Acne and rosacea aren’t the only things that can happen to your skin, and they’re not the only conditions that dermatologists treat. Many people don’t think of going to a dermatologist if they are suffering from a painful rash. Fewer still can identify their rash as a case of Herpes Zoster, or shingles. The Dermatology Consultants of South Florida is your premier dermatologist team in the Coral Springs area. If you’re looking for a dermatology office in the South Florida area that can diagnose and treat your Herpes Zoster, contact the Dermatology Consultants of South Florida today for a consultation with our medical team. We offer services to reduce scarring, skin discoloration, inflammation and swelling from rashes, pain relief, and more.
What Is Herpes Zoster?
Herpes Zoster is known to many by another name. This common disease goes by the name of “shingles” to most Americans. This condition is a reactivation of a disease usually caught during childhood, the varicella-zoster virus that is known to most people by the jocular term “chickenpox.”
The vaccine for chickenpox was only licensed for use in the United States in 1995. Before that, most people caught chickenpox as one of the “childhood diseases” that were impossible to eradicate. The majority of the population had experienced chickenpox sometime before adolescence, either by accidental exposure or during “chickenpox parties” that some communities would hold in order to deliberately infect children with the virus. This was thought to be the safest way of dealing with the disease, as initial infection for adults for teens and adults is significantly more dangerous than infection during childhood.
However, individuals who have contracted chickenpox at any time in their lives are not free from risk. Even after the chickenpox has left a patient’s body, the virus can stay dormant in the dorsal root ganglia, which is a small cluster of nerves found in the root of the spinal cord. When this virus is reactivated within the body, an outbreak of Herpes Zoster can occur. This is responsible for the rash known as “shingles,” which can be painful and lead to dangerous complications.
Herpes Zoster outbreaks occur in 10 to 20 percent of individuals who have contracted chickenpox at some point in their lives. The older you are, the more at risk you are of suffering an outbreak. Children under 15 usually do not get outbreaks, but 30% of cases occur in individuals who are over 55 years old. Once you turn 50, the risk of an outbreak doubles with each additional decade of life. Most people only have one outbreak of shingles in their lifetime if they get it, but second and even third incidences are possible. Around 4% of shingles patients are hospitalized for complications.
What Are the Symptoms of Herpes Zoster?
The prodrome stage of Herpes Zoster, or initial stage of an outbreak before more clinically identifiable symptoms set in, usually only lasts for one to two days. During this period, you may experience symptoms such as:
- Hyperesthesia, an intense sensitivity of the skin. You may experience pain or other unpleasant sensations when something presses or brushes against the affected region of skin.
- Parasthesias, a burning or prickling sensation that may feel like itchiness, skin crawling, or the “pins and needles” feeling that can happen when a limb falls asleep.
- Pruritis, an itching and burning sensation on the skin which presents with a painful need to scratch.
It can be up to three weeks before skin lesions set it, so many people do not associate the onset of these unpleasant skin symptoms with their shingles outbreak. Some people don’t even experience the lesions, which means they may not be correctly diagnosed (this particular type of outbreak is known as “zoster sine herpete”). Doctors may mistake these symptoms for the onset of a heart condition, a hernia, pleurisy, or different types of gastrointestinal or other internal problems.
Once in the stage where lesions may occur, Herpes Zoster appears as a rash of red skin bumps or marks which may attach to each other. These red areas may be concentrated in beltlike patterns around the body. They eventually develop into open sores with raised bases, much like mosquito bites. However, these sores are likely to be much more painful than mosquito bites. These lesions usually come with a stinging or burning pain that does not decrease in intensity. Along with these sores, many patients report flu-like symptoms such as nausea, body aches and headaches, and fever or chills. Anxiety and insomnia often come along with these symptoms. Within seven to ten days, most of these lesions will crust over and eventually fall off. Scarring and discoloration of the skin below are common. Unfortunately, this is not the end of an outbreak for many patients.
A common long-term complication of shingles is pain that lasts for more than three months, a result of postherpetic neuralgia. This occurs when nerve fibers become damaged, causing the electric impulses that send signals to the brain to become confused and to exaggerate or imagine painful sensations on the skin. Pain of this type can be triggered by even the slightest of stimuli, such as from clothing or even from wind. Symptoms tend to lessen over time; fewer than one in four patients still experience this pain six months after the initial outbreak, and only one in twenty patients still experience pain more than a year after their outbreak. The risk of chronic and continuing pain from a shingles outbreak increases with age, as does the severity and duration of the potential episode of pain.
Herpes Zoster outbreaks can have complications that last even longer than the pain. Individuals who have experienced an outbreak may be left with ocular or seeing problems, hearing or auditory problems, pneumonia, or an encephalitic inflammation of the brain.
What Triggers a Herpes Zoster Outbreak?
