Shingles, why does it still hurt after recovery?

Shingles is a skin disease caused by a viral infection. It is commonly known as "snake around the waist", "snake sores", "waist dragon", "waist snake", etc. In Guangdong, it is often called "snake". People who have had shingles know that clusters of blisters appear on the skin, arranged in strips along one side of the waist, back or limbs, just like a snake crawling on the skin. It is really painful!

The varicella-zoster virus has a very weak ability to survive in the outside world, and can only survive in the air for about 30 minutes. So why can a virus with such a short survival period still cause so much pain to people?

Why did I get chickenpox as a child?

I will still get herpes zoster when I get old

Although shingles mostly occurs in adults, especially middle-aged and elderly people, in fact, the varicella-zoster virus has already infected the human body when we were young.

Many people's first encounter with the varicella-zoster virus occurs before the age of 10, and 80% to 90% of those infected will develop chickenpox.

Chickenpox is a self-limiting disease that can be cured without treatment, so it is not terrible except for the discomfort when the pox breaks out. However, after the chickenpox patient recovers, the virus does not leave our body, but lurks in the ganglia at the root of our nerves, waiting for an opportunity to strike.

Under certain circumstances (such as trauma, fatigue, malignant tumors, weakness after illness, use of immunosuppressants, etc.), the virus will be reactivated from the latent nerve roots, along the nerve axons, to the skin of the nerve innervation area, causing shingles.

Therefore, the occurrence of shingles is caused by the reactivation of the varicella-zoster virus that has been dormant in our body for a long time.

Under what circumstances is herpes zoster likely to occur?

Shingles can occur spontaneously, but is more likely to occur when a person's immune system is weakened.

Common factors that contribute to decreased human immunity include: staying up late, lack of rest, overwork, excessive mental stress, malnutrition, weakness after illness, use of immunosuppressants, or suffering from diseases that lead to decreased immunity (such as HIV infection, malignant tumors, systemic lupus erythematosus, etc.).

Age is an important risk factor for herpes zoster, and the risk of people over 50 is 2 to 4 times that of people under 50. The annual incidence rate of people over 50 in Guangdong is 4.3‰.

How is shingles treated?

The treatment of herpes zoster mainly includes antiviral, sedative and analgesic and local symptomatic treatment.

Antiviral treatment: Early and adequate antiviral treatment can quickly control symptoms, shorten the course of the disease, and reduce the occurrence of postherpetic neuralgia. It is recommended to take medication within 72 hours. Commonly used drugs include acyclovir, famciclovir, valacyclovir, penciclovir, etc.

Sedation and analgesia: In the acute phase, nonsteroidal anti-inflammatory drugs, tramadol, etc. can be used. Gabapentin, pregabalin and other drugs combined with antiviral treatment can significantly reduce postherpetic neuralgia.

Local symptomatic treatment: Keep the skin clean to avoid secondary infection. Local physical therapy can promote the drying and scabbing of blisters and relieve pain.

The herpes has healed, why is it still painful?

Postherpetic neuralgia is the most common, with pain lasting at least 90 days or even years. It is more likely to occur in the elderly and those with weakened immune systems. Due to long-term pain, patients often suffer from sleep disorders, anxiety, depression, and other mental symptoms; severe pain can also cause suicidal tendencies in patients, seriously affecting their quality of life.

Herpes zoster ophthalmicus can cause keratitis, corneal ulcers, etc., and in severe cases can lead to blindness.

Facial herpes zoster can cause facial nerve paralysis, which manifests as facial paralysis, etc. (herpes zoster facial palsy).

Non-pain-related complications are relatively uncommon and include postherpetic pruritus, herpes zoster-related encephalitis, and myelitis.

Some immunocompromised patients may also develop disseminated infection, which has the risk of spreading to the lungs, brain, and liver. The condition is usually more serious, with a mortality rate of up to 40%.

The repair speed of human nerve tissue is very slow, while the recovery speed of skin tissue is much faster. Therefore, after herpes zoster is controlled, the skin herpes usually subsides first, while the nerve symptoms such as pain or itching will still continue for a period of time.

Early and standardized treatment can reduce the damage caused by the virus to the nerves and help the nerve pain recover as soon as possible.

How to prevent shingles?

Basic prevention focuses on enhancing resistance and developing healthy living habits, such as maintaining a regular schedule, combining work and rest, being positive and optimistic, enhancing nutrition, and eating a balanced diet.

The most effective means of active prevention is to get vaccinated against herpes zoster. The recommended vaccination population is middle-aged and elderly people aged 50 and above, which can significantly reduce the risk of herpes zoster.

Why is shingles so painful?

The varicella-zoster virus is neurotropic. When the latent virus is activated, it will first cause inflammation, edema, and necrosis of the affected nerves, resulting in severe neuralgia. The severity of nerve damage determines the intensity of the pain. Neuralgia is more severe in the elderly and people with weakened immune systems.

Will I die if shingles grows into a circle?

There is a folk saying that when herpes zoster circles the body, the patient will die. But in fact, the site of herpes zoster is often limited to the nerve innervation area, so it is usually located on one side of the body and does not circle the body. A small number of patients with low immunity will have disseminated infection and viremia. Herpes zoster will endanger the patient's life only when it causes serious infections such as viral encephalitis.

Is shingles contagious?

The varicella-zoster virus can survive in the blister fluid of shingles, but cannot survive in the scab. Therefore, the blister fluid of shingles is contagious, with a transmission probability of about 15%. Therefore, before the blisters on the skin of shingles patients have dried and scabbed, you should avoid skin contact with the patients to avoid infection.