Herpes zoster (shingles)

Her­pes zos­ter is cau­sed by reac­ti­va­ti­on of the vari­cel­la zos­ter virus, which remains in the ner­ve gan­glia for life after a chi­cken­pox infec­tion. When it beco­mes acti­ve again it tra­vels along a ner­ve to the skin, whe­re it cau­ses a pain­ful, band-shaped rash.

Cau­ses

A tem­po­ra­ry weak­ne­ss of the immu­ne sys­tem encou­ra­ges reac­ti­va­ti­on, for exam­p­le through age, stress, other ill­nesses or immu­no­sup­pres­si­ve medi­ca­ti­on. The risk rises mark­ed­ly from the age of six­ty. Shin­gles its­elf is not con­ta­gious in the clas­sic sen­se, but the flu­id in the blis­ters can cau­se chi­cken­pox in peo­p­le wit­hout immunity.

Sym­ptoms

Usual­ly the­re is first an abnor­mal sen­sa­ti­on, bur­ning or pain in a limi­t­ed area of skin. A few days later grou­ped blis­ters appear on a red­den­ed base, fol­lo­wing one ner­ve seg­ment on one side of the body in a belt-like pat­tern. Par­ti­cu­lar cau­ti­on is nee­ded if the face, eye or ear is affected.

Tre­at­ment

Anti­vi­ral the­ra­py should ide­al­ly start within 72 hours of the rash appearing in order to shor­ten the cour­se and the dura­ti­on of pain. In addi­ti­on, pain is trea­ted con­sis­t­ent­ly and the blis­ters are cared for with dry­ing pre­pa­ra­ti­ons. The most important late com­pli­ca­ti­on is post-her­pe­tic neur­al­gia with per­sis­tent ner­ve pain; vac­ci­na­ti­on can signi­fi­cant­ly redu­ce the risk.