Thanks for consulting us. Reactivation of varicella-zoster virus (VZV) that has remained dormant within dorsal root ganglia, often for decades after the patient’s initial exposure to the virus in the form of varicella (chickenpox), results in herpes zoster (shingles). Although it is usually a self-limited dermatomal rash with pain, herpes zoster can be far more serious; in addition, acute cases often lead to postherpetic neuralgia (PHN). Some people have chicken pox in milder form and probably unnoticed. In this condition, virus will remain dormant in nerve roots and will be reactivated when ever the immunity is lowered. Episodes of herpes zoster are generally self-limited and resolve without intervention. Conservative therapy includes nonsteroidal anti-inflammatory drugs (NSAIDs); wet dressings with 5% aluminum acetate (Burow solution), applied for 30-60 minutes 4-6 times daily; and lotions (such as calamine). Treatment is of greatest benefit in those patient populations at risk for prolonged or severe symptoms, specifically, immunocompromised people and persons older than 50 years. Medications used include steroids, analgesics, anticonvulsants, and antiviral agents. Acyclovir and its derivatives (famciclovir, penciclovir, and valacyclovir) have been shown to be safe and effective in the treatment of active disease and the prevention of postherpetic neuralgia (PHN). For other treatment options, consult your physician. Have a nice day.
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