Herpes zoster

Herpes zoster, also known as shingles, is a painful skin infection caused by a virus. It's very common and primarily affects adults and the elderly.

Herpes zoster causes a rash that quickly turns into fluid-filled blisters. They usually dry out and crust over within a few days. The rash and blisters tend to appear in the shape of a band on one side of the body. While herpes zoster can affect any area of the body, it most commonly appears on the chest, back, and stomach. Other possible symptoms of the virus include the following:

• Burning or shooting pain
• Fever
• Fatigue
• Tingling or itching in the affected area
• Skin redness
• Headaches

The pain can start a few days before the rash develops. The rash and blisters general last 2-3 weeks.

Herpes zoster can lead to certain complications, including the following:

• A pain that persists for several months after the rash has faded
• Scarring
• Vision loss if the virus affects the eye
• Bacterial skin infections (especially if the person scratches their blisters)

Causes and triggers

Herpes zoster is caused by the varicella-zoster virus, a member of the herpesvirus family. It's the same virus that causes chickenpox. Herpes zoster is due to a reactivation of the varicella-zoster virus. After a person has contracted chickenpox, the virus remains in the body in inactive form. Once reactivated, it causes herpes zoster. In most cases, the virus can be reactivated only once. However, some people have more than one outbreak.

Herpes zoster can affect anyone who has had chickenpox, though certain factors, including the following, increase the likelihood of developing the infection:

• Age (50 years or older)
• A weak immune system
• Cancer
• HIV
• Certain medications

A person with herpes zoster can transmit the varicella-zoster virus to others. Rather than transmitting herpes zoster, they transmit chickenpox. The virus is spread through contact with the infected person's blisters. Herpes zoster is contagious until the blisters scab over.

Treatment

Antiviral medications can be taken to reduce the intensity and duration of herpes zoster symptoms. To be effective, treatment must be started within 3 days of developing blisters.

Warm compresses can also soothe the pain, but pain relievers (e.g., Tylenol, Advil) are often necessary. It is recommended not to scratch the blisters, and keep the affected area clean and dry to avoid developing a bacterial skin infection.

There is a vaccine to protect against herpes zoster. It is recommended for people aged 60 and older. Adults aged 50-59 can also speak to their health care provider to request the vaccine. People who have been vaccinated against chickenpox are less likely to contract herpes zoster.

When should I see a health care professional?

Consult your health care provider as soon as possible if you experience any symptoms of herpes zoster.

Speak to your health care provider for more information on the herpes zoster vaccine.

For more information:

• Government of Canada