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Shingles (herpes zoster)

Herpes zoster · Pásový opar (herpes zoster)

What it is

Chickenpox virus reawakens in a nerve ganglion decades later.

Symptoms & signs

  • Burning pain in one band of skin
  • blistering rash in that band
  • fever
  • pain persisting after rash (neuralgia)

🚩 Get help if…

  • call 112 / 911 now Confusion, severe headache, stiff neck or weakness
  • see a doctor soon Rash on the tip of the nose or near the eye
  • see a doctor soon Painful red eye or blurred vision
  • see a doctor soon Rash spreading all over the body, or a weak immune system

Where it strikes

Medical treatment

  • Valaciclovir within 72 h trials support
  • Pain relief trials support
  • Amitriptyline or gabapentin for the nerve pain that follows — helps some, sedates most mixed evidence
  • Recombinant zoster vaccine (Shingrix) — about 90% fewer shingles episodes in trials, at the cost of a day or two feeling rough after each dose and a small Guillain-Barré signal (a few per million doses) trials support
  • Capsaicin 8% patch (Qutenza) for the pain after shingles — approved (FDA, EMA) mixed evidence

Natural & lifestyle

  • Vaccination over 50
  • stress and sleep management
  • calamine and cool compresses
  • keep the rash covered

Emerging & experimental

  • New antivirals (amenamevir)
  • cryoneurolysis

Alternative, off-label & anecdotal

Approaches used outside the guidelines, with what their supporters report and what testing has found so far.

  • Acupuncture for zoster pain — trials disagree mixed evidence
  • Manuka honey on the rash — a small study early / small studies
  • Lysine — anecdotal anecdotal / traditional

ICD codes