Introduction
Herpes Zoster, commonly known as Shingles, is a painful viral disease caused by reactivation of the Varicella-Zoster Virus (VZV)—the same virus that causes chickenpox. After recovery from chickenpox, the virus remains dormant in nerve cells and can reactivate later in life, leading to shingles.
HERPES ZOSTER
What is Herpes Zoster?
Herpes Zoster is a localized, painful skin eruption that usually appears as grouped fluid-filled blisters on one side of the body, following the path of a nerve (dermatomal distribution).
HERPETIC WHITLOW
Causes
- Reactivation of dormant Varicella-Zoster Virus
- Weak immune system
- Increasing age
- Stress and illness
- Chronic diseases (diabetes, kidney disease)
- Immunosuppressive drugs or chemotherapy
Who is at Risk?
- People above 50 years
- Patients with diabetes, cancer, HIV
- Organ transplant patients
- Long-term steroid users
- Individuals with severe mental or physical stress
Signs and Symptoms
Early Symptoms (Prodromal phase)
- Burning, tingling, or stabbing pain
- Fever
- Headache
- Fatigue
Skin Symptoms
- Red patches followed by clusters of blisters
- Blisters filled with clear fluid → become pustular → crusting
- Severe pain and tenderness
- Usually unilateral (one side of body)
Common Sites
- Chest and back
- Face (trigeminal nerve)
- Eyes (Herpes Zoster Ophthalmicus)
- Neck and limbs
Complications
- Post-Herpetic Neuralgia (PHN) – persistent nerve pain after healing
- Secondary bacterial infection
- Vision loss (if eye involved)
- Facial paralysis (Ramsay Hunt syndrome)
Diagnosis
- Clinical examination (typical dermatomal rash)
- Tzanck smear (rarely used)
- PCR test (in doubtful cases)
Treatment
Antiviral Drugs (within 72 hours is best)
- Acyclovir
- Valacyclovir
- Famciclovir
Pain Management
- NSAIDs
- Neuropathic pain medicines (gabapentin, pregabalin)
- Local soothing lotions
Supportive Care
- Adequate rest
- Proper nutrition
- Keep lesions clean and dry
Ayurvedic Perspective (Brief)
In Ayurveda, Herpes Zoster is correlated with Visarpa, mainly caused by Pitta and Rakta dosha vitiation. Treatment focuses on:
- Pitta-shamak drugs
- Rakta-shodhana
- External cooling applications
(Always under guidance of a qualified Ayurvedic physician)
Prevention
- Shingles vaccine (recommended for people >50 years)
- Good immunity maintenance
- Stress management
- Proper control of chronic diseases
When to See a Doctor?
- Severe pain or rash on face/eye
- Immunocompromised patients
- Persistent pain after rash healing
- Fever with widespread rash
Conclusion
Herpes Zoster is a painful but preventable and treatable disease. Early diagnosis and timely antiviral treatment can significantly reduce complications, especially post-herpetic neuralgia. Vaccination plays a crucial role in prevention, particularly in older adults.
