Update: October 2018
Autumn and spring are the most dangerous times of the year for people with
chronic diseases because more often
their exacerbations, as well as some viruses or
infections that are latent.
Such treacherous diseases include shingles,
symptoms of which are quite bright and painful. ANDм одинаково
often both men and women are sick, and most often it appears in
older people after 50 years.
However, with the general unfavorable ecological situation
residents of cities have increased the incidence of this disease and
young people whose immune system for various reasons
weakens and cannot cope with viral and infectious
diseases. And the increased incidence of cancer leads to
that shingles is a frequent companion of cancer patients, especially
those who receive radiation or chemotherapy that destroys
ANDзвестно, что большинство людей в детстве перенесли ветряную
smallpox, therefore, under conditions favorable to the virus, secondary
aggravation of herpes Zoster develops in the form of shingles and
during the life of each person the risk of such reactivation
Symptoms of the disease
The symptoms of this disease begin quite acutely, while
first in the place of localization of the human virus is experiencing a strong
burning, pain in a certain area.
Most often these are one-sided regions that are innervated by one.
nerve – where the trigeminal nerves are located on the face, upper,
lower jaw, forehead, neck, neck, intercostal nerves and nerves
limbs, as well as on the chest, shoulders, back, buttocks,
On the body, these are the so-called dermatomes supplied
spinal nerves, on the face – areas of lesion of the trigeminal
or facial nerves. This is because the main cluster
virus – in the nerve nodes (ganglia), the posterior horns of the spinal cord
or cranial nerves, and rashes go along the nerve.
Prodromal, characterized by general malaise,
neuralgic pains of varying intensity, it lasts
average 2-4 days:
- Субфебрильная температура тела, реже лихорадка до
- Chills, weakness
- Dyspeptic disorders, violation of the gastrointestinal tract
- Pain, itching, burning, tingling in the peripheral area
нервов в зоне, где потом будут высыпания.
- Most often during the acute process they become painful and
regional lymph nodes increase.
- With тяжелом течении заболевания возможно появление задержки
urination and other disorders of some systems and
After the temperature decreases, other common
Period of rash
The time when there are rashes characteristic of shingles
depriving. Symptoms and nature of the rash depend on the severity of the inflammatory
process. At first, the rash appears as a foci of pink spots the size of
2-5 mm, between which there are areas of healthy skin.
- With типичной форме заболевания на следующий день на их месте
small, closely grouped vesicles form, bubbles with
transparent serous contents, which turn cloudy after 3-4 days.
- With гангренеозной тяжелой форме герпеса содержимое пузырьков
may be mixed with blood, black. Herpetic eruptions
have a wavy flow, like with chickenpox, that is, with
in intervals of several days appear fresh rash with
vesicular elements. Bubbles crawl from one
places to another, girdling the body, hence the name of this
- With легких же формах воспалительного процесса трансформация
pustules do not form a skin nodule and their ulceration is not
occurs, and also the manifestation of herpes is possible only
neurological nature – pain without a rash, otherwise it still
called herpetic neuralgia and are often mistaken for
manifestations of intercostal neuralgia, osteochondrosis, or heart pain.
AND поэтому может быть назначено неадекватное лечение.
Period of formation of crusts
Usually in 14-20 days at the site of eruptions crusts form.
The whole erythematous background, i.e. the place where the vesicles were located
gradually become pale, dry up, and yellowish-brown
the crusts fall off, leaving little pigmentation or
The symptoms of this disease are due to the disruption of the nerve
cells in the zone of localization of the virus, therefore, in the process of its active
breeding nerve endings become overly sensitive,
even a light touch causes significant pain to the patient
as with burns, especially when in contact with water. Therefore, the question can be
whether to wash with herpes zoster is not decided unequivocally.
Существует несколько противоположных мнений, одно — что
wash with shingles is contraindicated, the other – that
swimming is necessary and very well help bath with sea salt, the third
– that it is better to take only a shower, after which should not
wipe off and gently wipe the body with a towel.
