Herpes zoster (also called as shingles) is an outcome of an attack by a virus called 'varicella-zoster' which is responsible for chicken pox. The condition causes an acute and localized infection on the skin resulting in a painful and blistering rash.

Herpes zoster may remain inactive in some specific nerve fibers following initial exposure. However, several factors like aging, tension, suppression of immune system and certain drugs or medications generally activate this condition.

Herpes zoster present in the nerves following an outbreak, affects only one side of the body or face because the layout of the nerves prevents it from moving towards other side.

It initially appears as a rash on the skin but soon turns into blisters and sores on the skin. The involvement of the nerve branch, which supplies the eye, may bring the forehead, nose and eyelids under the effect of Herpes zoster. The sores on the nose can be in indication for the involvement of eye in the condition.

Signs and Symptoms of Herpes Zoster

Herpes zoster not only affects the skin but also creates wide range of problems relating to eye. The severity of the condition largely depends upon the extent of its outbreak.

Following are the problems, which generally arise indirectly after an inflammation caused by Herpes zoster:

Flu-like symptoms i.e. fever, headache and fatigue.

Rash

Reddish, sensitive and sore skin

Painful blisters and sores appearing on the skin

Painful burning or throbbing, itching and tingling

Eye related problems

Redness

Sensitivity to light

Swellings in eyelids

Dryness of eyes

Blurred vision (depends upon the severity of the effect the eye)

Inflammation of Corneal resulting in scarring

Inflammation at inner part of the eye and optic nerve

Glaucoma

Cataract

Double vision

Loss of sensation

Diagnosis

The diagnosis, which may initially be suspected on the basis of the look of the skin lesions, can be strengthened by a previous history of chickenpox or shingles. Medical examinations are rarely required. However, following are the tests, which are generally conducted to confirm the diagnosis:

Viral culture (a test of skin lesion to confirm the presence of herpes zoster in the skin).

Tzanck test.

CBC (complete blood count) to determine elevation of white blood cells.

Measurement of immunoglobulin for determination of elevated varicella antibodies.

In case Herpes zoster leaves adverse impact on the eye, it becomes necessary to conduct medical examination through a slit lamp microscope and an ophthalmoscope. Visual acuteness and intraocular pressure are also observed.

What are possible complications?  

Post herpetic neuralgia

The condition may result in secondary bacterial skin infections

The condition may recur; albeit rarely.

Immunosuppressed individuals may be susceptible to generalized infection and visceral organ lesions. Encephalitis or sepsis may also occur in such individuals.

The formation of lesions in the eyes may cause blindness.

Deafness

Loss of taste

Facial paralysis

When to see a doctor?

See a doctor in case symptoms showing herpes zoster, especially if you have suppressed immune system or you feel deterioration of your condition.

Treatment

Treatment is rarely required for Herpes zoster because it often goes away on its own. However, Anti-viral, pain and anti-inflammatory medications may be prescribed for those who do not get desired relief from the condition.

Antiviral medication such as Acyclovir is prescribed for shortening the course and reducing pain, avoiding complications and protecting an individual with suppressed immune system.

Desciclovir, famciclovir, valacyclovir, and penciclovir that also work like acyclovir may also be prescribed for treatment.

The ophthalmic problems can be treated with eye drops and ointments. Surgery may be required in cases with secondary conditions caused by herpes zoster.

The infected persons should not come in contact with those who are more susceptible to contracting the disease. The elderly persons, kids, pregnant women and those with weak immune system are prone to infection. This is one of the useful herpes zoster treatment.

Self-care tips

If you think you are having Herpes Zoster, you must visit your doctor at the earliest considering the fact that antiviral medication will be effective only if it is given on time.

Avoid scratching as it may give rise to the chances of secondary bacterial infection and lead to scarring. Antihistamines can be used to reduce itching.

Pain medication is always essential.

Use tap water compresses for application to the weeping blisters. Apply compresses for at least 20 minutes and repeat this application for several times a day till you notice that blisters have dried. This will help dry the blisters and bring relief from pain besides removing scabs and reducing the chance of bacterial infection.

Use soft soap and water to maintain cleanliness of the area. Application of petroleum jelly will ensure quick healing. This is one of the useful home remedy for herper zoster.

Always put on loose clothes so that you don't feel extra pain through rubbing of clothes against the rash.

Don't come in skin-to-skin contact with those who never had chickenpox or fell ill. Also avoid skin contact with individuals having weakened immune system.