What are these painful blisters that appear on my body? Is that herpes zoster?

Have you suddenly developed a painful rash on your body? Perhaps it's accompanied by a burning sensation and itching? It's normal to feel a little nervous when something like this happens. Some people call this condition "chickenpox," but it's not really anything other than an animal. Today we're going to talk about this condition, which is medically known as Herpes Zoster , but is also known as Shingles among many people. Don't worry, we'll talk about it simply and in a way that you can understand.

What exactly is Herpes Zoster?

Simply put, Herpes Zoster is a skin rash that often causes painful blisters. It is caused by the same virus that causes chickenpox . Yes, you may be surprised, but it is true. We call this virus the Varicella-Zoster Virus (VZV) .

Do you remember when you got chickenpox when you were a kid? It was really annoying, with blisters all over your body, and itchy, right? After you get chickenpox, the virus doesn't completely disappear from your body. It's very cunning, it stays dormant in your nervous system, that is, in the nerve cells in your spinal cord and brain, for years, causing no problems. It's like sleeping.

So, herpes zoster is a condition where the Varicella-Zoster Virus, which has been dormant for years, suddenly wakes up again, becomes active, and travels along the nerves to the skin, causing shingles. That's why it's also called "Shingles."

Does everyone who has chickenpox get herpes zoster?

This is a problem that many people have. No, not everyone who has chickenpox will develop herpes zoster. However, anyone who has had chickenpox has a chance of developing this condition at some point in their life.

Imagine, the virus is like a "prisoner" inside the nerve cells of our body. As long as our immune system is strong, that is, as long as our body's defenses that fight diseases are working well, this virus cannot raise its head again. However, if for some reason this immune system weakens, the sleeping virus has the opportunity to wake up again, that is, to become active.

Typically, herpes zoster is most common in people over the age of 50 or 60. This is because our immune system naturally weakens as we age. However, it can sometimes occur in younger people and in people with other medical conditions that weaken their immune systems.

Why is this virus reactivating? What are the reasons?

As we've discussed before, the main cause is a weakened immune system. There are several factors that can contribute to this:

• Ageing: This is the main risk factor. The risk gradually increases after the age of 50.
• Severe Stress: Prolonged, excessive stress can affect our immune system.
• Other medical conditions: For example, people with HIV infection , cancer, or other diseases that affect the immune system are at increased risk of developing herpes zoster.
• Certain medications: Medications such as chemotherapy for cancer, immunosuppressants after organ transplants, or high doses of steroids taken for a long time can also weaken the immune system.
• Major surgery or a serious accident: The stress on the body from things like this can sometimes cause the virus to become active.
• Sometimes this can happen for no apparent reason .

The important thing is, it's not your fault that you got herpes zoster. It can happen to anyone.

What are the symptoms of herpes zoster (shingles)?

Symptoms of herpes zoster usually appear in two stages.

Stage One: Symptoms before the onset of symptoms

This may sound a little strange, but in fact, some symptoms start to appear a few days, maybe even a week, before the skin lesions appear.

• Pain: Severe pain, burning, numbness, tingling, or itching may be felt on one side of the body, usually in a belt-like strip (an area of ​​skin controlled by a nerve called a dermatome). This pain can sometimes be sharp, like a knife.
• Some people may also experience common symptoms such as fever, headache, malaise, and stomach upset during this time.

This pain is so severe that some people may even fear it as a serious illness, such as a heart attack or appendicitis.

Stage 2: Skin lesions and blisters appear

After a few days, red spots start to appear where the pain and inflammation were.

• Next, clusters of small fluid-filled blisters appear on top of these red bumps. These blisters are initially filled with a clear fluid, but may later turn milky or yellow.
• These sores and blisters usually appear on only one side of the body . They often appear as a band on one side of the chest, stomach, or back. However, they can also appear on the face, neck, arms, or legs.
• If these lesions appear on the face, especially around the eyes or on the forehead, you need to be very careful because they can damage the eyes. We'll talk about that later.
• After about 7-10 days, these blisters will dry up, form a crust, and gradually begin to heal. It can take about 2-4 weeks to fully heal.
• After the wound heals, sometimes the skin color in that area may change or scars may form.

Pain is the main and most bothersome symptom of herpes zoster. For some people, this pain can be unbearable.

Are these blisters contagious? Will they spread to others?

This is also a very important point. Yes, the fluid in herpes zoster blisters can be contagious.

But there's a slight difference here. Think about it this way:

• If the fluid from the blisters of a person with shingles comes into contact with the skin of someone who has never had chickenpox before and has not received the chickenpox vaccine, the second person will develop chickenpox , not herpes zoster.
• This means that herpes zoster is not spread directly from one person to another (like a cold). You get herpes zoster when the virus that was already present in your body becomes active.

So, if you have herpes zoster, you should be especially careful:

• From people who have never had chickenpox (especially pregnant mothers, newborn babies, and those with weakened immune systems).
• From people who have not received the chickenpox vaccine.

Things to do:

• Keep the blistered area covered with clothing as much as possible.
• Do not scratch or squeeze blisters. Doing so can spread the virus and cause injury and infection.
• Do not share your towels or clothes with others.
• Always wash your hands thoroughly with soap.

