Shingles (herpes zoster): Second disease after chickenpox
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Shingles (herpes zoster) occurs mostly at older ages. But it can also strike earlier - especially when the immune system is weakened. In any case, it is advisable to treat the shingles quickly. Because then the sometimes severe symptoms improve, usually within a few hours.
Shingles is a skin condition called late effect infection with the pathogen of chickenpox occurs - the so-called Varicella zoster virus (VZV), also human herpes virus type 3 (HHV 3) mentioned. Because varicella zoster virus or varicella belong to the group of herpes viruses. Accordingly, one calls the shingles as herpes zoster or simply as zoster.
Expressed differently: No shingles without chicken pox! can zoster herpes only those develop, one in the past - have been through chickenpox infection - sometimes unnoticed.
Shingles (herpes zoster) has the same causes as chickenpox: Both diseases are caused by Varicella zoster virus respectively varicella.
It works like this: If the chicken pox over, the varicella-zoster virus (so-called dorsal root ganglia.) Travels along the nerve fibers to certain nerve ganglia of the spinal column. The virus (called basal ganglia.) May also be up to the brain in the local ganglia penetrate.
Why exactly it comes to the reactivation of the dormant varicella, is far Not clarified. However, it is striking that especially older people and those with weakened immune systems get more frequent shingles. Possible Causes for a disturbed body defense are for example:
However, can also younger adults as well as children and young people who are otherwise completely healthy, develop shingles.
Other possible triggers for the reactivation of varicella and thus for the development of herpes zoster:
By the way: not only a natural infection with varicella can pull shingles result in: Even if you with a live vaccine against varicella vaccinated was, can develop following a herpes zoster. In vaccinated children the risk for shingles but is up to 12 times lower than in unvaccinated!
the designation shingles (Herpes zoster) goes on typical symptoms return of the disease: it imagines skin rash, the spreads typically of the spine, like a belt along the infected nerve path around the body.
A shingles usually arises only in a limited region of the body. The typical rash often spreads like a belt from - hence the name of the disease (© Lineair-Siegfried Kramer / Imagebroker / OKAPIA).
However, the rash is not the only and often not the first signs of shingles. The following symptoms are herpes zoster also common:
That a shingles in the early stages more general symptoms triggers is mainly because it takes a few days until making the reactivation of the varicella-zoster virus causative noticeable.
Unlike chickenpox which spread all over the body, are the symptoms of shingles locally: The cold sore is only on one side of the body only in the area which provides the affected spinal or cranial nerve. Occasionally, however, these lesions are missing: Such Shingles without a rash denote as physicians Zoster sine herpete.
Is usually the Thoracic and abdominal skin affected by shingles: Symptoms usually develop first in the spine and then spread like a belt around the body. In a herpes zoster on the trunk paralysis may occur in addition - but this form of the disease is rare. the House rash forms on the genitals, doctors speak of zoster herpes.
A shingles can also occur on the face. (© Science Source / OKAPIA)
By contrast, a herpes zoster leads in the area of ear (So-called. Zoster oticus) up to 60 percent of those affected to a facial paralysis (so-called. Bell's palsy), but completely recovered in some cases. Although shingles on neck forms can symptoms of muscle paralysis occur on the face. Of the pine can also be affected by shingles be (so-called. zoster maxillary).
A shingles (herpes zoster), the doctor can usually based on a survey on the medical history (so-called. Anamnesis) And from the typical symptoms determine. Only in some cases it is necessary to diagnose, detect the causative varicella-zoster virus (VZV). That's about the case if:
Also one blood test and a Study of brain fluid (CSF) can be used to obtain evidence of shingles: who is infected with the varicella-zoster virus, forming so-called antibodies against the virus. This increased number of antibodies can be observed in the blood.
With an infection with varicella, the cells proliferate in the cerebrospinal fluid and the protein content increases slightly. Runs the shingles straightforward, the study of the cerebrospinal fluid is not necessary. Triggers of herpes zoster but symptoms such as impaired consciousness or paralysis of view, this may indicate a brain or spinal cord infection - then the investigation is recommended.
