Herpes Zoster

What is herpes zoster?

Herpes zoster (HZ) is also called shingles. It is an infection caused by the same virus that causes chickenpox (varicella-zoster virus). After you get chickenpox, the virus stays in your body for several years without causing any symptoms. HZ occurs when the virus becomes active again. Once active, the virus will travel along a nerve to your skin and cause a rash.

What are the signs and symptoms of herpes zoster?

HZ often starts with pain in the back, chest, neck, or face. A rash then develops in the same area. The rash is usually found on only one side of the body. The rash may feel itchy or painful. It starts as red dots that become blisters filled with fluid. The blisters usually grow bigger, become filled with pus, and then crust over after a few days. You may also have any of the following:

  • Fatigue and muscle weakness

  • Pain when your skin is lightly touched

  • Headache

  • Fever

  • Eye pain when exposed to light

How is herpes zoster diagnosed?

Your caregiver will ask you questions about your signs and symptoms. Tell him if you have had chickenpox. Tell him if you have recently been around anyone who has chickenpox or herpes zoster. Tell him if you have been around any sick people. Usually, the appearance of your rash will be enough for your caregiver to know you have HZ. He may also send skin scrapings or fluid from your blisters for tests.

How is herpes zoster treated?

  • Antiviral medicine: These help decrease symptoms and healing time. They may also decrease your risk of developing nerve pain. You will need to start taking them within 3 days of the start of symptoms to prevent nerve pain.

  • Pain medicine: You may need NSAIDs, acetaminophen, or opioid medicine depending on how much pain you are in.

  • Topical anesthetics: These are used to numb the skin and decrease pain. They can be a cream, gel, spray, or patch.

  • Anticonvulsants: These decrease nerve pain and may help you sleep at night.

  • Antidepressants: These may also be used to decrease nerve pain.

  • Epidural medicine: This is put into your spine to block pain. This medicine treats severe pain that does not get better with other pain medicines. Epidural medicine includes numbing medicine and steroids.

What increases my risk of herpes zoster?

  • Your risk is increased if you are older than 50. Your risk is also increased if you had chickenpox while your mother was pregnant with you.

  • Medical conditions such as cancer, AIDS, and Hodgkin disease increase your risk of HZ. Some treatments for cancer may decrease your immune system and increase your risk.

  • Stressful life events may weaken your immune system and increase your risk.

  • Organ and stem cell transplants can also increase your risk.

Can I infect others with herpes zoster?

The virus can be passed to a person who has never had chickenpox. This person may get chickenpox, but not shingles. You may pass the virus to others as long as you have a rash. The virus is spread by direct contact with the fluid from the blisters. Usually, you cannot spread the virus once the blisters dry up.

What are the risks of herpes zoster?

If left untreated, HZ may cause eye problems, such as a drooping eyelid or blindness. It may lead to a brain infection or stroke. HZ can also cause nerve damage and lead to twitching, dizziness, or loss of taste and hearing. The blisters may leave scars or changes in skin color. HZ may cause pain even after the rash is gone. It may also lead to trouble moving parts of your body.

How can I care for myself?

Keep your rash clean and dry. Cover your rash with a bandage or clothing. Do not use bandages with adhesive. These may irritate your skin and make your rash last longer.

What can I do to help prevent herpes zoster?

You may be able to get a vaccine to help prevent shingles if you are older than 50. Ask your caregiver for more information about this vaccine.

Where can I find more information about herpes zoster?

  • Centers for Disease Control and Prevention
    1600 Clifton Road
    Atlanta , GA 30333
    Phone: 1- 404 - 6393311
    Phone: 1- 800 - 3113435
    Web Address: http://www.cdc.gov

When should I contact my caregiver?

Contact your caregiver if:

  • You feel weak or have a headache.

  • You have a cough, chills, or a fever.

  • You have abdominal pain, nausea, or vomiting.

  • Your rash becomes more itchy or painful.

  • Your rash spreads to other parts of your body.

  • Your pain worsens and does not go away even after you take medicine.

  • You have questions or concerns about your condition or care.

When should I seek immediate care?

Seek care immediately or call 911 if:

  • You have painful, red, warm skin around the blisters, or the blisters drain pus.

  • Your neck is stiff or you have trouble moving it.

  • You have trouble moving your arms, legs, or face.

  • You have a seizure.

  • You have weakness in an arm or leg.

  • You become confused, or have difficulty speaking.

  • You have dizziness, a severe headache, hearing or vision loss.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

© 2013 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

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