Herpes zoster is a viral disease that affects the skin and nerve endings. It is characterized by severe pain and rashes on the epidermis. Pathology is caused by the same virus as chicken pox. It is more common in middle-aged and older people. This disease has other names - herpes zoster, or shingles. Every person who has had chickenpox, under adverse conditions, can get this ailment. After all, the virus remains in human cells even after full recovery from chickenpox.
Pathogen
As already mentioned, the causative agent of herpes zoster is the varicella-zoster virus. In medicine, it is called the herpes virus of the third type, or Varicella Zoster (varicella zoster). This microorganism, once inside a person, remains for a long time in the neurons of the roots of the spinal cord. Therefore, only those people who have had chickenpox in the past suffer from shingles.
The mechanism of the occurrence of the disease is as follows:
- After suffering chickenpox, the virus does not disappear, but remains in the bodyfor many years. It is found in the nerve cells in an inactive form.
- Under adverse conditions, the virus is activated. He becomes sick again.
- A person has signs of herpes zoster.
You can say that shingles is a relapse of the chickenpox virus. The disease can occur many years and even decades after the infection.
Is the disease contagious
The herpes zoster virus is easily transmitted to others by airborne droplets and contact. You can also become infected through items that the patient used: towels, bedding and underwear, clothes. In this case, the infected person does not develop herpes zoster, but chicken pox. The patient is a danger to children and adults who do not have immunity against chickenpox. It is impossible to transmit the disease in the form of shingles.
Provoking factors
It is currently unknown exactly what activates the herpes zoster virus. With a strong resistance of the body, the pathogen can be in a "sleeping" state for a very long time. It is assumed that its activation is due to a decrease in immunity. In children under 10 years of age, shingles is not observed. Most often, the disease manifests itself after 60 years, when a person's immunity decreases with age.
The following causes of herpes zoster can be identified:
- diseases leading to a decrease in immunity (chronic internal pathologies, HIV infection, tumors);
- stress;
- bad food;
- avitaminosis;
- hypothermia;
- treatment with corticosteroids or cytostatics.
It can be concluded that the risk group includes people with weak immunity who have had chickenpox in the past.
Symptomatics
The disease can affect different parts of the body. Most often, the focus of rashes is localized on the trunk, less often on the face and in the ears. In the initial stage, a person experiences pain, burning and itching at the site of the future lesion. General well-being is disturbed, the temperature often rises. Feeling weak and broken. This period of illness lasts about 1-3 days.
Then, redness, swelling and rashes appear on the affected area. This rash looks like blisters filled with a colorless liquid. It resembles the skin manifestations of chickenpox. Within 3-5 days, a person develops more and more rashes. This is how skin signs and symptoms of herpes zoster appear in adults. A photo of a rash on the epidermis of a sick person can be seen below.
Then the process of bubble formation stops, their content breaks out. A serous crust or erosion forms on the surface of the former rashes, which disappears after 7-14 days. Complete healing of the skin can take from 2 weeks to 1 month. Traces at the site of herpetic eruptions usually do not remain.
It is important to remember that the patient is contagious during the entire period when new blisters form on his skin. After the rashes are coveredcrusts, the patient stops excreting the virus and does not pose a danger to he althy people.
Itching with herpes zoster is expressed to varying degrees. However, this symptom always accompanies this disease. In some patients, excruciating unbearable itching is noted, which is difficult to stop. A bacterial infection can penetrate into the wounds through scratching on the skin, which significantly complicates the course of the disease.
The appearance of rashes is often accompanied by severe pain. This is due to the fact that bubbles on the skin form along the nerve endings. Very often the rash is localized in the region of the ribs. The virus affects not only the skin, but also the peripheral nerves. There are severe excruciating pains of the type of neuralgia. They can radiate to the region of the heart, under the scapula, to the lower back. Unpleasant sensations usually increase at night.
After the illness, the patient goes into stable remission. Relapses of pathology are extremely rare.
Forms of pathology
The general manifestations of herpes zoster have been described above. However, there are several varieties of this disease. Each form of this pathology is characterized by its specific symptoms. The following types of shingles are distinguished:
- Eye shape. Rashes are noted on the face along the trigeminal nerve. The disease is accompanied by severe pain syndrome. Herpes zoster in the eye form is characterized by inflammatory processes in the organ of vision. Patients present with keratitis, blepharitis, orconjunctivitis of herpetic origin. There is redness and severe pain in the eyes.
