Herpes zoster
Herpes zoster (shingles) is a painful, blistering rash caused by reactivation of the varicella-zoster virus (VZV) – the same virus responsible for chickenpox. Nearly all adults who have had chickenpox carry dormant VZV, and about one in three will develop shingles in their lifetime. Reactivation risk significantly rises in adults over 50, especially those with weakened immunity. The classic presentation is a unilateral, dermatomal rash, often described as a burning stripe of blisters. While shingles itself is not contagious, active lesions can transmit VZV to individuals without prior exposure, causing chickenpox.
How common is herpes zoster?
Herpes zoster affects one-third of people during their lifetime, making it a common and clinically relevant condition, particularly in older and immunocompromised people.
What causes herpes zoster?
After primary infection, VZV remains latent in dorsal root ganglia. Age-related immune decline or immunosuppression can trigger reactivation as herpes zoster. Cell-mediated immunity plays a central role in keeping the virus dormant, although the precise mechanisms driving reactivation remain unclear.
What are the symptoms of herpes zoster?
Herpes zoster typically presents with a painful, raised or blistered rash, most often affecting one side of the face, neck, chest, or torso. People may also experience deep nerve pain, itching, skin discoloration, fever, headache, and malaise, sometimes days before the rash appears. In rare cases, herpes zoster occurs without a rash (zoster sine herpete).
What are the treatments for herpes zoster?
Treatment decisions for herpes zoster depend on symptom severity and the risk of complications. Prompt antiviral therapy, ideally initiated within 72 hours of rash onset, can reduce symptom severity and complications. Options include acyclovir, valacyclovir, or famciclovir. Pain management may involve non-steroidal anti-inflammatory drugs (NSAIDs), corticosteroids, or neuropathic agents. Vaccination is recommended for adults aged 50 or older to prevent shingles and postherpetic neuralgia.
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Herpes zoster quiz
What are the symptoms, tests, preventative measures and treatments for herpes zoster, more commonly known as shingles? How well do you know this common condition in the elderly? Find out by taking this quiz and learn more with additional content on Medthority.
