Everything You Need to Know About Herpes

What Is Herpes?

Herpes or herpes zoster is a viral infection, commonly called Shingles, that usually affects the skin causing painful skin lesions. This is a misnomer since the infection is actually caused by the Varicella virus.

Varicella virus causes a primary infection called chicken pox. This virus then goes dormant and stays latent in the sensory nerve root ganglia. Later on, this can cause a secondary infection called Shingles or Herpes Zoster.

Who Are at Risk?

A person is at risk when his/her immunity is reduced due to the below-mentioned factors:

• Advancing age
• Pre-existing health conditions
• Immunosuppression as a treatment for certain diseases like autoimmune conditions or post-transplant
• Recent illness

Herpes Zoster causes painful skin lesions and is restricted usually to a certain dermatome. Dermatomes are areas on the skin that are each supplied by a separate nerve root. The lesions characteristically do not cross the midline.

What Is Disseminated Herpes?

In certain conditions, skin lesions can occur outside the dermatome due to the dissemination of the infection. It is usually defined as the appearance of 10-15 lesions outside the primary area (dermatome) within 7-14 days of the onset of the first skin lesion.

What Is the Treatment for Herpes?

The treatment for herpes is by initiation of antiviral usually in the form of tablets. However, some situations may warrant the need for injectable antiviral to manage the infection.

Can Herpes Involve the Eye?

Herpes zoster ophthalmicus is the viral involvement of the ophthalmic division of the trigeminal nerve and requires urgent ophthalmologist referral to prevent complications.

What Is PHN?

Herpes active infection is usually a self-limiting condition, but post-herpetic neuralgia (PHN) can cause severe pain. This can last up to several months and is severely debilitating. For this, several medicines such as capsaicin cream for local application, anesthetic skin patches, anticonvulsants, antidepressants and opioid analgesics are used. In severe PHN, steroid injections into the nerve root are advised. Newer modalities of treatment such as Scrambler therapy, Neuromodulation and Autohemotherapy can help manage chronic pain.

Can We Prevent This Disease?

As always, prevention is better than managing complications for which recombinant vaccine is available in India for Shingles which can be taken as 2 doses, 2-4 months apart and is recommended for those above the age of 50 years.