Introduction
What should I know about Herpes Zoster?
The very same virus that causes chickenpox is the virus that causes herpes zoster, or shingles. This virus is known as varicella zoster virus (VZV). Chickenpox, while uncomfortable and very contagious, is usually a benign illness of childhood that is characterized by a rash with small blisters. When the VZV is reactivated, commonly after the sixth decade of life, herpes zoster presents itself as a rash that is accompanied by severe pain. (1)
Primary infection with this menacing virus is most likely to take place by way of the respiratory tract. After the virus begins to develop, it results in the usual blisters. But what causes this virus to be reactivated and display itself later in life as herpes zoster remains unknown. It simply remains latent until some stimulus reactivates it. Most who are diagnosed with herpes zoster have no history of recent exposure to individuals with VZV infection. Herpes zoster, more commonly known as shingles, can occur at any age, but seems to occur with the greatest frequency in the sixth to eighth decade of life. It has also been suggested that approximately 2 percent of patients who suffer from herpes zoster will suffer a second episode of the infection. The prevalence of herpes zoster in HIV-infected individuals appears higher than in other age-matched immunocompetent persons. (2) , (3)
The onset of this disease is accompanied by pain that is often severe and may continue throughout the progression of the disease. Blistering that crusts over in one to two weeks follows the initial signs of itching, burning, and tingling. (4) The total duration of the disease is generally between 7-10 days; however, it may take as long as two to four weeks for the skin to return to normal.
Approximately 45 percent of patients over 50 who develop shingles will experience pain persisting for more than six weeks after the rash clears up. This is known as postherpetic neuralgia, and is intense, burning, and unrelenting. It is almost never seen in children who develop zoster, and is a rarity among adults less than 50 years old. Sometimes nerves in the facial area are affected and the individual can lose the sense of taste on part of their tongue. This syndrome is known as Ramsay-Hunt syndrome.
People who are immunocompromised are at risk for zoster. In fact, individuals with Hodgkin’s disease and non- Hodgkin’s lymphoma are at greatest risk for the development of shingles. Another population at much greater risk of developing shingles are individuals who have received a bone marrow transplant. (5)
Statistic
International Herpes Management Forum, 2007.
-
One in five people will develop shingles during their lifetime.
National Institute of Neurological Disorders and Stroke (NINDS), 1999.
About 10 percent of normal adults can be expected to get shingles during their lifetime, usually after age 50.
The incidence increases with age so that shingles is 10 times more likely to occur in adults over 60 than in children under 10.
Most people who get shingles develop immunity to the virus and will not get the disease again.
Youngsters whose mothers had chickenpox late in pregnancy – 5 to 21 days before giving birth – are also vulnerable to shingles.
National Institutes of Allergy and Infectious Diseases, 2003
Shingles is estimated to affect 2 in every 10 persons.
- This year, more than 500,000 people will develop shingles.
Signs and Symptoms
The following list does not insure the presence of this health condition. Please see the text and your healthcare professional for more information.
A red rash on the skin that follows the path of a nerve and generally occurs on one side of the body are the first signs of shingles. Spots may be present that look like chicken pox; starting as red, raised bumps clustered in one area around a nerve or in a line. They then turn into blisters and within about 7 days will form a crust or scab. These affected areas of the skin occur most commonly on the back, chest or abdomen, but may occur on the face and neck. The rash is generally quite painful and is sometimes described as burning, intense pain. Occasionally the person may experience pain or a tingling sensation that occurs 2-3 days before the rash breaks out. The pain can last long beyond when the rash clears up; this is called post-herpetic neuralgia. Post-herpetic neuralgia occurs most often in patients over 50 years old.
General
- A red rash on the skin that follows the path of a nerve
- A painful, burning rash on one side of the body
- Spots look like chicken pox, starting as red, raised bumps clustered in one area around a nerve or in a line. They then turn into blisters, and within about 7 days, form a crust or scab
- Occurs most commonly on the back, chest, or abdomen, but may occur on the face or neck
Treatment Options
Conventional
Aluminum acetate soaks can be both soothing and cleansing for shingles lesions. In addition, a physician may prescribe one of the following drugs: Acyclovir, famcyclovir, and valacyclovir. In addition, analgesics or other drugs may be prescribed for the pain. In AIDS patients and intravenous acyclovir may be used for several days.
