Herpes Zoster or Shingles: An Old "Friend"

If not controlled properly, herpes zoster can even cause blindness.

As if it were an old “friend”, herpes zoster is the adult manifestation of a virus we most likely suffered from as a child – the chickenpox virus. This classic childhood infection returns strongly in more than 75% of cases, although this time it has changed.

This virus surprises us with some manifestations known under the name of shingles. It’s a virus that takes advantage of the fast path of the body’s nerves to remain in our bodies. We’ll take a look at its causes and effects, as well as the appropriate treatment to control it and some recommendations.

Herpes zoster: resistance

In our early childhood, most people experience the famous chicken pox pustules.

In fact, it’s estimated that by the age of 10, 90% of the population has had this infection. Some cultures have the tradition of bringing kids with the virus together so that they go through the disease “in a controlled way”, in order to avoid its subsequent appearance in adulthood.

However, this virus is famous for its insistence, and, in search of a survival strategy, it seeks shelter in the nerve ganglia. These are hard-to-reach spots for defenses, and the virus tends to stay there as a “silent resident”.

It isn’t until years later that the herpes zoster virus ends its hibernation, taking advantage of the lowering of the body’s defenses. It’s at that moment that, instead of returning to the blood and creating the classic manifestation of chickenpox, it decides to move through the rapid channels of the peripheral nerves.

It especially affects the ganglia of the spinal cord, so its favorite highways are the nerves of the costal area and back. On some occasions, it can lodge in the facial ganglia, producing its annoying effects on the nerves in this area.

Manifestations

Once reactivated, the virus travels through the nerves, irritating them and causing pain. A burning, stabbing, stinging pain covers the initial period of 2-3 days. All this is accompanied by fever and malaise, typical of an immune system that is defending itself.

However, it doesn’t stop there, and the virus continues to multiply, depleting the nerves and working its way up to the skin. In this way, it creates a classic belt-shaped rash, with vesicles filled with fluid (and viruses!). Thus, it receives the famous nickname of shingles on its way through the nerves.

Complications appear when the virus takes the facial route, and it can affect the jaw, palate, tonsils, and even eyes and ears. Even if the virus has decided to opt for wider and more complex pathways, it can take the path of the central nervous system, manifesting meningitis and motor paralysis in the most complex cases.

In general, this whole process can take up to 10 days, although the total recovery of the skin can take up to 4 weeks, and nerve pain or neuralgia last for months.

Triggers

It’s estimated that the prevalence of this disease is higher after 50 years of age. The virus takes advantage of elusive defenses to develop, which is why the elderly are especially susceptible, where persistent neuralgia are more frequent.

Pregnant women are highly susceptible, with the possibility of pregnancy complications. In addition, people who haven’t contracted chickenpox or who aren’t vaccinated against it should be especially cautious. The blisters have most of the viral load to transmit the disease.

Treatment and prevention of shingles

The treatment of choice for shingles is to apply effective antivirals and pain relievers.

Among the most widely used antivirals, oral acyclovir is the treatment par excellence. We also have others such as valaciclovir, and even brivudine is being studied for its greater efficacy and simpler dosing regimen compared to their respective cycloviruses.

If the treatment is applied in the first 72 hours, the progress and sequelae of the disease are significantly reduced, especially regarding neuralgia.

Prevention

Maintaining a healthy lifestyle, based on a balanced diet and frequent physical activity, will help maintain strong defenses and prevent the spread of the virus.

On the other hand, there’s a vaccine for people at high risk: the elderly and pregnant women. In addition, vaccinating against chickenpox in those who have not suffered from it will be a way to prevent the spread of this disease.

Advice

The annoying manifestations of this infection can be avoided if we apply some strategies such as:

• Hygiene: We should wash our clothes and shower with soaps that don’t contain scents or perfumes. In this way, we will avoid increasing the irritation that occurs in this disease.
• Comfortable clothing: Loose, cotton clothing will reduce the discomfort caused by the disease.
• No creams or powders: We must avoid the application of creams to avoid skin irritation, as well as use those that the doctor has prescribed.
• Strengthen defenses: Helping the immune system fight viruses is the best defense and attack strategy.

Finally, remember that properly following the treatment prescribed by the doctor is necessary in order to prevent possible sequelae. Vaccination is an effective strategy in the highest risk cases, both for herpes zoster and chickenpox. If you have any questions about the disease or its treatment, consult your doctor or pharmacist.