Herpes zoster: causes, symptoms and treatment
Herpes zoster is a viral infection that should not be confused with herpes simplex and that is caused by the same virus as chickenpox.
In this article we will explain what this condition consists of, what its causes are and what we can do to treat it.
What is herpes zoster?
Herpes zoster (HZ) is a local reactivation of the varicella virus that remains latent, so to suffer this disease it is necessary to have had chickenpox. This occurs after the primary infection has occurred and the virus is present in the spinal ganglia of the spinal cord or cranial nerves.
Statistics indicate that between 15% -20% of those affected by chickenpox will develop herpes zoster at some point in his life. The virus manifests itself in different situations intermittently, but usually with the weakening of the immune system.
Causes
When the person is infected with Varicella-Zoster virus (usually occurs in childhood but also in adulthood), develops chickenpox, a disease characterized by watery reddish skin eruptions, which then become crusted . 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, even if the symptoms are not present it does not mean that the virus has disappeared, because it can continue inside the organism and manifest itself throughout life. Although in the initial phases 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 the brain, where they remain hidden even for decades.
Below you can see a video in which an expert tells us about these diseases.
Symptoms and signs
Herpes zoster is not only a visually very unpleasant disease, but also can cause great pain to the person who suffers . The symptom picture usually begins with the patient's discomfort: the patient is tired and fatigued. After two or three days, pains and itching appear and in many cases a great sensitivity in the area of the affected nerve and then skin manifestations occur, with reddish swelling in this area and cluster nodules form. Later vesicles are formed that can have different sizes, even reaching a pea. As the days go by, the skin dries and scabs appear.
Normally, the skin manifestation takes place in the skin of the thorax or the abdomen, which is commonly started in the spine and extends towards the front of the body, as a half belt (so this infection is called colloquial shingles) . Occasionally, it may cause paralysis of the trunk, although it is rare.
Now, 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 produce the loss of vision.
When herpes occurs in the ear, it is called zoster oticus and in up to 60% of cases it causes facial paresis , that is, paralysis on the face (usually disappears over time). Shingles can appear in any part of the body (including the genitals), and it occurs at any stage of life when there are conditions in which the immune system does not work properly. It is more frequent to appear after 50 years.
Postherpetic neuralgia: when herpes gets complicated
The symptoms of herpes zoster usually last from 2 to 4 weeks, although sometimes the outbreak is complicated and what is known as postherpetic neuralgia appears, because the pain continues but not the cutaneous 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 acute and intermittent or constant and can be very debilitating.
Treatment
Without a doubt, the best treatment of herpes zoster is prevention, and for this the vaccination has proven to be very effective in more than 50% of cases. However, in Spain, social security does not cover its administration and in Europe it is only authorized for people who are over 50 years old. There is the possibility of varicella vaccination, but some studies conclude that although it reduces the symptoms and the appearance of varicella, shingles continues to appear.
When a person suffers from this problem and manifests, the treatment should begin as soon as possible , but 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 can be administered, including gabapentin, cyclic antidepressants, or lidocaine patches. Opioid analgesics may be necessary and intrathecal methylprednisolone may be beneficial. Recent studies suggest that injecting botulinum toxin A several times in the area can reduce pain.
Differences between herpes zoster and herpes simplex
It is important not to confuse herpes zoster with herpes simplex (labial and genital) , because they are produced by different viruses, which belong to the viral herpesviridae family. Herpes zoster is caused by the varicella-zoster virus (VZV), as I have already mentioned, also called human herpes-3 (HHV-3, in English); however, herpes simplex is spread by the herpes simplex virus (HSV-2) in the genitals) and (HSV-1) in the area of the lips, cheeks or nose.
How it is spread
In the case of herpes simplex, it is not necessary to have suffered chickenpox, so it is spread from person to person, for example, with a kiss. Shingles is not contagious from one person or another; however, the individual with herpes zoster can transmit the virus from one person to another when the subject who is exposed to the virus has not previously suffered from chickenpox. When this happens, the person does not develop herpes zoster, but varicella.
If you want to know more about herpes zoster, you can visualize the audiovisual content that you can find below.
