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Herpes zoster

What is it?

Herpes zoster is also known as "shingles." It is an infection of the skin. The virus lives in your central nervous system (CNS). The CNS includes the brain and the spinal cord. The brain and spinal cord connect to nerves in the skin and the rest of the body. People 50 years or older get herpes zoster most often. A person who has not had chickenpox can get chickenpox from you if you have shingles. You can have shingles more than once.

Causes:

A germ called varicella (vair-ih-chell-uh) causes both chickenpox and shingles. This germ can infect you but not cause any symptoms. This is called lying "dormant." The virus can become active at any time, causing symptoms.

Signs and Symptoms:

You will have small fluid-filled blisters on red skin. The blisters usually appear in a wide band on one side of your body. This is because they are following the path of a nerve, making the skin near it very tender. The sores may take a few hours to a few days to show up. You may also have chills, fever, or nausea. You may have pain in your abdomen (belly), chest, or face.

Your skin may feel like it's burning. Pain may be constant or come and go and may last for 3 to 5 weeks until the rash is gone. Some people have pain, itching, or skin burning for months or years.

Wellness Recommendations:

Many people notice that they get shingles when they are under stress (work, a death, or other problems). Try reducing stress (see RELAXATION TECHNIQUES document). Do not bandage the skin sores. When bathing, gently wash the blisters but do not open them because this could cause an infection. Until the rash is healed, stay away from people who have not had chickenpox or who are sick.

Medical Care:

Aspirin or other pain-relievers that you can buy in a store may be helpful to control fever and to lessen pain. You need rest and liquids. Lukewarm baths and calamine lotion may help you feel better. Use heat to lesson pain. Heat brings blood to the area and helps it heal faster. Use a heating pad (turned on low), a hot water bottle, or sit in a warm water bath. Do this for 10 to 20 minutes every hour for as long as you need it. Do not sleep on the heating pad or hot water bottle. This can cause a bad burn.

There are a variety of medical treatments for herpes zoster, including:

  • Antiviral medications are helpful if used shortly after the outbreak occurs.
  • Antidepressants, in low doses, can help if chronic pain develops afterward.
  • Anticonvulsants can be used if chronic pain develops.
  • Capsaicin creams (made from hot peppers) can be used on the skin to reduce chronic pain (once the sores have healed).
  • Analgesics are sometimes used for pain but are usually not very effective.
  • A TENS (transcutaneous electrical nerve stimulator) unit at the affected site may decrease pain.

Dietary Measures:

There are no dietary treatments that help herpes zoster. Avoiding nuts and chocolate may be helpful.

Herbs and Supplements:

Before taking any herbs or supplements, ask your caregiver if it is OK. Talk to your caregiver about how much you should take. If you are using this medicine without instructions from your caregiver, follow the directions on the label. Do not take more medicine or take it more often than the directions tell you to. The herbs and supplements listed may or may not help treat your condition.

Herbs:

    Supplements:

      Complementary Therapies:

      • Acupuncture has been helpful for the nerve pain that sometime happens after herpes zoster has gone away.
      • Biomagnets have been found to help in other nerve pain and may help in the nerve pain that sometimes happens after zoster has gone away.

      Other ways of treating your symptoms : Other ways to treat your symptoms are available to you.

      Talk to your caregiver if:

      • You would like medicine to treat herpes zoster.
      • Your symptoms have not gone away or improved by these self-help measures.
      • You have questions about what you have read in this document.

      SEEK CARE IMMEDIATELY IF:

      • You become confused, get neck stiffness, or have trouble walking or moving muscles.
      • You get blisters on your eye or eyelids.

      Care Agreement:

      You have the right to help plan your care. To help with this plan, you must learn about your health condition and how it may be treated. You can then discuss treatment options with your caregivers. Work with them to decide what care may be used to treat you. You always have the right to refuse treatment.

      References:

      1. Bernstein JE, Korman NJ, Bickers DR et al: Topical capsaicin treatment of chronic postherpetic neuralgia. J Am Acad Dermatol 1989; 21(2 pt 1):265-270.

      2. Grachev IuV, Kukushkin ML, Sudarikov AP et al: Clinical course and treatment of herpetic trigeminal ganglionic neuropathy. Zh Nevrol Psikhiatr Im S S Korsakova 1998; 98(11):4-8.

      3. Sklar SH, Blue WT, Alexander EJ et al: Herpes zoster. The treatment and prevention of neuralgia with adenosine monophosphate. JAMA 1985; 253(10):1427-1430.

      4. Vallbona C, Hazelwood CF & Jurida G: Response of pain to static magnetic fields in post polio patients: a double-blind pilot study. Arch Phys Med Rehabil 1997; 8(11):1200-1203.

      5. Weintraub MI: Chronic submaximal magnetic stimulation in peripheral neuropathy. Am J Pain Management 1998; 12-16.

      6. Weintraub MI: Magnetic bio-stimulation in painful diabetic peripheral neuropathy: A novel intervention-a randomized, double-blind, placebo-crossover study. Am J Pain Management 1999; 9:8-17.


      Last Updated: 4/4/2014

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