Herpes Zoster occurs when the varicella-zoster virus is reactivated inside the body. While the exact mechanism of this reactivation is complex, it is clear that outbreaks are related to the strength of the body’s immune system and usually correspond with periods of weakened immunity. The human body tends to decline in immune function with age, and that is believed to be the reason why a Herpes Zoster outbreak is more likely for individuals over age 55. Patients with immune systems that are compromised in other ways are also likely to have outbreaks of shingles. Patients with HIV or human immunodeficiency virus infections are 15 times more likely to undergo an outbreak of shingles in their lifetime, while 25 percent of patients who have Hodgkin’s Lymphoma experience an outbreak. People undergoing chemotherapy or radiation treatment for cancer or other reasons may also experience outbreaks, as well as patients on high doses of corticosteroids.
How Do You Contract Herpes Zoster?
If you have had chickenpox in the past, then you are at risk for an outbreak of Herpes Zoster. Because the Herpes Zoster outbreak is a product of the varicella-zoster virus, shingles can only be contracted through a previous chickenpox infection. Individuals who have been immunized against chickenpox are the only people who will never have to worry about an outbreak of shingles in their lifetime.
Despite outbreaks of Herpes Zoster not being technically contagious, individuals experiencing an outbreak still carry and can transmit the varicella-zoster virus. It is transmitted through direct contact with the fluid that seeps from the rash blisters. Individuals with active outbreaks can transmit the virus to people who have not yet had chickenpox or been vaccinated against chickenpox, which can cause the initial infection of chickenpox in these individuals. Within a household, rates of infection from an individual with shingles to someone who is not immune to chickenpox are 15 percent. It’s only possible to infect another person when the rash is in its blister period before it crusts over. The risk of spreading the virus is lower from someone with shingles than from someone with the initial infection of chickenpox, and the likelihood of infecting someone else is even smaller if you cover the blisters while they are active.
If you are experiencing an outbreak of Herpes Zoster, you can reduce the chance of transmission and infection of others by following some guidelines:
- Cover the rash with a clean, water-tight bandage.
- Do not touch or scratch the rash, as this will spread the infected fluid.
- Wash your hands often, especially if you have touched the area around your rash recently.
- Until the rash is crusted over, avoid physical contact with individuals who have never had chickenpox or the chickenpox vaccine, pregnant women or babies, or people with compromised immune systems.
How Is Herpes Zoster Treated?
When medical professionals treat Herpes Zoster, there are usually three primary goals for treatment. Your health care professional will need to treat the viral infection that started the outbreak, treat the pain and physical discomfort of the rash while containing the infectious fluids as much as possible, and prevent postherpetic neuralgia from occurring as much as possible.
While viral infections usually need to run their course, medical professionals use antiviral agents in cases of Herpes Zoster outbreaks in order to shorten the length of the outbreak and reduce the pain and discomfort patients feel when they have a shingles rash. These medications are usually most helpful when they are administered within 72 hours after the onset of the initial rash, while new lesions are being formed on the skin. By the time the lesions from an outbreak have begun to crust over, signaling the end of the infection, the efficacy of any antiviral medications administered will have waned significantly. This is why it is crucial to seek medical assistance as soon as you notice the rash.
Corticosteroids are the second line of defense when dealing with an outbreak of shingles. These medications can help calm the swelling and itching of the rash, helping decrease the pain and reducing the potential damage to nerves that have been affected by the viral outbreak. Doctors will also prescribe analgesics to reduce the pain further. Lotions with calamine as an ingredient are usually used on open lesions to manage the itching and burning sensations, while lotions containing capsaicin should only be used once any lesions have crusted over in order to avoid adding chemical burns to the mix. Lotions such as lidocaine and nerve blockers may also be effective when used as directed by your health care professional. A regular dosing schedule is crucial for pain-reducing treatments of Herpes Zoster.
Remember to use all medications and treatments, whether taken orally or used topically, in the dosage and intervals that your physician has directed. Always check with a doctor before choosing an over-the-counter treatment to use on a rash. If you experience a mysterious rash on your skin, seek a diagnosis with a medical health care professional before you attempt any treatment at home.
What Can a Dermatologist Do for Your Herpes Zoster?
A Herpes Zoster outbreak can leave you with neural pain, scarring, and discolored skin even when the infection has run its course. At the Dermatology Consultants of South Florida, our Coral Springs dermatology staff of medical professionals offer services to help treat your symptoms of Herpes Zoster and get your skin back to normal. Pain from Herpes Zoster can hinder your movements, reduce your energy, and severely impact your quality of life. If you’re looking for a dermatologist in South Florida who can remove the unhappy remnants of your shingles outbreak, the Dermatology Consultants of South Florida offers a variety of services to combat pain, scarring, and discolored skin.
The best way to determine which course of treatment is ideal for your particular case of Herpes Zoster is to consult with our medical team in our office in Coral Springs or Sunrise. If you’re suffering from the effects of Herpes Zoster, contact us today to schedule your appointment!