What is herpes zoster and does it require treatment or not?
Herpes zoster better known as shingles or zoster is a disease caused by the virus from the class of herpes called varicella. Like other types of herpes, varicella never leaves the body once it is acquired. However, most of the time the virus is dormant, i.e. it doesn’t cause any negative symptoms.
When a person first contracts the virus, they develop chickenpox. Even after it is treated, the virus is still in the body and can exacerbate and cause zoster many years after chickenpox. Worth noting, only people who had chickenpox can develop shingles. It means the first time you contract the pathogen you develop chickenpox and not shingles. So if you are having close contact with a person with zoster and have never had chickenpox, there is a high chance you will develop it.
You may think that since herpes is never fully eliminated from the body it can be left untreated but it is not quite so. The thing is that the virus can exacerbate and cause multiple negative symptoms that interfere with normal life. Besides, when the virus causes a flare-up, it becomes highly contagious but while it is dormant or suppressed it is not as contagious.
Short information about zoster
How is zoster manifested?
Unlike chickenpox, zoster rash develops usually on one side of the face or body. The rash commonly forms a stripe on a forehead, chest, back, and so on. Another thing that differentiates zoster from chickenpox is that the site affected by the virus is in intense internal, neurologic pain.
How is zoster diagnosed?
There is no difficulty in diagnosing zoster when a strip-forming rash is present with intense ache. However, the rash can develop one to three days after ache occurrence which can make the diagnosis more difficult. In this case, for instance, if the ache is in the chest area, a doctor should check a patient for heart function problems.
When can zoster develop?
As we have already said, the disease develops because the virus that is already present in the body becomes active. But what activates the virus? In short, anything that lowers immune response can trigger the development of shingles. However, there are certain groups of people who are more likely to develop zoster due to lowered immunity:
- People older than 55 years with chronic diseases;
- Pregnant women;
- Cancer patients;
- People with untreated HIV and AIDS;
- People who use antibiotics for extended periods of time;
- People who use immune suppressive medicines (for example, for organ transplantation, cancer, autoimmune diseases, and so on);
- People with any of the risk factors who were exposed to overcooling of the body.
How is zoster treated and does it require treatment?
Zoster like any type of herpes can go away without any treatment if a person has a good immune system in general. However, it causes a lot of discomfort – itchy rash and intense nerve pain. Besides, it can contribute to the development of a complication – postherpetic neuralgia, i.e. the chronic inflammation and pain in the impacted nerve. And considering that the disease develops in people with lowered immunity, they are likely to suffer from it for many weeks and even months if proper treatment isn’t received.
So how is zoster treated? First of all, antiviral agents that suppress the replication of the virus must be used within the first 72 hours after the occurrence of the symptoms. It is desirable to start taking the medicines as soon as ache occurs without waiting for it to become intense and rash to flare-up.
Here we list the medicines for zoster with their properties:
- Antiviral medicines: Acyclovir or Valacyclovir. The second one is transformed in acyclovir in the body so basically they render the same effect. However, Valacyclovir is taken fewer times a day (2-3 times by 1000 mg instead of 4 times for Acyclovir) as it has a prolonged effect. Remember that it is only reasonable to take antivirals not later than 2-3 days after the first symptom occurrence.
- Painkillers: The first choices are over-the-counter drugs such as Ibuprofen, Naproxen, Ketorolac, and others. If their effect is insufficient, you may need opioid analgesics that are sold only with a prescription from a doctor.
- Anticonvulsants: In intense nerve pain that lasts for more than two weeks, anticonvulsants such as gabapentin and pregabalin can be prescribed. These medicines are also appointed for postherpetic neuralgia, i.e. chronic nerve pain that lasts for more than 3 months after the first zoster symptom.
- Tricyclic antidepressants: These are prescription medicines that your doctor can prescribe you in case you are at high risk of postherpetic neuralgia, i.e. if the pain isn’t controlled by painkillers and lasts for many weeks.
- Amantadine is another medication that is appointed in the suspected/high risk of postherpetic neuralgia. This drug both has an antiviral effect and also blocks pain receptors at the stage of pain impulse transmission. You can buy some of the shingles medicines from our online drugstore to save on the price per pill as we sell high-quality generics identical to the branded drugs cheaper. But make sure to consult your doctor before using any drugs.