Herpes Zoster Treatment

How Do You Treat Herpes Zoster?

Herpes zoster is the virus that causes the common infection known as shingles and chicken pox.    The initial exposure to the virus is caused from the development of chicken pox.

Chicken pox is common in children between the ages of 2 and 6.  Once children are older than 6 or 7 the disease becomes more painful and uncomfortable for the child and past adolescents it can become dangerous.

After this exposure the virus herpes zoster becomes dormant along certain nerve fibers and can reactivate during periods of stress, with aging, suppression of the immune system and taking certain medications.  It is more common for one attack to occur with a recurrence.

Because of the way that the nerves are laid out in the body and the way that the virus attaches to certain fibers an outbreak will only affect one side of the body or face or the other.  An outbreak will usually begin with a rash that leads to blisters and sores on the skin.   If nerves of the face are affected then the infection can reach the eyes and nose, which can lead to long term eye damage.

The typical shingles rash will start approximately 2-3 days after the virus has migrated to the skin.  The patient will find small blisters similar to early chicken pox.  The rash continues to increase over the next 3-5 days and the blisters break causing small ulcers that dry and form a crust.

The trunk of the body is most often affected with a rectangular belt of a rash from the back (spine) to one side of the chest.

Many people who experience this infection find that it’s painful and this phase can last for several weeks.  However, some people may find that they continue to experience the nerve pain long after the outbreak has cleared.  This is called post-herpetic neuralgia and is most often experienced by the elderly.

People who are suffering from a herpes zoster infection may experience flu-like symptoms, rash, red and sensitive skin, blisters and pain.  Doctors rarely use tests to confirm the illness because the pattern is very distinct.  If tests are used then the doctor may order a viral culture of the skin, a Tzanck test, a complete blood count or specific antibody for varicella antibodies.

Patients may question their doctor about how to treat herpes zoster.  The treatments will depend upon where the infection has migrated.  If the eye is infected treatment will be more aggressive to prevent side effects that include double vision, corneal damage or iritis.

Treatment includes the use of anti-viral medications (Acyclovir) as well as treatments to decrease pain and inflammation.  Most of the time herpes zoster will heal on it’s own and patients require only supportive care for pain and discomfort.  Corticosteroids may also be used to reduce inflammation and decrease the risk of post-herpetic neuralgia.  They have been shown to be most effective in the elderly population.

Eye drops and ointments may be prescribed to treat any ocular problems.  In more severe cases involving the eye surgery may be required.

When people have an active infection with herpes zoster, whether an initial infection with chicken pox or the subsequent shingles, they should avoid contact with people who are susceptible to contracting the disease such as the elderly, pregnant women and people with a compromised immune system such as AIDS and cancer.

Herpes zoster can affect any age group but is more common in adults over 60 and children who had the chicken pox before they were 1 year old.  If patients find that they have recurrent shingles it may be because of an underlying problem with the immune system such as HIV, cancer or organ transplant.

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Herpes Zoster Treatment


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