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Information on Herpes Zoster Shingles

Herpes zoster, or shingles, is a disease caused by the varicella-zoster virus, which also the virus that causes chickenpox. More than 500,000 people a year develop shingles, or an estimated two in every 10 people in their lifetime. After a person has the chickenpox, the virus becomes dormant in the body. It is unknown how the virus becomes active and re-infects the body, but signs have been linked to aging, stress or a suppressed immune system.

After chickenpox, the virus is non-active in the nerve tracts that emerge from the spine. When the virus becomes active again in body, it spreads along the nerve tract, which causes pain or a pain in the form of a burning sensation, generally on one side of the body or face. Early signs of herpes zoster, or shingles, include burning or shooting pain, tingling and itching. Often the pain associated with early signs of shingles is severe.

The common rash characteristic of shingles appears in two to three days, once the virus has reached the skin. Red patches of skin with small blisters appear on the surface of the skin, with small blistered areas. The rash looks very much like chickenpox. In the next three to five days, however, the rash increases, mostly on the one side of the body where the infection began. Within a week of the first appearance of the rashes, the infected areas will begin to form into blisters. The blisters form into small ulcers, which start to dry and form crusts along the edges. In the healing process, over a two to three week period the crusts will fall off the skin and leave behind pink healing skin. The skin will be very sensitive.

The rashes typically appear unilaterally, or on one side of the body. The middle section or trunk of the body is most often affected, appearing like a belt of rashes from the spine around one side of the chest to the breastbone. Lesions can occur on the face or neck, especially along the trigeminal. The trigeminal consists of three branches that go into the forehead, the mid-face and lower face. Shingles in the trigeminal may cause lesions in your eyes or mouth. These lesions can cause temporary or permanent blindness if not treated with emergency medical care.

Shingles is more common in people over the age of 50, but if you have had chickenpox, you are at risk for developing shingles. The disease is also prevalent among those people with weakened immune systems from HIV infection, transplant operations, radiation or chemotherapy treatments and excessive stress.

Other symptoms of herpes zoster aside from the burning or intense sensations of sharp pain include reddening of the skin, known as erythema followed by the blistering of the skin. Those infected with herpes zoster may also have grouped, dense small blisters that ooze and crust. More symptoms include headache, general nausea, fever, chills, lymph node swelling, impaired vision and taste, hearing loss, joint pain, abdominal pain and drooping eyelid, also known as ptosis.

Diagnosis is determined by the appearance of skin lesions and a prior history of chickenpox or other occurrences of shingles. Note, herpes zoster can be confused with herpes simplex. But herpes zoster has characteristic traits in the appearance of lesions and pain along one side of the body. Tests to diagnose herpes zoster are often not necessary but if a doctor suspects shingles, he or she may perform a viral culture of the skin, tzanck test of skin lesion, complete blood count to show elevated white blood cells, which can indicate infection and a specific antibody measurement to see elevated levels of varicella antibodies.

To treat herpes zoster, there are a number of medications and treatment options. Herpes zoster often resolves itself spontaneously and may not require treatments aside from pain medication for the relief of symptoms. However, if treatment is needed, often acyclovir, an antiviral medication, can shorten the course of herpes zoster and reduce pain and complications. Acyclovir is usually prescribed to those individuals who have compromised immunities. Acyclovir or like medicines have the greatest effect if started within 24 hours of the first appearance of lesions, pain or burning sensations. This type of medicine is to be taken orally, often four times a day.

Corticosteroid, for example prednisone, is also a common treatment for herpes zoster. Corticosteroid treatments can reduce the inflammation and are often used with the elderly infected with the disease. For pain, analgesics are often prescribed to patients. Antihistamines are also used to reduce inflammation and itching by applying topically or taken orally. Doctors also recommend that patients with herpes zoster outbreaks use cold compresses to reduce pain, take baths with soothing additives including oatmeal, starches or lotions. Calamine lotion can also help the itching associated with herpes zoster. Bed rest is also recommended, along with keeping skin clean and the disinfecting of items in the home; sheets, towels and clothes to prevent the spread of the disease.

Disinfection is important in the prevention of herpes zoster spreading to others. Contact with those infected with herpes zoster can spread the disease, especially if you have never had the chickenpox or shingles in your lifetime or your immune system is compromised. During childhood, it is recommended that children receive the chickenpox vaccine, varicella.

However, research is being done to prevent shingles, or herpes zoster. A national study of an experimental vaccine was recently conducted by several centers of study including the Department of Veteran Affairs, the National Institute of Allergy and Infectious Diseases and Merck & Co, the vaccine producer. The study concluded that the herpes zoster vaccine showed marked reduced illness from the disease among older adults. Merck & Co submitted a license application to the Food and Drug Administration for the vaccine in April of 2005. The researchers have estimated that if the vaccine is approved and used, it could prevent 250,000 cases of herpes zoster in the United States and reduce the severity of the disease in just as many cases annually. The National Institutes of Health (NIH) also conduct research in its NIH laboratories and throughout the country. Research is underway to find new ways to prevent herpes zoster.

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