Facial erysipelas is a specific form of shingles, which usually occurs between the ages of 30 and 50. It can manifest itself in varying degrees of severity and often represents a high psychological burden for those affected.
What is facial erysipelas?
Facial erysipelas is a skin disease that is triggered by the varicella zoster virus. This belongs to the herpes family and is also responsible for diseases such as shingles, which occurs mainly on the trunk. The disease manifests itself as a painful rash on the face and especially on the forehead, nose, cheeks, scalp and neck. The upper chest and back may also be affected by the disease. Facial erysipelas is usually chronic, but can be treated well with early detection.
Causes
Facial erysipelas can have several causes. In most cases, it develops due to an illness in childhood. For example, those who have chickenpox retain the virus in their bodies and must expect an outbreak of the disease. This usually happens between the ages of 30 and 50. The herpes virus can also cause facial erysipelas. It nests in the spinal cord and often does not reappear until years or decades later. This is what makes it so difficult for sufferers to determine the exact cause. In addition, a weakened immune system can also lay the foundation for facial erysipelas. Finally, stress favors facial erysipelas and shingles. Affected are mainly women, but men can also get it.
Symptoms, complaints and signs
Facial erysipelas usually announces itself by mild skin irritations such as burning and pain on touch. The discomfort initially occurs in only one side of the face and then spreads to the entire face. The outbreak of facial erysipelas is characterized by the appearance of conspicuously reddened pustules, purulent vesicles and papules. In the course of the disease, the skin changes spread to the entire head and the upper parts of the trunk. If the inflammation takes a severe course, the vesicles develop into nodules and indurations. More rarely, paralysis of the facial muscles or swelling around the eyelids occur, often associated with impaired vision. Facial erysipelas occurs predominantly in individuals between the ages of 30 and 50. The skin changes affect the entire face as well as the neck and throat. Redness and nodules develop especially on the bridge of the nose and cheeks. Occasionally, the ears are also affected, which can lead to hearing and balance disorders. Accompanying facial erysipelas may be fever, fatigue and exhaustion. The symptoms develop in different phases of two to three days each, before the vesicles finally open and the acute phase subsides. Scars often remain after recovery.
Diagnosis and course
Diagnosis of facial erysipelas can be made by the affected individual by recognizing various symptoms. These include a recognizable redness of the skin, which is often associated with mild skin irritation and burning pain. In most cases, only one half of the face is affected at first. In addition, larger pustules, papules and purulent vesicles appear on various parts of the face. Later, the entire head and back may also be affected. It is therefore particularly important to consult a dermatologist if corresponding symptoms occur. The dermatologist can then perform further examinations and differentiate the disease from similar skin diseases. This is done, on the one hand, by means of a detailed discussion with the affected person, who should point out existing diseases in childhood as well as the possibility of a herpes disease. In addition, private or professional stress factors are identified. Facial erysipelas can take a serious course if it is not treated. For example, inflammation leads to permanent induration and nodule formation within a few weeks. Paralysis of the facial muscles occurs and vision is impaired due to swelling of the eyelids. Facial erysipelas is therefore one of the most serious diseases and must be treated at an early stage.
Complications
Facial erysipelas causes relatively unpleasant and unsightly formations on the skin, mainly on the face.The affected person feels unattractive due to facial erysipelas in most cases and suffers from reduced self-confidence and inferiority complexes. The quality of life is limited by the symptom in most cases. Inflammations and infections can also develop, in which the skin swells strongly. It is also not uncommon for pustules to form. The inflammations on the skin can further lead to paralysis of the affected body regions and also impair vision if the eyelids are affected by facial erysipelas. Diagnosis is usually made with the help of medications or ointments and does not lead to further complications or discomfort. Most cases are characterized by a positive course of the disease. If there is more severe pain, it can be contained with the help of painkillers. Life expectancy is not limited or reduced by facial erysipelas.
When should you see a doctor?
Skin lesions on the face have serious causes in many cases. Therefore, a doctor should be consulted as soon as redness or other discolorations appear. If swelling is seen or there is growth of nodules, ulcers or growths, a doctor is needed. If skin blemishes or open sores form, a doctor’s visit should be made. Pathogens can enter the organism through the skin, leading to further diseases as well as blood poisoning. In case of pain, itching or a feeling of tension on the skin, a medical clarification of the symptoms should take place. If the skin changes spread or increase in intensity, a doctor must be consulted. If the affected person suffers from fever, inner restlessness, increased irritability or if there is a feeling of illness, a doctor should be consulted. If emotional or mental problems occur, a doctor should also be consulted. In the case of a depressive and melancholic mood, consultation with a doctor should be sought as soon as it persists abruptly for several weeks. If there is an aggressive appearance or social withdrawal, it is advisable to contact a doctor. If food intake is refused due to the symptoms, there is cause for concern. If there is a reduction in weight or if there are problems with concentration as well as attention, a visit to the doctor is necessary.