Frequently Shingles occurs in people with weakened immune systems. Therefore, it is always advisable for herpes zoster, as part of the diagnosis, even after Elementary and comorbidities to search.
In a shingles (herpes zoster) seeks treatment from the fact that symptoms alleviate and the duration of the disease shorten. Normally the disease heals then for at least four weeks out.
Who gets an early stage drugs against the herpes zoster, in which the pain and skin redness most cases improve within a few hours. Therefore applies: Search at the first sign of shingles as soon as possible a doctor on so that treatment can work optimally. The better the chance that the symptoms recede quickly.
The doctor will then prescribe a rule drugs, whose active ingredients specifically against herpes viruses addressed are: These so-called anti-virals fight the causative agent of shingles by inhibiting their growth. Thus, the active compounds are suitable for the treatment of herpes zoster, for example,
Against the burning pain associated with shingles additional treatment usually comes with painkillers used: For example, NSAIDs such as diclofenac can alleviate the pain associated with herpes zoster with. Take the painkillers consequent one, so there will be no so-called postherpetic pain. This severe pain can occur as a result of shingles and persist for a long time.
However, the typical shingles rash can even with a mild course Leave traces: If the herpes zoster healed, often pigmented skin areas remain. The affected skin is then tanned either stronger or has lost its tone.
In addition, the course of shingles from hanging Older of those affected: in the case children the disease is usually straightforward. at adults Herpes zoster, however, may be partly linked to severe pain. A consistent pain management is important to prevent persistent so-called post-herpetic pain.
A shingles may be associated with various complications. So it can, in rare cases permanent paralysis come that may affect the face, but also the diaphragm, for example. further possible inflammatory complications Herpes zoster:
If the nerve roots or nerve mitbeteiligt in the shingles, can a polyneuropathy or a Guillain-Barre Syndrome develop: In the latter often muscle weakness occur that rise from the legs and can follow up to a paralysis of the arms and legs lead. In rare cases, the diaphragm during herpes zoster may be mitbeteiligt and fail breathing - this makes ventilation of those affected required.
Join shingles complications in the brain and spinal cord Halbseiten- or paraplegia on, the disease can lead to serious condition - sufferers then need intensive medical care.
In rare cases, shingles on the whole body and internal organs can spread (so-called. Zoster generalized satus) - while it also is a life-threatening complication. So severe may extend particularly in people a herpes zoster who have an immune deficiency, or whose immune system is suppressed by drugs (immunosuppressants).
In about 10 to 15 out of 100 cases associated with shingles neuralgia may exist for a long time (so-called. Postherpetic neuralgia or herpetic neuralgia) - with over 60 of which is one in two affected. A post-herpetic neuralgia can last for months to years. Timely pain treatment can help to prevent further complications. A particularly effective pain management is the combination of painkillers (analgesics) and certain medicines for mental disorders that even with herpes zoster act (so-called. Tricyclic antidepressants).
For several years, a vaccine is available, which can be used to prevent shingles (herpes zoster) in certain degree. The vaccine is much more concentrated than the chickenpox. Vaccination is well tolerated in general.
However, the vaccine is one for shingles Not the recommended standard vaccinations. This is partly due to their limited efficacy. Because with age, the vaccine protects less and less - even though at the same time increases the risk of a severe herpes zoster:
© Jupiter Images / iStockphoto
Vaccination can protect to some degree against herpes zoster.
If you already have a shingles are usually no specific behavioral measures to protect against infection of those around necessary as herpes zoster little contagious is.
A exception applies in Dealing with pregnant women: Here it is important not to endanger the fetus. Anyone who has shingles, should it avoid close contact with pregnant women! The reason: He who is not immune to the causal varicella (because there was never a chickenpox infection and no vaccine protection is), can become infected on the content of herpes zoster vesicles and develop chickenpox. If this happens to a woman during pregnancy, it can transmit in rare cases, the infection to the unborn child. If this happens just before or after the birth of the child, there is a serious health risk for the newborn.
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