- Ear shape. Localization of manifestations of herpes zoster on the face is noted. The virus infects the nerve that sets the mimic muscles in motion. Rashes are observed in the ear area, as well as in the mouth. They are very painful, the patient cannot bear even a slight touch on the skin. Due to damage to the facial nerve, muscle paralysis occurs on the affected side. The patient's face looks distorted. There is severe pain in the ear, hearing worsens. Due to a violation of the innervation of the tongue, the patient does not distinguish the taste of food. Doctors call this symptom complex Ramsey-Hunt syndrome.
- Bullous shape. This type of disease is characterized by severe skin manifestations. Rashes merge with each other and form extensive areas of damage. The skin is covered with large blisters that take a very long time to heal.
- Generalized form. Local rashes eventually spread over the entire surface of the body. A blistering rash covers most of the trunk. This form of the disease occurs in severely immunocompromised patients.
- Hemorrhagic form. With this type of pathology, the vesicles are not filled with a colorless liquid, but with bloody contents.
- Gangrenous form. In the area of the rash, tissue necrosis occurs. After healing, scars may remain on the skin.
- Meningoencephalitic form. This type of pathology is characterized by an extremely severe course. The virus affects not only the peripheral nerves, but also the brain. There is a strongheadache, vomiting, fever, hallucinations. The meningoencephalitic form of the disease is extremely dangerous, it leads to death in more than half of cases.
- Erased (abortive) form. There is a rash in the form of pimples on the skin. Unlike bubbles, such rashes do not contain liquid. Skin manifestations do not last long and quickly disappear. This is the most difficult form of the disease to diagnose.
Complications
Unfortunately, patients do not always manage to get off, so to speak, with little blood or a slight fright. What can patients who are diagnosed with herpes zoster face? Complications can be quite serious. The most common consequence of the disease is postherpetic neuralgia. It is expressed in the fact that the patient retains pain in the affected areas even after complete healing of the skin. In addition, there is a strong itching (in the absence of rashes), numbness, a feeling of crawling "goosebumps" on the skin. Sometimes it is very difficult to stop discomfort even with the help of strong analgesics, and you have to additionally apply physiotherapy.
A part of patients after the disease periodically experience attacks of headache and dizziness. With the eye and ear form of the pathology, a sharp decrease in vision and hearing is possible, as well as paralysis of the facial muscles.
In extremely rare cases (about 0.2%), patients develop heart and vascular disease that leads to ischemia.
As for the prognosis for life, the danger is meningoencephaliticform of the disease. It can lead to the death of the patient. This form of pathology is observed very rarely, mainly in people with sharply reduced immunity. All other types of herpes zoster respond well to treatment and end in recovery.
Diagnosis
Diagnosis of herpes zoster is not difficult. The doctor detects the disease during the examination. External signs of this pathology are so characteristic that additional laboratory diagnostics is usually not required. Only in rare cases, serological tests of blood or the contents of vesicles on the skin are prescribed.
If there are signs of shingles, you should consult a general practitioner (physician). He will conduct an initial examination and make a diagnosis. For further treatment, the patient is usually referred to an infectious disease specialist or dermatologist.
Therapy Methods
Usually, the treatment of this disease is carried out in a clinic. However, if the patient has a bullous, generalized or meningoencephalitic form of the disease, then hospitalization is indicated. Such severe pathologies require constant medical supervision.
Therapy for shingles is aimed at solving the following problems:
- virus inactivation;
- relieve pain and inflammation;
- rapid skin healing;
- immunity boost.
Oral antivirals are given first:
- "Aciclovir".
- "Valacyclovir".
- "Famvir".
- "V altrex".
Additionally, antiviral ointments are used to treat rashes: Acyclovir, Zovirax, Panavir. They are applied to the affected areas in the form of compresses. However, ointments are effective only at the stage of formation of active rashes. During the appearance of crusts and at the stage of skin healing, it makes no sense to use antiviral topical agents.
These medicines for internal and topical use inhibit the reproduction of the virus. The drug "Acyclovir" (in the form of tablets and ointment) is most effective. It is the first choice in the treatment of herpes zoster in adults. A photo of the packaging with this medication can be seen below.
