Dermatology Facts—Herpes Zoster

Herpes zoster, also known as shingles, is an uncomfortable and often painful outbreak of skin sores that occurs in persons who have had chicken pox earlier in life. The same varicella virus that caused the chicken pox lies dormant in the body until it is reactivated later in life, this time in the form of herpes zoster. About 10 to 20 percent of the population will acquire zoster as adults.

What causes the zoster virus to reactivate is unknown. However, experts believe the virus triggered by a weakened immune system, often brought on by physical or emotional stress. The virus is most commonly seen in people over 50, although children can acquire it, too.

What are the symptoms?

The initial symptom of zoster is a burning pain or tingling and sensitivity in one area of the skin, generally followed by a rash. Mild flu-like symptoms, such as headache, fever and nausea also may occur. The rash soon blisters. The blisters generally last for two to three weeks. Next, the blisters slowly crust, scab and heal.

The level of pain and discomfort caused by zoster varies from person to person. For some people then pain so intense it interferes with daily activities. In this case, your physician may prescribe pain medicine. Other people may experience sensation more closely resembling chicken pox --- burning or stinging and then itchiness as the sores begin to heal.

What are the complications?

Once the blisters are healed, some people continue to experience periods of pain for weeks or possibly longer. This complication, known as post-herpetic neuralgia, is more common in older adults. There are new medicines available for this condition.

A bacterial infection of the blisters can also occur, which can delay the healing process. In this circumstance, your physician will prescribe antibiotics.

Discoloration or scarring of the skin also is possible. However, it is usually slight and fades with time.

Is it contagious?

Zoster can only be passed on to people who have never had chicken pox, and they will develop chicken pox, not zoster. However, zoster is much less contagious than chicken pox. The virus can be transmitted by close physical contact if the blisters are broken. Newborns or persons who are immunosuppressed, such as cancer patients, are at the highest risk.

How is it treated?

In most people, zoster clears on its own in a few weeks and seldom recurs. Treatment usually consists of pain relievers and cool compresses on the outbreak site.

Acyclovir, an anti-viral drug, is often prescribed to stop new blisters from forming. It works best when taken at the onset of the illness.