Herpes zoster is a skin disease caused by a virus infection. It is commonly known as “snake loincloth”, “snake sore”, “loist dragon”, “loist snake” and so on. It is often called “raw snake” in Guangdong. These common names vividly describe the characteristics of herpes zoster: clusters of blisters appear on the skin, arranged in strips along one side of the lower back or limbs, like a snake crawling on the skin.
The full name of herpes zoster virus is called varicella-zoster virus, which belongs to the herpes virus family. Among the currently known herpesviridae, there are 8 species that can cause human disease, known as human herpesviruses. Varicella-zoster virus is human herpesvirus type 3, the smallest human herpesvirus.
The varicella-zoster virus is very weak in the outside world and can only survive in the air for about 30 minutes. Then why does a virus with such a short survival period still cause so much pain to people?
Why do people get shingles
Although shingles mostly occurs in adults, especially middle-aged and elderly people, in fact, the varicella-zoster virus has infected the human body when we were young.
Many people’s first encounter with the varicella-zoster virus occurs before the age of 10. Through droplet transmission or direct contact with the liquid in the blisters, the virus invades our respiratory mucosa, multiplies and replicates, enters the blood and spreads to the whole body. Among them, 80% to 90% of infected people will develop chickenpox.
Chickenpox is a self-limiting disease, and it can be cured without treatment, so it doesn’t feel terrible except for the discomfort when the pox occurs. However, after the chickenpox patient recovers, the virus does not leave our body, but lurks in the ganglia at the root of our nerves, waiting for an opportunity to move.
Under certain circumstances (such as trauma, fatigue, malignant tumors, weakness after illness, use of immunosuppressants, etc.), the virus will be reactivated, from the dormant nerve root, along the nerve axon, to the innervation site of the skin, causing shingles.
So the occurrence of shingles is caused by the reactivation of these varicella-zoster viruses that have been dormant in our body.
What causes herpes zoster
Shingles can appear spontaneously, but is more likely to occur when the body’s immunity is weakened.
Common factors that cause the decline of human immunity include: staying up late, lack of rest, overwork, excessive mental stress, malnutrition, weakness after illness, use of immunosuppressants, or diseases that reduce immunity (such as HIV infection, Malignant tumors, systemic lupus erythematosus, etc.).
Age is an important risk factor for the occurrence of herpes zoster, and the risk of people over 50 years old is 2 to 4 times that of people under 50 years old. The annual incidence rate of people over 50 years old in Guangdong area is 4.3‰.
How to Treat Shingles
The treatment of herpes zoster mainly includes antiviral, sedative and analgesic and local symptomatic treatment.
Antiviral treatment: Early and adequate antiviral treatment can quickly control symptoms, shorten the course of the disease, and reduce the occurrence of postherpetic neuralgia. It is recommended to take medication within 72 hours. Commonly used drugs include acyclovir, famciclovir, valacyclovir, penciclovir, etc.
Sedation and pain relief: Non-steroidal anti-inflammatory drugs, tramadol, etc. can be used in the acute phase. Drugs such as gabapentin and pregabalin combined with antiviral therapy can significantly reduce postherpetic neuralgia.
Local symptomatic treatment: keep the skin clean to avoid secondary infection. Local physical therapy can promote drying of blisters and scabbing, relieving pain.
Herpes is gone, why does it still hurt?
Nerve tissue in the human body repairs very slowly, while skin tissue does so much faster. Therefore, after herpes zoster is controlled, skin herpes usually subsides first, while neurological symptoms such as pain or itching will continue for a period of time.
Early standardized treatment can reduce the degree of nerve damage caused by the virus and help the recovery of neuralgia as soon as possible.
What are the complications and sequelae
There are several complications of shingles, the most common of which is postherpetic neuralgia, which lasts at least 90 days and may last for years. The elderly and those with weakened immune systems are more prone to it. Due to long-term pain, patients are often accompanied by sleep disorders, anxiety, depression, and other mental symptoms; severe pain can also cause patients to have suicidal tendencies, which seriously affects the quality of life.
Herpes zoster of the eye can cause keratitis, corneal ulcer, etc., and severe cases can lead to blindness.
Facial herpes zoster can cause facial nerve paralysis, manifested as crooked mouth and eyes (herpetic facial paralysis).
Non-pain-related complications are relatively rare, including postherpetic pruritus, herpes-zoster-associated encephalitis, and myelitis.
Some immunocompromised patients also develop disseminated infection. This infection has the risk of spreading to the lungs, brain and liver. The disease is usually serious and the mortality rate can reach 40%.
How to prevent herpes zoster
Basic prevention focuses on enhancing resistance and developing healthy and good living habits, such as regular work and rest, work and rest, being positive and optimistic, enhancing nutrition, and eating a balanced diet.
The most effective means of active prevention is the shingles vaccine. The recommended vaccination population is middle-aged and elderly people aged 50 and above, which can greatly reduce the risk of herpes zoster.