After the rash has crusted over, the affected areas are treated with antiseptic solutions of brilliant green or methylene blue. This will help to avoid infection of the wounds. If there is a danger of bacteria attaching, then oral antibiotics are used.
If the virus affects the organ of vision, then eye drops "Interferon", "Ophthalmoferon" are prescribed. They have antiviral properties.
Patients with shingles suffer from severe excruciating pain. Therefore, non-steroidal anti-inflammatory drugs (Diclofenac, Ibuprofen, Ketanov) or analgesics (Baralgin, Pentalgin) are necessarily used in the treatment. If the pain syndrome is difficult to treat andis delayed for a long time, then antidepressants are additionally used: Amitriptyline, Fluoxetine, Duloxetine, Venlafaxine. In severe cases, novocaine blockades are carried out.
To relieve itching, corticosteroid ointments with dexamethasone or hydrocortisone are prescribed. However, hormonal agents can be used for a very short time and with caution. These drugs reduce the immunity that the body needs to fight the virus. Therefore, with itching, antihistamines are more often used: Suprastin, Claritin, Dimedrol. A good effect is given by the non-hormonal ointment "Fenistil".
Interferon preparations play a big role in the treatment of herpes zoster. These are immunomodulators that mobilize the body's defenses to fight infection. Usually, for herpes, drugs are prescribed: Interferon, Viferon, Galavit. Additionally, vitamins A, C and group B are used. This also helps to strengthen the immune system.
The treatment of herpes zoster in the elderly has its own characteristics. In older patients, side effects from the use of drugs are often noted. Therefore, therapy should be gentle. Oral forms of antiviral drugs, if necessary, are replaced with rectal suppositories with a similar active ingredient. The course of treatment with painkillers should not continuemore than 5 - 7 days. Particular care must be taken when prescribing "Analgin". This remedy has a toxic effect on the body of elderly patients, therefore, during therapy, it is necessary to monitor the patient's well-being.
Quick treatment with folk remedies
Is it possible to carry out effective treatment of herpes zoster at home? Quickly get rid of the virus with only one use of folk remedies will not work. This disease requires the use of medications and medical supervision. Self-medication can only lead to the development of complications.
However, you can reduce the most unpleasant manifestations of the disease with the help of folk remedies. But their use must be agreed with the doctor. Home therapy should complement medical treatment for herpes zoster. The following recommendations will help to quickly stop the symptoms of the disease:
- With skin manifestations, alcohol tincture of walnut is useful. This drug can be purchased in pharmacy chains. It is applied to cotton wool and rubbed on the affected areas three times a day.
- You can use an ointment of propolis, cedar resin and wax. It can also be purchased at a pharmacy. It is sold under the trade name "Propolis wax-cream with cedar oleoresin". The ointment is applied to rashes 2-3 times a day.
- It is recommended to take half a tablet of "Acetylsalicylic acid" per day. However, the use of such a remedy requires the mandatory consultation of a doctor.
The use of these remedies in conjunction withdrug therapy significantly speeds up the healing process.
Therapy Reviews
There are many different opinions about the medical treatment of herpes zoster. Reviews of the treatment indicate that the best result is achieved with an integrated approach. It is far from always possible to cope with the disease with local remedies alone. Patients report that oral and topical antiviral drugs are most effective.
Judging by the reviews, postherpetic neuralgia is the most difficult to treat. This usually helps with the appointment of painkillers in combination with antidepressants. Physiotherapeutic procedures helped many patients get rid of post-herpetic pain: transcutaneous electrical stimulation, electrophoresis, UHF.
Prevention and vaccination
To prevent pathology, all people who have had chickenpox in the past should be attentive to their he alth. It is very important not to allow a decrease in immunity. It must be remembered that the virus remains in the body and can become active at any time. Therefore, it is important to strengthen the body's defenses, eat well and, if possible, avoid stress and hypothermia. Elderly people especially need to take care of themselves, because they have shingles most often.
Currently created vaccine "Zostavax". It is the only vaccine available for shingles in the world. Vaccination is indicated for people over the age of 50 - 60 years, adults who have not had chickenpox, andalso in patients with postherpetic neuralgia. The use of the Zostavax vaccine will help prevent an unpleasant and painful disease.
