Herpes zoster: causes, symptoms and treatment

This viral infection may cause different symptoms than common shingles.

Shingles is a viral infection not to be confused with herpes simplex. and is caused by the same virus as chickenpox.

In this article we will explain what this condition is, what causes it and what we can do to treat it.

What is shingles?

Herpes zoster (HZ) is a local reactivation of the chickenpox virus that remains latent, so it is necessary to have had chickenpox in order to suffer from this disease. This occurs after the primary infection has occurred and the virus is present in the spinal ganglia of the spinal cord or in the cranial nerves.

Statistics indicate that between 15%-20% of those affected by chickenpox will develop shingles at some point in their lives. at some point in their lives. The virus reoccurs intermittently in different situations, but usually with the weakening of the immune system.

Causes

When a person becomes infected with the Varicella-Zoster virus (usually in childhood but also in adulthood), he or she develops chickenpox, a disease characterized by reddish watery rashes on the skin, which then crust over. Fever is also a symptom of this disease. After about two weeks, our body takes control of the infection and the symptoms are reduced..

However, the absence of symptoms does not mean that the virus has disappeared, as it can remain inside the body and manifest itself throughout life. Although in the initial stages of chickenpox, it invades the nerve endings of the skin, it can migrate to some chains of ganglia located next to the spinal cord and brain, where they remain hidden even for decades.

Below you can watch a video in which an expert talks about these diseases.

Symptoms and signs

Shingles is not only a visually very unpleasant disease, but it can also cause great pain to the person. can cause great pain to the person suffering from it.. The symptom picture usually begins with the patient's malaise: the patient is tired and fatigued. After two or three days, pain and itching appear and in many cases a great sensitivity in the area of the affected nerve and then the cutaneous manifestations occur, with reddish swelling in this area and some cluster-shaped nodules are formed. Later, vesicles are formed which may have different sizes, even the size of a pea. As the days go by, the skin dries and crusts appear.

The cutaneous manifestation usually occurs on the skin of the chest or abdomen, commonly starting on the spine and extending to the front of the body, like a half-belt (hence the colloquial name shingles). Occasionally, it can cause paralysis of the trunk, although this is rare.

However, when the virus is in the cranial nerve, shingles can also appear on the face, for example, in the eye, nose, forehead, jaw and scalp of one half of the face (called zoster ophthalmicus). This can cause serious problems, because if it affects the cornea of the eye it can even lead to loss of vision.

When shingles occurs in the ear, it is called zoster oticus and in up to 60% of the cases it causes facial paresisthat is, paralysis of the face (usually disappears with time). Shingles can appear on any part of the body (including the genitals), and occurs at any stage of life under conditions in which the immune system is not functioning properly. It most frequently appears after the age of 50.

Postherpetic neuralgia: when shingles becomes complicated

The symptoms of shingles usually last from 2 to 4 weeks, although sometimes the outbreak becomes complicated and what is known as postherpetic neuralgia appears, as the pain continues but not the skin manifestations.

Slightly less than 4% of patients with herpes zoster experience this complication, which may persist for months or years or permanently. The pain of postherpetic neuralgia can be sharp and intermittent or constant and can be very debilitating.

Treatment

Undoubtedly, the best treatment for shingles is prevention, and vaccination has been shown to be very effective in more than 50% of cases. in more than 50% of cases. However, in Spain social security does not cover its administration and in Europe it is only authorized for those over 50 years of age. There is the possibility of vaccination against chickenpox, but some studies conclude that although it reduces the symptoms and the appearance of chickenpox, shingles continues to appear.

When a person suffers from this problem and it manifests itself, treatment should begin as soon as possible.However, not to eliminate the virus, which is not possible, but to alleviate the symptoms. Doctors usually prescribe creams such as acyclovir or corticosteroids to relieve pain and also Antiviral drugs. In cases where postherpetic neuralgia occurs, different drugs may be administered including gabapentin, cyclic antidepressants or lidocaine patches. Opioid analgesics may be necessary and intrathecal methylprednisolone may be beneficial. Recent studies suggest that multiple injections of botulinum toxin A into the area may reduce pain.

Differences between herpes zoster and herpes simplex

It is important not to confuse herpes zoster with herpes simplex (labial and genital).They are caused by different viruses, which belong to the herpesviridae viral family. Herpes zoster is caused by the varicella-zoster virus (VZV) as I have already mentioned, also called human herpes virus-3 (HHV-3); however, herpes simplex is spread by the herpes simplex virus (HSV-2) on the genitals and (HSV-1) on the lips, cheeks or nose.

How it is spread

In the case of herpes simplex, it is not necessary to have had chickenpox, so it is spread from person to person, for example, by kissing. Shingles is not contagious from one person to another; however, the individual with shingles can transmit the virus from one person to another when the subject who is exposed to the virus has not previously had chickenpox. When this occurs, the person does not develop shingles, but chickenpox.

If you want to know more about shingles, you can view the audiovisual content below.