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 manifests itself intermittently in different situations, but generally with the weakening of the immune system.
Causes
When a person is infected with the Varicella-Zoster virus (usually occurs in childhood but also in adulthood), they develop chickenpox, a disease characterized by reddish watery rashes on the skin, which later turn into a scab. . 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, although 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 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 watch a video in which an expert tells us about these diseases.
Symptoms and signs
Shingles is not only a very unpleasant visually disease, but It can cause great pain to the person who suffers from it The symptomatic picture usually begins with the patient’s discomfort: the patient is tired and fatigued. After two or 3 days, pain and itching appear and in many cases great sensitivity in the area of the affected nerve and then skin manifestations occur, with reddish swelling in this area and cluster-shaped nodules form. Later, vesicles form that can have different sizes, even reaching the size 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 starting at the spine and extending towards the front of the body, like a middle belt (hence this infection is colloquially called shingles) . Occasionally, it can cause paralysis of the trunk, although this is rare.
Now, when the virus is found in the cranial nerve, shingles can also appear on the face, for example, on the eye, nose, forehead, jaw, and the 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 of the face (it usually disappears over time). Shingles can appear anywhere on the body (including the genitals), and occurs at any stage of life when conditions exist in which the immune system does not function properly. It is more common to appear after the age of 50.
Postherpetic neuralgia: when herpes becomes complicated
The symptoms of herpes zoster 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 the skin manifestations do not.
Just under 4% of patients with herpes zoster 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 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 appearance of chickenpox, shingles continues to appear.
When a person suffers from this problem and it manifests itself, treatment should begin as soon as possible, but not to eliminate the virus, which is not possible, but to relieve 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 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 into the area several times can reduce pain.
Differences between herpes zoster and herpes simplex
It is important not to confuse herpes zoster with herpes simplex (labial and genital), as they are produced by different viruses, which belong to the herpesviridae viral family. Shingles 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 area.
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 to 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 had chickenpox. When this occurs, the person does not develop shingles, but rather chickenpox.
If you want to know more about shingles, you can view the audiovisual content that you can find below.
