Herpes Zoster

Herpes Zoster

Herpes zoster or snake pox is a disease characterized by the appearance of rashes and watery nodules accompanied by pain on one side of the body. This disease is caused by the infection of the  Varicella Zoster virus , which is also the cause of chicken pox.

Herpes zoster or chicken pox is not life-threatening, but it can cause very disturbing pain. Generally, herpes zoster only occurs once. However, in rare cases, people who have been affected by herpes zoster can experience a recurrence.

The way to deal with this disease is by giving  antiviral drugs , in order to speed up healing and to reduce the risk of complications.

Causes of Herpes Zoster

Herpes zoster is caused by the  Varicella Zoster virus , which is the virus that also causes  chicken pox . In people who have recovered from chicken pox, the virus does not die, but only becomes inactive.

This dormant virus then moves to the nerves in the spinal cord and brain to reside for years. In this phase, the virus does not cause any symptoms.

However, under certain conditions, the virus that resides in the nerve cells can become active again. The active virus will affect the nerve cells in the skin so that it can cause symptoms of herpes zoster rash on the sufferer's skin.

It is not yet known what causes the  Varicella Zoster virus to reactivate  , because not everyone who has had chickenpox will develop herpes zoster. Some conditions that are thought to increase a person's risk of developing herpes zoster are:

  • Age 50 and above
    As you get older, your body's resistance will weaken so that the risk of contracting herpes zoster will increase.
  • Stress Physical or emotional
    stress can make the body release chemical compounds that can interfere with the body's resistance.
  • Weak body strength
    This condition can occur as a result of  AIDS , cancer, organ transplant surgery, or long-term consumption of corticosteroid drugs.

Recent research has found that cases of herpes zoster have occurred in some people who have received the COVID-19 vaccine . The appearance of herpes zoster is considered to be one of the KIPI that appears as a result of the Varicella Zoster virus reaction to the vaccine.

Symptoms of Herpes Zoster

The main symptom of herpes zoster is the appearance of watery bumps on the skin, with the following characteristics:

  • Lumps appear like  chicken pox  on one side of the body, either right or left
  • Nodules appear only in one area of ​​the skin
  • The skin tissue around the lump becomes swollen
  • The nodule will develop into a blister that will break and crust over, then slowly disappear in 2–3 weeks
  • Lumps appear in nerve strips from the spinal nerves, such as on the back, chest, and abdomen
  • Pimples appear on the face, eyes, mouth, and ears

In addition,  herpes nodules on the skin feel painful such as burning, stiffness, and tingling, which worsens when touched. This pain actually started 2-3 days before the lump appeared, and will still be felt even after the lump is gone.

In addition to lumps and pain, other symptoms experienced by herpes zoster sufferers are:

  • Fever
  • Shivering
  • Headache
  • Fatigue
  • Sensitive to light
  • Stomachache

Herpes zoster can also occur in and around the eyes. This condition is called herpes zoster ophthalmicus . Blister rash caused by this type of herpes zoster appears on the eyelids, forehead, and sometimes around the nose area. The symptoms that appear can be:

  • Eyes feel burning and throbbing pain
  • Red and inflamed eyes
  • Eyelids are swollen
  • Blurred vision

When should you go to the doctor?

Check with your doctor if you experience symptoms of herpes zoster as mentioned above, especially if you:

  • Aged 60 years or older
  • Having a weak immune system due to suffering from cancer or a chronic disease, a history of organ transplantation, or taking certain medications
  • Experiencing pain and rash around the eyes
  • Live in the same house with people who have weak immunity
  • Having a rash that spreads and feels very painful

Diagnosis of Herpes Zoster

Doctors can diagnose herpes zoster or snake pox through questioning and answering complaints, history of chicken pox, and physical examination of rashes or blisters that appear on the patient's skin.

In cases of herpes zoster that causes painful symptoms but is not accompanied by a rash, the doctor will perform laboratory tests to confirm the diagnosis. Some laboratory tests that can be done are:

  • PCR test, to detect Varicella Zoster virus DNA on skin samples
  • Serological tests, to detect the increase of IgM and IgG in the blood

Treatment of Herpes Zoster

Once the diagnosis of herpes zoster is confirmed, treatment with antiviral drugs should be done immediately to speed up healing and to reduce the risk of complications. Examples of antiviral drugs that can be given are:

  • Famiciclovir
  • Acyclovir
  • Valacyclovir

In addition to antiviral drugs, over-the-counter pain relievers can also be used. These medicines can be oral medicines containing paracetamol and ibuprofen , or topical medicines containing lidocaine. Antihistamines can also be prescribed to relieve itching.

In addition, also make some efforts below to ease the symptoms of herpes zoster :

  • Bathe with cold water, to clean the skin and reduce inflammation
  • Apply a cold compress to the rash to relieve pain and itching
  • Apply calamine lotion, to reduce itching
  • Wear loose clothing and soft material, such as cotton, to prevent friction and irritation on the skin
  • Cover the rash to keep it clean and dry

Complications of Herpes Zoster

If left untreated, herpes zoster can cause several serious complications, such as:

Postherpetic neuralgia

This condition is characterized by pain that lasts for months or even years after the rash has healed. Postherpetic neuralgia is mostly experienced by sufferers who are over 60 years old.


If it appears around the eyes, herpes zoster can cause inflammation of the optic nerve and develop into blindness .

Ramsay Hunt syndrome ( herpes zoster oticus )

Ramsay-Hunt syndrome  can occur when herpes zoster affects the nervous system in the head area. The symptoms depend on the affected nervous system, dizziness, vertigo, ringing in the ears ( tinnitus ), ear pain, hearing impairment, rash around the ear, or paralysis in half of the face.

Skin infection

Skin infection can occur if bacteria enter the blister that has broken. Examples of skin infections that can occur due to herpes zoster are impetigo or cellulitis .

Prevention of Herpes Zoster

The way to reduce the risk of herpes zoster is to get the chicken pox vaccine or the varicella vaccine . The vaccination is recommended for people aged 50 and over. In addition, the vaccine can also be given to herpes zoster sufferers to prevent recurrence.

Although it cannot prevent herpes zoster completely, the varicella vaccine can reduce the severity of the symptoms of this disease. In addition, this vaccine also speeds up the healing time.

As previously mentioned, herpes zoster is a continuation of the chicken pox disease so herpes zoster cannot be transmitted. Even so, the Varicella Zoster virus  can still spread to other people who have never suffered or never received the chicken pox vaccine .

The following are things that can be done to avoid spreading the Varicella virus to others:

  • Cover the blister wound so that the liquid in the blister does not contaminate things that can be an intermediary for transmission.
  • Do not touch or scratch the blister.
  • Wash your hands with soap and running water routinely.
  • Avoid direct contact with pregnant women who have never had chicken pox, babies with low birth weight or premature babies, and people with weak immunity.
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