Herpes zoster Health Dictionary

Symptoms: Two-to-four-day fever precedes a red rash which develops into clear blisters. Blisters dry up to form scabs that drop off leaving scars. Lesions and pain follow the path of the infected nerve. Pain described as intense, burning, itching: may persist for months as post-herpetic neuralgia. When virus affects the fifth cranial nerve vision will be impaired. In the elderly it may reveal some underlying malignancy. Patients having chemotherapy or radiotherapy are at risk.

Alternatives. Specific anti-viral therapy. Remedies in general use: Asafoetida, Jamaica Dogwood, Marigold, Mistletoe, Nettles, Passion flower, Poke root, Queen’s Delight, Valerian, Wild Lettuce, Wild Yam. St John’s Wort plays a role in reducing the long-lasting neuralgia. Echinacea imparts strength to endure the ordeal. The addition of a stomachic remedy (Gentian) to a prescription may prove beneficial. Mild short-term analgesics include: Oats, Valerian, Asafoetida, Passion flower, Wild Lettuce, Hops.

Tea. Formula. Equal parts: Oats, Nettles, St John’s Wort.

Decoction. Formula. Echinacea root 2; Valerian half; St John’s Wort 1.

Tablets. Formula. Hops BHP (1983) 45mg; Passion flower BHP (1983) 100mg; Extract Valerian 5:1 20mg. (Gerard 99)

Powders. Combine: Echinacea 2; Jamaican Dogwood 1; Gentian root 1. 500mg (two 00 capsules or one- third teaspoon) thrice daily.

Tinctures. Alternatives. (1) Formula. Equal parts Goldenseal and Lupulin (Hops). Or, (2) Formula. Queen’s Delight 1; Valerian quarter; Goldenseal quarter; Asafoetida quarter. Dose: 1 teaspoon in water thrice daily.

Practitioner. Tincture Gelsemium: 5 drops (0.3ml) in water, as indicated, for pain.

Formula. Liquid Extract Hops, half an ounce; Liquid Extract Echinacea, 1oz; Tincture Goldenseal, 30 drops; Tincture Rhubarb BP, 1oz. Essence of Peppermint 20 drops. Water to 8oz. Dose: 2 teaspoons in water after meals. (Arthur Barker, FNIMH)

Topical. Aloe Vera. Houseleek – fresh juice or pulp. Evening Primrose oil. Wash with decoction of seaweed (Bladderwrack, Kelp): follow with Zinc and Castor oil cream or ointment. Slippery Elm made into a paste (powder mixed with few teaspoons of milk): apply after cleaning with Olive oil. Castor oil compress. Dilute Tea Tree oil. Ice-cube – 10 minutes on, 5 minutes off.

Russian study. Liquorice powder ointment.

Diet: Oatmeal porridge. Muesli with oats. Yoghurt. Wholefoods.

Supplementation. One high potency multivitamin daily. Anti-herpes amino acid L-lysine; one 500mg tablet, twice daily. Vitamin B12, 10mg daily. Upon relief, reduce L-lysine to one daily. (Dr L. Mervyn) Minerals: Calcium, Selenium, Zinc.

Self-Care. Resist temptation to touch sores. No sharing of face cloths, towels, etc.

Note: The chicken-pox virus is believed to lie dormant in nerve cells around the spine for many years, after people catch the childhood infection. Virgorous massage of the spine may trigger an attack by activating the dormant virus.

Information. Herpes Association, 41 North Road, London N7 9DP, UK. Send SAE. 

Herpes zoster is caused by the varicella–zoster virus, which also causes chickenpox. After an attack of chickenpox, some of the viruses survive and lie dormant for many years. In some people, a decline in the efficiency of the immune system, especially in old age or because of disease, allows the viruses to re-emerge and cause herpes zoster. Herpes zoster is also common in people whose immune system is weakened by stress or by certain drugs, such as corticosteroid drugs or anticancer drugs.

The first indication of herpes zoster is excessive sensitivity in the skin, followed by pain. After about 5 days, the rash appears as small, raised, red spots that soon turn into blisters. These dry and develop crusts that drop off, sometimes leaving small pitted scars.

The most serious feature of herpes zoster is pain after the attack (postherpetic pain), caused by nerve damage, which may last for months or years. Herpes zoster ophthalmicus may cause a corneal ulcer or uveitis.

If treatment is begun soon after the rash appears, antiviral drugs, such as aciclovir, will reduce the severity of the symptoms and minimize nerve damage.

Analgesic drugs may also be helpful.

Causes Shingles is due to the same virus that causes chickenpox. This invades the ganglia of the nerves, particularly the spinal nerves of the chest and the ?fth cranial nerve which supplies the face. Despite being due to the same virus as chickenpox, it is rare for herpes zoster to occur as a result of contact with a case of chickenpox. On the other hand, it is not unusual for a patient with herpes zoster to infect a child with chickenpox. It is a disease of adults rather than children, and the older the person, the more likely he or she is to develop the disease. Thus in adults under 50, the incidence is around 2·5 per 1,000 people a year; between 50 and 60 it is around 5 per 1,000; whilst in octogenarians it is 10 per 1,000. Occasionally it may be associated with some serious underlying disease such as LEUKAEMIA, LYMPHADENOMA, or multiple myeloma (see MYELOMATOSIS).

Symptoms The ?rst symptoms are much like those of any feverish attack. The person feels unwell for some days, has a slight rise of temperature, and feels vague pain in the side or in various other parts. Often the area of skin to be affected feels hypersensitive (hyperaesthesia) as though something were rubbing on it. The pain ?nally settles at a point in the side, and, two or three days after the ?rst symptoms, the rash appears. Minute yellow blebs – or vesicles, as they are known – are seen on the skin of the back, of the side, or of the front of the chest, or simultaneously on all three, the points corresponding to the space between one pair of ribs right around. These blebs increase in number for some days, and spread until there is often a complete half-girdle around one side of the chest. The pain in this stage is severe, but it appears to vary a good deal with age, being slight in children and very severe in old people, in whom indeed herpes sometimes forms a serious illness. After one or two weeks, most of the vesicles have dried up and formed scabs. The pain may not pass o? when the eruption disappears, but may remain for weeks or even months – a condition known as post-herpetic NEURALGIA. Old people are prone to develop this condition.

Treatment ACICLOVIR or famciclovir can be given orally, and are e?ective if started in large doses early in the attack. Later, topical antibiotics may be required. Analgesics may be necessary if neuralgia is severe.