Herpes zoster is a viral infection caused by varicella – zoster virus. It is the same virus that causes the chickenpox. All of us who had chickenpox can later have herpes zoster.
After chickenpox the virus remains inactive in certain nerve cells and when it is reactivated it causes herpes zoster. The statistics show that about 20% of the persons who had chickenpox will have herpes zoster. Most people get infected by it only once.
What is the cause of the disease?
To date it has not been fully clarified which factors lead to reactivation of the virus from its dormant state. Temporary weakness of the immune system can cause the virus to multiply and spread across the nerves to the surface of the skin. Sickness, trauma and stress can also cause the disease.
What are the symptoms of herpes zoster?
First symptoms of herpes zoster can be burning, itching, tingling or extreme sensitivity of a part of the skin which is most often at one side of the body. These symptoms can be present one to three days before the redness on the skin. Also, fever and headache can be a part of the clinical picture. Very quickly, on top of the present redness there appear grouped blisters which last two to three weeks. Pain, most often very strong, is one of the main characteristics of the disease. Very rarely, herpes zoster can manifest it self only in pain and without blisters, or with blisters but with no sense of pain.
Where does the disease manifest most often?
Herpes zoster manifests its self mostly on the trunk of the body and on the buttocks of the patient, and rarely on the face, hands and legs. A special care is necessary in patients who have their eyes infected by herpes zoster, because permanent damage is possible if adequate treatment is not provided in time.
How is diagnosed?
Most often it is diagnosed by a dermatological examination. Based on the dermatologist’s assessment, the fluid in the blisters can be sent to special laboratory tests.
How contagious is the disease?
Herpes zoster is less contagious then chickenpox. Persons who have herpes zoster can transmit the virus if the blisters are not intact. Newborns and persons with a significantly decreased immunity are at great risk of catching chickenpox from a person that has herpes zoster.
How is herpes zoster treated?
Herpes zoster usually goes away spontaneously over a few weeks. If the disease is diagnosed in the early phase, antiviral medication can be prescribed which will prevent further propagation and spreading of the virus. In more severe cases and when the eye is caught in the infection, the dermatologist prescribes a combination of systemic corticosteroids and antiviral medication.
What complications are possible?
The most often complication of the herpes zoster is postherpetic neuralgia which manifests in pain, numbness, stinging or itching which continue even after the complete withdrawal of all the changes at the affected area of the skin. Complications are most common in older patients. Early use of antiviral therapy can prevent the appearance of this complication.
Spec. Dr. Svetlana Djurisic, dermatologist