Synonyms in a broader sense
- Herpes Zoster
- Zoster
General information
Shingles, a viral infection, is a late consequence of chickenpox infection. A weakened immune system reactivates the virus. However, it does not necessarily occur in all people who have already contracted chickenpox.
The main symptom is the formation of blisters in a limited area of skin, which is accompanied by redness and medium to severe pain. Above all, however, it is always restricted to dermatomes. These are certain areas that are supplied by a skin nerve.
They usually run horizontally. Since the zoster virus is located in nerve cells, the areas that are supplied by the nerve affected by the virus are always affected when shingles breaks out. It is estimated that around 90% of people are infected with the varicella zoster virus by the age of 14.
They now have lifelong immunity to chickenpox. Up to 20% of these partially immune adults later develop shingles. The first signs of beginning shingles are initially very unspecific.
Those affected complain of a slight feeling of weakness, which is accompanied by tiredness, exhaustion and a slight fever. The fever usually only rises to values up to 38°C. After one to two days, more specific signs such as sensitivity disorders and pain in the affected skin area are added to the list of symptoms.
In addition, blisters start to form and the skin begins to swell. This rash or inflammation now spreads, in most cases unilaterally, in the form of a belt over the trunk (or other areas depending on the area affected), which is the most specific sign of the presence of shingles. In most cases there is also a nerve pain (Latin: neuralgia) of the affected nerve, which is accompanied by severe itching.
This nerve pain is perceived by many as stabbing and painful and should be treated by adequate pain therapy. This is discussed in more detail in the section What helps against pain in shingles. The viruses that cause shingles are the same as those that cause chickenpox.
Direct skin contact with the contents of the blister is necessary for infection with these viruses (smear infection). If the blisters are encrusted, there is no longer any danger of virus transmission. However, it is not possible to become directly infected with shingles: there can only be an outbreak of chickenpox – and even this only affects people who have not yet had chickenpox or have not been vaccinated.
As a rule, chickenpox develops after about 2 weeks, in individual cases after just one week or even after 4 weeks. If you have already had chickenpox or have been vaccinated against it, there is therefore no risk of infection for people suffering from shingles. Shingles itself is an endogenous infection.
This means that the chickenpox viruses are reactivated at some point in time when the immune system is weakened. Shingles is caused by the varicella zoster virus. Initial infection with this virus leads to the clinical picture of varicella, chickenpox.
Normally, chickenpox is contracted once during childhood and adolescence. Chickenpox is transmitted by droplet infection (e.g. coughing). However, the viruses remain in the body even after healing.
They retreat along the nerve fibres into the spinal ganglia. Spinal ganglia are switchboards of the central nervous system. They are located near the spinal cord.
If the immune system is weakened, the virus can be reactivated. This disease is called shingles. Solar radiation and stress can also promote zoster.
The infection of the herpes zoster is only possible through the transmission of the virus-containing vesicle contents, but it is minimal. Only people who have not yet had chickenpox and have not been vaccinated can be infected. However, these people would get chickenpox, not shingles.
There is no direct infection with the clinical picture of shingles. This means that someone who has shingles cannot infect another person with shingles. Stress is one of the risk factors for the outbreak of shingles.
Through various factors such as stress, it can now reactivate the viruses. The consequence is the development of shingles.The extent to which stress leads to activation of the viruses is not yet understood in detail. It is currently assumed that stress weakens the immune system, which means that the virus can no longer be kept in check and reactivation occurs.
Other risk factors are
- An immune deficiency,
- Major traumas
- And intensive UV radiation.
Many different factors can cause the onset of shingles. To the question why the varicella zoster viruses are sometimes inactive for years in a body and suddenly become activated and cause shingles, science is currently unable to provide an exact answer. However, some risk factors are known that make an outbreak of shingles more likely.
These include stress, major injuries and immunodeficiency. There are many reasons that can cause an immune deficiency. One of these reasons can be the presence of HIV or AIDS. However, it is wrong to conclude that shingles is a clear indication of the presence of HIV.