Treatment and therapy
To treat facial erysipelas, various therapies can be used. When choosing the form of treatment, the stage of the disease as well as the previous course of treatment are included. Most treatment approaches focus on symptom relief, as it is still not possible to completely cure facial erysipelas and shingles. Therefore, it is enormously important to act early. Once the disease has become chronic, which is the case after three to six months, therapies are not very promising. Ointments that inhibit irritation are prescribed to treat external symptoms such as swelling, redness and pustules. In addition, certain preparations are used which restrict the growth of the virus. Important active ingredients include deoxyuridine, idoxuridine and aciclovir. Injections with certain steroids have also proven effective in the past. Part of the therapy is also the targeted treatment of pain. For this purpose, various anticonvulsants such as gabapentin or carbamazepine are prescribed, which have a seizure-inhibiting effect. If these drugs no longer work, morphine-like painkillers are used. In addition, alternative treatment methods such as acupuncture can be used to treat facial erysipelas. However, the aforementioned forms of therapy rarely lead to a complete and permanent healing of the disease. Only if the outbreak of the varicella-zoster virus is prevented from the outset can facial erysipelas or shingles be effectively avoided.
Outlook and prognosis
If shingles occurs on the face, a particularly sensitive area is affected. Therefore, secondary problems cannot be ruled out. Especially if the affected person has a weakened immune system, complications can occur. If the eye is affected, inflammation of the sclera may occur. The cornea can also become inflamed. If facial erysipelas of the eye remains untreated, the intraocular pressure may increase. The consequence is glaucoma (green star). In the worst case, untreated facial rosacea leads to optic nerve damage and blindness.Untreated shingles not infrequently leave scars. The sensitive skin in the face and neck area is particularly susceptible to this. The scars form even without external influence. The affected person does not even have to have scratched to suffer scars. If facial erysipelas is treated in time, scars are extremely rare. Shingles on the face increase the risk of postzosteric neuralgia. The affected person experiences persistent pain. These may occur for years after facial erysipelas has been overcome. Facial erysipelas does not take a fatal course. In people with acquired immunodeficiency, the course of the disease is much more aggressive. AIDS patients are among the risk groups. Here, a fatal course is also not excluded.
Prevention
Facial erysipelas can be prevented only to a very limited extent. However, the risk can be minimized by a healthy lifestyle. So if you exercise a lot, eat a balanced diet and make sure you get enough sleep, you can at least minimize the risk of developing facial erysipelas. In general, everything should be done to strengthen the immune system to prevent the outbreak of the varicella-zoster virus. Avoiding stress in private and professional life is also an important factor. If facial erysipelas has already broken out, at least severe pain and other discomfort can be prevented by acting in time. If the disease is detected in the early stages and treated comprehensively, accompanying symptoms can be suppressed as far as possible.
Aftercare
In the case of facial erysipelas, no special options for aftercare are usually necessary or even possible. The affected person is thereby primarily dependent on the medical treatment of this disease, since it does not come to a self-healing. Furthermore, the triggering substance should be avoided so that the facial erysipelas does not recur. The disease can be treated relatively well in most cases. As a rule, those affected rely on taking medication and using ointments and creams to alleviate the symptoms. Care must always be taken to ensure that the medication is taken correctly and, above all, regularly. Possible interactions should also be taken into account, and in cases of doubt a doctor should be consulted. Even after the symptoms have subsided, the medicines and creams must continue to be used so that the symptoms do not recur. In this case, there are usually no particular complications. In general, the virus responsible for facial erysipelas should be avoided. The life expectancy of the affected person is not reduced by this disease. In many cases, contact with other sufferers of facial erysipelas is also useful.
This is what you can do yourself
Facial erysipelas, regardless of its localization, is almost always accompanied by an unpleasant itching. This must be resisted in any case. Giving in to it would only make the symptoms worse. The affected skin areas could also become inflamed. Instead, in addition to medical treatment and medication, skin-soothing measures are recommended. The decoction of decoctioned chamomile flowers has a soothing effect and reduces itching. For this purpose, gauze is soaked with the decoction and applied to the affected area. However, ointments and fats of any kind should be avoided. These clog the pores and may aggravate the inflammation. In addition to caffeine and nicotine, strongly spiced and especially spicy foods should also be avoided if possible. Steamed vegetables and gentle foods are a good alternative. Green tea, for example, is an excellent alternative to coffee: green tea has a stimulating and at the same time strengthening effect on the immune system. It is anti-inflammatory, antiviral and antibacterial. Those affected should avoid contact with pregnant women in any case. Herpes viruses are transmissible and can irreparably damage the unborn child. An outbreak of chickenpox in an unvaccinated mother in the last weeks of pregnancy means danger to the life of the child.
