"Shingles" doesn't just grow on the waist. This article will help you to understand shingles again!

Recently, a well-known singer became a hot topic because of the pain around his eyes. Most people think that herpes zoster, also known as "waist-wrapped dragon", grows either on the waist or between the ribs, but it is rare to hear of it around the eyes. And it is said that the pain is like electric shock, knife cutting and needle prick, which makes people feel miserable. Regarding herpes zoster, how should it be treated and effectively prevented?

" Lung disease " is caused by a virus

Herpes zoster, also known as "herpes zoster" and "snake herpes zoster", is an infectious skin disease caused by the reactivation of the varicella-zoster virus lurking in the ganglia (dorsal root ganglia of the spinal cord or cranial nerve ganglia).

The first infection with the virus mainly causes systemic chickenpox. After being defeated, the remaining virus can "lurk" in the ganglia. When the body's immunity is low, it will be "awakened" and replicate in large quantities, involving multiple sensory neurons, and then penetrate the skin to cause herpes zoster. The disease is mainly transmitted through droplets and contact (contact with broken blisters).

Advanced age is a high-risk factor for the onset of herpes zoster. After the age of 50, the body's specific cellular immune function declines with age, and the probability of the virus being "awakened" again will gradually increase. In addition, immunosuppression caused by trauma, chronic diseases (diabetes, hypertension, kidney disease, chronic obstructive pulmonary disease, etc.), human immunodeficiency virus infection, malignant tumors, etc. can also cause the virus to be "activated."

Pain is the main symptom

(1) Neurotropic, unilateral, band-like distribution

Herpes zoster first appears as erythema, followed by a rash the size of soybeans distributed in clusters, and then turns into blisters. It often appears on one side of the body, along a peripheral nerve area (intercostal nerve, cervical nerve, trigeminal nerve and lumbar sacral nerve) in a belt-like arrangement, often appearing in the waist, between the ribs, and neck.

Because of its "neurotropic" property, the varicella-zoster virus can also invade the ophthalmic branch of the trigeminal nerve (such as herpes zoster ophthalmicus, manifested as unilateral eyelid swelling and conjunctival congestion); invade the facial nerve and auditory nerve (such as herpes zoster oticus, which can cause facial paralysis and hearing loss); invade the central nervous system (causing viral encephalitis); and invade the visceral nerves (causing acute gastroenteritis and cystitis).

(2) Diverse Pain Attacks

Postherpetic neuralgia is the most common complication. The pain period can exceed 3 months. The pain is of various natures, which can be burning (like touching a flame, hot or scalding), electric shock, knife-like, needle-like or tearing. Often multiple pains occur at the same time, making people feel miserable.

(3) Multi-pronged approach of antiviral and analgesic treatment

The treatment goals of herpes zoster are to relieve acute pain, shorten the duration of skin lesions, prevent the spread of skin lesions, and prevent or alleviate complications such as postherpetic neuralgia.

(4) Antiviral therapy is the first choice

It is recommended to start antiviral treatment within 24 to 72 hours after the onset of the rash. Drugs include acyclovir, valacyclovir, famciclovir, brivudine and sodium foscarnet.

(5) Choose different analgesics according to the pain level

For mild to moderate pain, choose acetaminophen, nonsteroidal anti-inflammatory drugs or tramadol; for moderate to severe pain, use morphine or oxycodone, or drugs for treating neuropathic pain such as gabapentin, pregabalin, and the antidepressant amitriptyline.

(6) External medication as an auxiliary

When the blister is not broken, calamine lotion, acyclovir cream or penciclovir cream can be applied externally; after the blister has broken, 3% boric acid solution can be used as appropriate; or 2% mupirocin ointment can be applied externally. For ocular herpes zoster, 3% acyclovir eye ointment or iodine glycoside eye drops can be applied externally.

It should be noted that the blister fluid or erosion surface of damaged skin still contains the virus, which can be transmitted through contact. Isolation and protection are required, and the skin lesions must be kept clean to avoid secondary bacterial infection.

Vaccination is an effective measure to prevent herpes zoster, including live attenuated vaccines and recombinant subunit vaccines. The latter is recommended for people aged 50 years and above with normal immune function (regardless of whether the individual has a history of varicella infection or has received varicella vaccine).

Develop healthy living habits: balanced diet, proper exercise, and adequate sleep are the basis for enhancing immunity. At the same time, avoid fatigue, pay attention to relaxation, and reduce stress.