Once the blisters dry up and crust over, the risk of transmitting the virus is gone.

Can herpes zoster (shingles) be dangerous? Are there any complications?

Although herpes zoster usually clears up in a few weeks, some people can develop complications. It's important to be aware of these.

• Post-Herpetic Neuralgia (PHN): This is the most common complication. In this condition, even after the herpes zoster rash has healed, there is still pain, inflammation, or numbness in the nerves where the rash first appeared. This pain can sometimes last for months or even years. It is a very distressing and life-threatening condition. Older people are at higher risk of developing PHN.
• Ophthalmic Zoster: If herpes zoster occurs on the face, especially on the forehead or around the eyes, it can affect the eyes. Symptoms include eye pain, redness, and blurred vision. This is an emergency! If not treated promptly by an eye doctor, permanent vision loss may occur.
• Ramsay Hunt Syndrome: This is when the herpes zoster virus affects the facial nerves that run from the ear to the face. This can cause symptoms such as facial paralysis, ear pain, hearing loss, and vertigo. This also requires prompt treatment.
• Skin infections: If blisters are not properly cleaned and broken, bacterial infections can develop, making the wound slower to heal and more painful.
• Other rare complications: Very rarely, brain infection (encephalitis), meningitis, or other nerve damage in the body may occur.

These complications are not mentioned to scare you, but to make you understand the importance of being aware of this condition and seeking medical advice as soon as symptoms begin.

Is there any treatment for this? Do I need to see a doctor?

Yes! Absolutely! If you suspect you have herpes zoster, see a doctor as soon as possible. Especially if you can start treatment within 72 hours of the onset of symptoms, it will greatly help reduce pain, heal the disease faster, and reduce the risk of those complications we talked about.

The doctor usually prescribes treatments like this:

• Antiviral medications: These are the main treatment. For example, medications like Acyclovir, Valacyclovir, and Famciclovir can be given. These control the spread of the virus in the body.
• Painkillers: Various types of painkillers can be given to control pain. Sometimes, special medications for nerve pain may also be needed.
• Skin Creams/Lotions: The doctor will recommend suitable creams to reduce itching, inflammation, and cool the skin.
• Other medications: Sometimes, especially for conditions like PHN, other medications may be needed.

Things you can do at home:

• Keep the affected area clean and dry .
• Apply cool compresses . Soak a clean cloth in cold water, wring it out, and place it on the affected area for a few minutes.
• Wear loose, cotton clothing . Tight, rough clothing that is tight against the skin can increase pain.
• Get as much rest as possible.
• Take the medications prescribed by the doctor exactly and on time.

Can herpes zoster (shingles) recur?

This is also a question that many people ask. Yes, although rare, herpes zoster can recur. Just because you've had it once doesn't mean it won't happen again. However, it's relatively rare to get it a second time. People with weakened immune systems are at a slightly higher risk of reoccurrence.

Is there a way to avoid this? I've heard about a vaccine...

The good news is, yes! There is now a very effective vaccine to protect against herpes zoster!

• Shingrix vaccine: This vaccine has been proven to be highly effective in protecting against herpes zoster and its complication, PHN.
• This vaccine is generally recommended for all adults aged 50 and over .
• Also, people aged 19 and over who have a weakened immune system (e.g. due to certain medical conditions or medications) can get this vaccine.
• Even if you have had herpes zoster before, getting this vaccine can reduce your risk of getting it again.
• This vaccine is given in two doses.
• It's best to talk to your doctor and ask if this vaccine is right for you.

• Chickenpox vaccine: Getting the chickenpox vaccine as a child can help prevent chickenpox. If you don't get chickenpox, the varicella-zoster virus won't enter your body, so you won't get herpes zoster later. If you didn't get chickenpox as a child and didn't get the chickenpox vaccine, you can get the vaccine as an adult. Talk to your doctor about this.

In addition, following a healthy lifestyle , which means eating a well-balanced diet, getting enough sleep, exercising, and managing stress, also helps to keep the immune system strong in general.

So, what are the things we need to remember from all of this? (Take-Home Message)

Okay, so let's recap the most important points from what we've talked about:

• Herpes Zoster is a painful, blistering rash caused by the reactivation of the chickenpox virus (Varicella-Zoster Virus) in our bodies.
• It is spread through the fluid in the blisters, but it can also cause chickenpox in others (if they have had chickenpox before/have not been vaccinated).
• Pain is the main symptom. Sometimes complications such as post-herpetic neuralgia (PHN) can occur.
• Seek medical advice as soon as symptoms begin. Early treatment has many benefits.
• There is an effective vaccine (Shingrix) to protect against herpes zoster. It is recommended for people over 50 years of age and those in risk groups.
• Don't be afraid, but be aware. If you have any questions about this, never hesitate to talk to a doctor.

I hope you find this information useful. Stay healthy!

` Herpes Zoster, Shingles, Chickenpox, Skin Diseases, Blisters, Nerve Pain, Herpes Zoster, Varicella-Zoster Virus, Shingles vaccine