Many patients describe herpes zoster pains as
burning, dull, boring, or like passing an electric current,
aggravated by the slightest thermal or mechanical
impact. Skin pain accompanies both the period of illness and
retained in 15% of those who recovered after the healing of herpetic
This is not due to the progression of the disease, but because
viral lesions were abnormalities in the nerve tissues, on
recovery which takes time. This period is called
postherpetic neuropathy, which in young people can last
not more than a month, but in older people in 70% of cases it lasts
several months. In patients older than 70 years old, neuralgia may
last even more than a year.
How to treat herpes zoster?
Treatment of this disease in young people who do not have serious
chronic diseases and health problems are required.
Herpes zoster in such cases leads to complete
recovery after 2 – 3 weeks. However, in any case,
the appearance of the above symptoms of the disease should be required
seek medical advice. Which doctor treats shingles
deprive herpes? To begin with, you should contact the therapist, then
dermatologist or infectious diseases, and in severe disease
You may need to consult a neurologist or with an ophthalmic form
herpes – ophthalmologist.
Read also on the topic:
- Is shingles contagious?
- Shingles – causes
- Herpes ointment on the lips
- Herpes on the lips – treatment
- How to quickly cure herpes on the lips
To relieve pain and discomfort the doctor may prescribe
painkillers such as Ibuprofen, Paracetamol,
Naproxen or gel with lidocaine. If pains are more intense
character, then such strong painkillers like gabapentin and
Oxycodone will be prescribed with antiviral agents.
It is also possible to use nonsteroidal anti-inflammatory
препаратов (см. список всех НПВС уколы от боли в спине).
The doctor may prescribe antiherpetic specific
drugs, injections, tablets, in the form of creams or ointments:
- Acyclovir preparations – Acyclovir, zovirax, virolex.
- Valaciclovir preparations – Valciclovir, valtrex. Ether
acyclovir, transformed after absorption into acyclovir.
- Penciclovir preparations – in the form of penciclovir triphosphate also
blocks the synthesis of viral deoxyribonucleic acid.
- Famciclovir preparations. Prodrug that turns into
penciclovir in liver cells
Antiviral therapy is necessary because without adequate
treating shingles can give complications, besides
antiherpetic treatment promotes rapid healing
sores, reduces pain and improves the overall condition. AND
dosage, and the course of therapy is determined by a specialist taking into account
individual course of the inflammatory process, concomitant
diseases and on average is no more than 10 days.
Today, quite an effective drug for
treatment of herpes is considered Epigen’s antiviral cream, a part of
which includes glycyrrhizic acid. He is having a local
anti-inflammatory, antiviral, immunomodulatory,
When gangrenous form when bacterial
infection prescribe broad-spectrum antibiotics. Also at
the need for a specialist can be assigned nemomodulators,
such as Cycloferon, Genferon, physiotherapy and vitamin therapy.
For the treatment of rashes, there are also several
opposing opinions. One thing – you can use brilliant green –
solution of brilliant green, boric acid – liquid Castellani,
fukortsin, strong solution of potassium permanganate. All of these tools have
drying effect and should be used with caution
avoid burns, which worsens the skin condition. Other
the opinion that it is not worth treating the rashes with these agents, but
it is better to use antiviral, antiherpetic creams,
Do not use corticosteroids, either orally or
in the form of creams and ointments, as this only worsens the situation.
Hormonal drugs have a suppressive effect on the immune system.
a system that must cope with viral agents.
Treatment of postherpetic neuralgia with chronic pain
older people are not always successful because antiviral
drugs are powerless. Neurologists can prescribe
plasmapheresis, acupuncture, physiotherapy, tricyclic
antidepressants, pregabalin, gabapentin.
- In severe disease, facial paralysis may occur.
nerve or other paralysis due to motor nerve damage.
- It is also possible violations of the internal organs, such
like pneumonia, diseases of the urogenital system, duodenal
- With damage to the eyes, optic nerve neuritis can occur and
significantly reduced visual acuity.
- With a very dangerous encephalitic form of shingles,
complication is meningoencephalitis – a serious illness, often
all leading to disability.
- With bacterial infection, purulent processes
aggravate the patient’s condition, the recovery process after
The disease is delayed for months.
The prognosis for non-severe forms of the disease is favorable, usually
Recurrence and serious consequences of herpes zoster does not happen.
However, in debilitated people after a severe inflammatory process
further exacerbations are possible.
Автор: Мельникова Светлана Георгиевна врач-дерматолог