Shingles: causes, symptoms and treatment

Herpes zoster is a viral infection that should not be confused with herpes simplex and that it 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 chickenpox virus that remains latent, so to suffer from 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 in the cranial nerves.

Statistics indicate that between 15% -20% of those affected by chickenpox will develop shingles at some point in your life. The virus reappears in different situations intermittently, but generally with a weakening of the immune system.

Causes

When the person is infected with the Varicella-Zoster virus (it usually occurs in childhood but also in adulthood), develop chickenpox, a disease characterized by reddish watery rashes on the skin, 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, as it can continue 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 during decades.

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

Symptoms and signs

Shingles is not only a very visually unpleasant disease, but can cause great pain to the person who suffers it. The symptomatic picture usually begins with the discomfort of the patient: the patient is tired and fatigued. After two or 3 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 nodules in the form of cluster. Later vesicles are formed that can have different sizes, even reaching that of a pea. As the days go by, the skin dries and scabs appear.

Normally, the cutaneous manifestation takes place on the skin of the chest or abdomen, commonly beginning on the spine and spreads towards the front of the body, like a half belt (for which this infection is colloquially called shingles). It can occasionally 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 For example, on 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 cause 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 in the face (usually disappears with time). Shingles can appear anywhere on the body (including the genitals), and occurs in any stage of life when there are conditions in which the immune system is not working correctly. It is more common to appear after the age of 50.

Post-herpetic neuralgia: when herpes gets complicated

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

Slightly less than 4% of patients with shingles experience this complication, which can 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

Without a doubt, the best treatment for shingles is prevention, and for this, vaccination has proven to be very effective in more than 50% of the cases. However, in Spain social security does not cover its administration and in Europe it is only authorized for those people who are over 50 years old. There is the possibility of vaccination against chickenpox, but some studies conclude that although it reduces the symptoms and the appearance of chickenpox, herpes zoster continues to appear.

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

Differences between shingles and herpes simplex

It is important not to confuse shingles with herpes simplex (labial and genital), as they are produced by different viruses, which belong to the viral family herpesviridae. Herpes zoster is caused by the varicella-zoster virus (VZV) as I have already mentioned, also called human herpes-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 is it 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 are not contagious from one person or 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 suffered from chickenpox. When this happens, the person does not develop shingles, but chickenpox.

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