Herpes zoster also known as shingles is a common viral skin disease that manifests as a painful rash usually in the shape of a strip on one side of the body. The virus, varicella zoster virus known to cause chicken pox in children and adults, is often not eliminated from the body, even after the disease is treated. This virus goes on to cause shingles, often many years later. Herpes zoster should not be confused with herpes simplex, as both are from the same family, but are different diseases.

Causes of Herpes Zoster: The Varicella Zoster Virus(VZV) sometimes becomes latent in the never cell bodies, and the non neural satellite cells of the dorsal root, cranial nerve or the autonomic ganglion. It remains in active for years after chicken pox outbreak. But sometimes the virus travels down the axon, having broken out of the nerve cells body, and causes a viral infection on the skin, in the general area surrounding the nerve ending.

Symptoms and Signs of Herpes Zoster: The first few symptoms to manifest are a mild fever, headaches and malaise. But these are often ignored and/or misdiagnosed as they maybe mistaken for the common cold. Following these symptoms are itching, hyperesthesia (oversensitivity), paresthesia (tingling or 'pins and needles' sensation) and a burning pain in the region affected. The pain is accompanied by sensations that are described by patients as tingling, aching, stinging, throbbing or numbing. It is also interspersed with stabs of pain that is agonizing.

The initial phase is followed by an appearance of a skin rash that is characterized by herpes. This occurs within 1-2 days of the infection becoming active, but sometimes this rash takes up to 3 weeks to manifest. Initially the rash resembles hives, but soon it turns into blisters that are filled with serous exudate. Soon the blisters become cloudy or darkened and eventually crust up and fall off. It usually doesn't leave a mark, but at times there is discoloration and scarring of the skin that was affected.

Treatment of Herpes Zoster: The treatment for herpes zoster is usually to make the symptoms bearable by the patients, to shorten the duration of the episode and to limit its severity. Several treatments of herpes zoster are followed by doctors:

Analgesics: over the counter pain medication is usually recommended to people with mild to moderate pain. Topical analgesics like calamine are also used to soothe the rash. In severe cases of pain, stronger prescription pain killers are given.

Antiviral: Several antiviral are prescribed by doctors to reduce the severity and inhibit replication of the virus.

Steroids: Steroids are used in the treatment, but they are not a highly recommended course of action.

Prognosis of the disease: In most patients the rash and the pain subside within 3 to 5 weeks. One in five patients, though develop a condition called Postherpetic Neuralgia, which is a painful condition and often difficult to manage. The risk of developing cancer after Herpes Zoster is also there. Certain complications may be faced, even though the disease resolves in 2 weeks:

• A secondary bacterial infection

• Weakness in motor activities

• Eye involvement: Trigeminal Nerve involvement is seen, and should be treated as fast as possible, and as aggressively as possible as it may lead to blindness.

• Postherpetic Neuralgia: it is a chronic pain condition that at times follows the Herpes Zoster infection.

Herpes Zoster can be a painful condition that is often misdiagnosed in the early stages. But once treated properly and extensively, it is fully curable and the chances of relapse are low.