Zoster Virus Infection Information
Zoster virus infection is a painful skin rash caused by the virus that causes chicken pox. The varicella zoster virus falls under the “herpes” classification. Once an individual acquires zoster virus, the organism disappears into the nerves and is never completely cleared from the body. Under situations of stress, major illness or use of corticosteroids, the virus is reactivated and presents as a painful linear rash with blisters. However, in the majority of people the reason for activation for the varicella zoster virus is never discovered. Most people only get one episode of herpes zoster virus but it is something that people rarely forget.
Shingles tends to occur in elderly individuals and current data indicate that close to a million people get this disorder each year.
Just prior to the rash, one may feel a burning or knife like pain usually on the chest wall. The area of skin becomes hypertensive to touch and there may be episodic tingling. Soon this is followed by a red rash which has blisters. The blisters are filled with fluid and eventually rupture. Over the next few days, the blister dry out and become crusted. Shingles occurs on one side of the body and the entire episode may last 10-21 days. The pain can be variable and is often confused with a skin infection, heart attack or bone pain.
Shingles is contagious but only for people who have never had chicken pox as children. Shingles is most contagious during the time blisters are forming and crusting over. However, some individuals develop pain but never have the rash or blisters.
The diagnosis of shingles is not difficult. A physician can look at the rash and determine the cause. There is no need for fancy radiological tests or blood work. Once the condition is diagnosed, the majority of cases of shingles resolve on their own. However, most people seek treatment for pain, which can be excruciating. Unfortunately, all the available treatments are not very effective and in order to work must be started within 24 hours after onset of symptoms. The drugs do not work when used after 48-72 hours. There are both topical and oral medications to treat shingles pain. Topical creams (like zostrix) and lotions are a waste of money and not recommended. The pills have to be taken 3-5 times a day for 7 days and are very costly. If medications are taken within the first 24 hours, they can help reduce the intensity of pain and duration of the rash. Unfortunately, less than 10% of patients see any benefit from drugs like acyclovir or valacyclovir. Topical local anesthetic creams are available but in most cases only provide pain relief for a very shor time.
The area of infection should be kept cleaned and one can bath or shower. However, the skin site can be exquisitely sensitive to hot water. Cool compresses and calamine lotion do help relieve the itch. There are a variety of alternative health care treatments being offered for zoster virus infection but the efficacy of such treatments remains questionable.