Shingles (Herpes Zoster)
Description
A viral infection caused by varicella (chickenpox virus). The virus lives in the nerve cells dormant after the initial infection causing chicken pox. The virus re-emerges many years later causing painful lesions that look like pimples. They typically appear on only one side of the body and are localized to one area. Stress, old age and other infections can cause the re-emergence of the virus. Also called herpes zoster.
Symptoms
Initial symptoms consist of tingling and burning of the skin, followed by pain which can be intense. Later a rash develops consisting of bumps, blisters , pimples, crusting. The rash is typically only on one side of the body, and in one area. Unfortunately some patients can have persistent symptoms even after the rash has resolved. This is called post herpetic neuralgia.
Tests
A history and physical exam will be performed. Rarely a lesion may be examined to identify the virus.
Treatment
Treatment involves antiviral medications (acyclovir/Zovirax, famciclovir/Famvir, valacyclovir/Valtrex), pain medications, and occasionally steroids. Treatment is more effective the sooner it is started.
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