Shingles (Herpes Zoster)

Related Terms

  • Post-herpetic Neuralgia


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Herpes zoster (shingles) is an acute, painful infection caused by the varicella-zoster virus, the organism that causes chicken pox. It develops many years after the original chicken pox infection, typically in the elderly or those with compromised immune systems. The first sign may be a tingling feeling, itchiness, or shooting pain on an area of skin. A rash may then appear, with raised dots or blisters forming. When the rash is at its peak, rash symptoms can range from mild itching to extreme pain. People with shingles on the upper half of the face should seek medical attention, as the virus may cause damage to the eyes. Shingles usually resolves without complications within 3 to 5 weeks. However, in some people, especially seniors, the pain may persist for months or years. This condition is known as post-herpetic neuralgia (PHN). It is thought to be caused by a continuing irritation of the nerves after the infection is over. Conventional medical treatment for shingles includes antiviral drugs (acyclovir, famicyclovir, valacyclovir). When used properly, these lead to faster resolution of symptoms including lesions and acute neuralgia, and may reduce the incidence and severity of PHN. Steroids (prednisone) and tricyclic antidepressants (amitriptyline) are also prescribed to lessen shingles symptoms, and the former might help prevent PHN. Individuals who do develop PHN may be treated with steroids, antidepressants, and topical creams ( see Capsaicin, below ). In severe cases, nerve blocks might be used.

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