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... see also   Herpes sheets - Vic health Department 2 page pdf

What is herpes zoster?

It is an infection in a nerve by the same virus that causes chickenpox. The term comes from the Greek herpes (to creep) and zoster (a belt or girdle). Shingles is from the Latin cingere (to gird) or cingulum (a belt).

How does it occur?

Contact with someone with chickenpox may cause it, but usually it is a reactivation of the chickenpox virus lying dormant (often for many years) in the root of a nerve in the brain or spinal cord. The dormant virus can be stirred into activity by stress or by the loss of natural immunity as we get older. The virus multiplies and spreads, causing pain in the nerve in which it resides.

Where does it occur?

  • Almost any part of the body can be involved, but a common site is the right or left side of the chest or abdomen.
  • What are the symptoms?
  • Apart from feeling unwell, sometimes with a fever, the main symptoms are pain and a rash.

Pain

  • This can vary from mild to severe.
  • It is burning in nature, but can be knife-like.
  • It precedes the rash and lasts for 1 week after the blisters disappear; it can persist for several weeks.
  • It always improves in time.
  • Rash

Groups of blisters appear in the skin that is supplied by the nerve. They itch and become crusted. The rash disappears after about 7 days but will leave scars or discoloured skin.

Who gets herpes zoster?

This relatively common disease is unpredictable and a person of any age can be affected. It is seen more often in people over the age of 50; sometimes children will get it during a chickenpox epidemic.

Is it contagious?

Yes, but only mildly. Rarely, children might acquire chickenpox after contact wit someone who has herpes zoster, but it would be very unusual to 'catch' herpes zoster from another person.

Can the problem recur?

It is possible but most unlikely. One attack generally protects you from a second attack and gives lifelong immunity.

Old wives' tales

It is not true that it is a dangerous disease or that the patient will go insane. Another myth is that a person will die if the rash spreads from both sides and meets in the middle: this is nonsense.

For the majority, herpes zoster is a mild disease and an excellent recovery can be expected.

What is the treatment?

  • There is no cure for this viral infection, but you should see a doctor without delay because proper treatment may reduce the likelihood of pain after the sores have healed. You should:
  • Rest as much as possible.
  • Take simple pain-killers, such as aspirin or paracetamol, regularly.
  • Avoid overtreating the rash, which may get infected. Calamine lotion may be soothing, but removal of the calamine crust can be painful. A drying lotion such as menthol in flexible collodion is better.
  • New drugs that help relieve severe infections are acyclovir for the acute illness and capsaicin cream for painful skin.

Copyright 1995: John Murtagh, Professor of General Practice
Monash University, Melbourne, Australia

 

North East Valley Division General Practice, Victoria, Australia, Disclaimer 
Level 1, Pathology Building, Repatriation Campus, A&RMC, Heidelberg West VIC 3081. .. map
Phone: 03 9496 4333, Fax: 03 9496 4349,  Email: nevdgp@nevdgp.org.au
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