Nutritional Suplementation
Vitamin C
Ascorbic acid’s antiviral activity makes it a logical choice to use in the treatment of shingles. Unfortunately, only a few studies have been published on this topic. One study published in 1950 reported that 327 patients were helped by receiving 3 continuous days of intravenous vitamin C infusions. (6)
Vitamin E
One study reported that administration of 400 to 1,600 IU of vitamin E daily provided almost complete control of pain in 9 out of 13 patients, 2 patients were moderately improved, and 2 only slightly improved. (7) However, another published study reported no benefit from vitamin E at similar dosages. (8)
Herbal Suplementation
Cat’s Claw
Cat’s claw is one of the most promising herbs to come out of the rain forest to date. It has been used as a traditional medicine, possibly dating back as far as the Incan civilization. Cat’s claw reportedly affects the immune system and acts as a potent free radical scavenger. (9) Cat’s claw has glycosides which are said to reduce inflammation and edema which might prove to be beneficial in managing herpes zoster.
Olive Leaf
Olive leaf extract is thought to be an effective antimicrobial agent against a wide variety of pathogens. (10)
Olive leaf extract has reported antiviral activity, reportedly caused by the one of its chemicals known as calcium elenolate. (11) , (12)
Grapefruit Seed
Grapefruit seed extract has been reported to be a broad-spectrum antimicrobial and may prove useful in this condition.
Reishi Mushroom
Reishi is reported beneficial as an antioxidant, antihypertensive, hypoglycemic, antiviral, and hepatoprotective agent.
Polysaccharides in reishi have been reported in several clinical studies to have antiherpetic properties, and it has been used in treating herpes (13) and postherpetic neuralgia. It was found to decrease pain in a small number of patients with severe pain due to herpes zoster infection. (14)
References
- Whitley RJ. Varicella-Zoster Virus Infections. In: Fauci AS, Braunwald E, Isselbacher KJ, et al, eds. Harrison’s Principles of Internal Medicine, 14th ed. New York: McGraw-Hill; 1998:1086-1088.
- View Abstract: Rogers MF, Morens DM, Stewart JA, et al. National case control study of Kaposi’s sarcoma and Pneumocystis carinii pneumonia in homosexual men: Part 2, Laboratory results. Ann Intern Med. 1983;99:151-158.
- View Abstract: Melbye M, Grossman RJ, Goedert JJ, et al. Risk of AIDS after herpes zoster. Lancet. 1987;1:728-731.
- Tyler KL. Aseptic Menigitis, Viral Encephalitis, and Prion Diseases. In Fauci AS, Braunwald E, Isselbacher KJ, et al, eds. Harrison’s Principles of Internal medicine, 14th ed. New York: McGraw-Hill; 1998:2445-2446.
- Whitley RJ. Varicella-Zoster Virus Infections. In: Fauci AS, Braunwald E, Isselbacher KJ, et al, eds. Harrison’s Principles of Internal Medicine, 14th ed. New York: McGraw-Hill; 1998:1086-1088.
- Zureick M. Treatment of shingles and herpes with vitamin C intravenously. J des Practiciens. 1950;64:586.
- Ayres S Jr, Mihan R. Post-herpes zoster neuralgia: response to vitamin E therapy. Arch Dermatol. Dec1973;108(6):855-6.
- Cochrane T. Letter: Post-herpes zoster neuralgia: response to vitamin E therapy. Arch Dermatol. Mar1975;111(3):396.
- View Abstract: Aquino R, et al. Plant Metabolites. Structure and in Vitro Antiviral Activity of Quinovic Acid Glycosides from Uncaria tomentosa and Guettarda platypoda. J Nat Prod. 1989;52(4):679-85.
- View Abstract: Bisignano G, et al. On the in-vitro antimicrobial activity of oleuropein and hydroxytyrosol. J Pharm Pharmacol. Aug1999;51(8):971-4.
- Renis HE. In vitro antiviral activity of calcium elenolate. Antimicrob Agents Chemother. 1969:167-72.
- Heinze JE, et al. Specificity of the antiviral agent calcium elenolate. Antimicrob Agents Chemother. Oct1975;8(4):421-5.
- View Abstract: Eo SK, et al. Antiherpetic Activities of Various Protein Bound Polysaccharides Isolated from Ganoderma lucidum. J Ethnopharmacol. Dec1999;68(1-3):175-81.
- View Abstract: Hijikata Y, et al. Effect of Ganoderma lucidum on Postherpetic Neuralgia. Am J Chin Med. 1998;26(3-4):375-81.
