[Health Lecture] Understanding shingles can help you stay away from pain!

In order to ensure the popularization effect of learning health knowledge in the 3rd China Elderly Health Knowledge Competition, the organizers have collected various health science articles suitable for elderly people to learn from various hospitals. We will share them through the "Health Lecture Hall" column. Today we bring you a popular science article on the prevention of herpes zoster brought by Lu Xianhua from the Second Central Hospital of Baoding City. Elderly friends are welcome to learn.

1. What is shingles?

Herpes zoster is commonly known as spider sores, herpes zoster, and herpes zoster. It is an infectious skin disease caused by the reactivation of the varicella-zoster virus that has long been dormant in the dorsal root ganglia of the spinal cord or cranial nerve ganglia. It is often accompanied by neuropathic pain, which affects the quality of life of patients.

2. What kind of people are prone to shingles?

Advanced age, cellular immune deficiency, genetic susceptibility, mechanical trauma, systemic diseases (such as diabetes, kidney disease, fever, hypertension, etc.), recent mental stress, fatigue, etc.

3. Is shingles contagious?

Varicella-zoster virus particles are mainly transmitted through air droplets, entering the body through the respiratory mucosa. Because the fluid in the herpes is contagious, patients with herpes zoster need to take respiratory isolation measures from other people before the scabs fall off, and their underwear should be washed separately.

4. What are the clinical manifestations of herpes zoster?

Typical clinical manifestations: before the eruption, there are systemic symptoms such as mild fatigue, low fever, loss of appetite, and the skin in the affected area feels burning or painful. The intercostal nerves, cervical nerves, trigeminal nerves and lumbosacral nerves are prone to occur. The affected area first appears erythematous, and soon papules ranging in size from millet to soybean appear, distributed in clusters without fusion, and then quickly turn into blisters, with tense and shiny blister walls, clear blister fluid, and a red halo around the periphery. The lesions are arranged in a band along a peripheral nerve area, mostly on one side of the body, generally not exceeding the midline. After the blisters dry up and the scabs fall off, temporary light red spots or pigmentation remain. Neuralgia is the main symptom, which can occur before the eruption, during the eruption, and after the skin lesions have healed.

5. How to treat shingles?

Western medicine treatment

1. Antiviral drugs: should be started within 24 to 72 hours after the onset of rash, including acyclovir, valacyclovir, famciclovir, etc.

2. Glucocorticoids.

3. Analgesics: non-steroidal anti-inflammatory drugs (such as diclofenac sodium, celecoxib, loxoprofen sodium tablets, etc.), tramadol, pregabalin or gabapentin, morphine or oxycodone, etc.

Traditional Chinese Medicine Treatment

1. Traditional Chinese medicine treatment

2. Acupuncture is a special treatment method of traditional Chinese medicine for herpes zoster. Treatment methods include fire needle, electroacupuncture, local circumferential needling, bloodletting, cupping, acupoint injection or thread embedding and moxibustion.

Topical treatments

Topical therapeutic drugs: When the blisters have not broken, you can apply calamine lotion, acyclovir cream or penciclovir cream; after the herpes has ruptured, you can use 3% boric acid solution or 1:5000 furacillin solution for wet compresses, or apply 0.5% neomycin ointment or 2% mupirocin ointment, etc.

6. The blisters are gone, but why does my skin still hurt? What should I do?

If the blisters are gone but the skin still hurts, it may be postherpetic neuralgia (PHN). my country stipulates that PHN is pain that lasts for 1 month or more after the rash heals. It is common in the unilateral chest, trigeminal nerve (mainly the ophthalmic branch) or neck. The nature of the pain is diverse, and it can be burning, electric shock, knife-like, needle-like or tearing. One type of pain is dominant, or multiple pains coexist. It significantly disrupts the patient's sleep and mood, affects work and daily life, and can cause mental disorders and depression in severe cases. 30% to 50% of patients have pain that lasts for more than 1 year, and some have a course of 10 years or longer. Early treatment of patients with PHN can shorten the duration of pain and reduce the difficulty of treatment. First-line treatment drugs include pregabalin and gabapentin, amitriptyline and 5% lidocaine patch. In addition, it can also cooperate with relevant departments such as the pain department to use neurointervention and physical therapy to relieve patient symptoms.

7. How to care for shingles?

1. Try to avoid scratching to avoid secondary infection

2. Avoid fatigue and get more rest

3. When lying in bed, lie on your side to prevent blisters from bursting. Keep the sheets and blankets clean, and change your underwear frequently and make sure it is soft.

4. Drain the fluid from the bulla with a syringe needle

5. For patients with ulcers and excessive exudate, the wound surface should be disinfected promptly and bandaged if necessary to prevent infection.

8. How to prevent shingles?

1. Strengthen physical fitness and improve disease resistance.

2. Prevent infection.

3. Prevent trauma (can reduce your own immunity).

4. Avoid contact with toxic substances (which can reduce your immunity).

5. Improve nutrition.

6. Get vaccinated.

References: The information comes from the Internet and "Chinese Expert Consensus on Herpes Zoster"

About the Author:

Lu Qianhua, anesthesiologist at the Second Central Hospital of Baoding, member of the Pain Branch of the Chinese Medical Doctor Association