It is most dangerous if it occurs on or around the eyes, since the virus can cause permanent eye damage.

What causes the virus to recur?

It is commonly believed that a weakness in the body's immune system is the reason the virus starts to come out of its resting phase in the nerve endings and migrate to the surface of the skin. People who have compromised immune systems or disease are more likely to have more painful and prolonged outbreaks.

How is it diagnosed?

The diagnosis of herpes zoster is often made by the appearance and symptoms of the disease. When it is necessary, your doctor can sample some to the cells from a blister and examine them under a microscope to confirm the diagnosis.

Is herpes zoster contagious?

Yes. Once a person has had the chicken pox anyone can develop herpes zoster. The good news is that shingles are less contagious than the chicken pox.

Can herpes zoster be prevented?

Yes. A shingles vaccine (Zostarax) is available which reduces the risk of developing shingles by 50% and lessens the symptoms of shingles when cases do occur. The shingles vaccine helps prevent shingles in the person receiving the immunization, and because shingles is a contagious viral infection, the vaccine also works to stop the spread of the virus. The vaccine is approved for people 50 and older, and recommended for people 60 and older.

What treatments are available?

Herpes zoster is treated with the same anti-viral drugs as are usually prescribed for herpes Type 1 and herpes Type 2, acyclovir and famcyclovir. Pain relievers and corticosteroids are sometimes also used to reduce swelling and pain.