Herpes Zoster

Herpes zoster, also known as shingles, is a viral infection caused by the varicella-zoster virus, which is the same virus that causes chickenpox.

Cause and Risk Factors

The varicella-zoster virus remains dormant in the nerve cells after a person has recovered from chickenpox. Years or even decades later, the virus can reactivate and cause shingles. The risk of developing shingles increases with age, and people over 50 years old are more likely to get the condition. Other risk factors include:

• Weakened immune system due to illness, medication, or stress
• Cancer, particularly lymphoma or leukemia
• HIV/AIDS
• Organ transplant recipients
• Pregnancy

Symptoms

The symptoms of shingles typically begin with a burning or tingling sensation on one side of the body, usually on the chest or abdomen. A rash then appears, which can be painful and itchy. The rash consists of small blisters that crust over and heal within 2-4 weeks. Other symptoms may include:

• Fever
• Headache
• Chills
• Upset stomach
• Fatigue

Diagnosis

A diagnosis of shingles is typically made based on the appearance of the rash and the patient's medical history. A physical examination and laboratory tests, such as a viral culture or PCR (polymerase chain reaction) test, may be performed to confirm the diagnosis.

Treatment

Treatment for shingles usually involves antiviral medications, such as acyclovir, valacyclovir, or famciclovir, which can help reduce the severity and duration of the symptoms. Pain relief medications, such as acetaminophen or ibuprofen, may also be prescribed to manage pain and discomfort.

In some cases, corticosteroids may be used to reduce inflammation and swelling. Topical creams or ointments, such as capsaicin or lidocaine, can help relieve pain and itching.

Complications

Shingles can lead to several complications, including:

• Postherpetic neuralgia (PHN), a condition characterized by persistent pain after the rash has healed
• Bacterial infections of the skin or soft tissues
• Eye problems, such as uveitis or keratitis, if the rash affects the eye
• Hearing loss or tinnitus (ringing in the ears) if the rash affects the ear
• Ramsay Hunt syndrome, a condition that causes facial paralysis and hearing loss

Prevention

A vaccine is available to prevent shingles, known as the zoster vaccine. The Centers for Disease Control and Prevention (CDC) recommends that adults aged 50 years and older receive two doses of the vaccine, separated by 2-6 months.

Practicing good hygiene, such as washing hands frequently and avoiding contact with people who have weakened immune systems, can also help prevent the spread of the varicella-zoster virus.