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After chickenpox the virus remains inactive in certain nerve cells and when it is reactivated it causes herpes zoster. To date it has not been fully clarified which factors lead to reactivation of the virus from its dormant state. First symptoms of herpes zoster can be burning, itching, tingling or extreme sensitivity of a part of the skin which is most often at one side of the body.
Herpes zoster manifests its self mostly on the trunk of the body and on the buttocks of the patient, and rarely on the face, hands and legs. The most often complication of the herpes zoster is postherpetic neuralgia which manifests in pain, numbness, stinging or itching which continue even after the complete withdrawal of all the changes at the affected area of the skin.
All rights reserved © 2016, Dermatology center DERMATIM, Kralja Petra 71a, 11000 Belgrade.
The statistics show that about 20% of the persons who had chickenpox will have herpes zoster.
Temporary weakness of the immune system can cause the virus to multiply and spread across the nerves to the surface of the skin. A special care is necessary in patients who have their eyes infected by herpes zoster, because permanent damage is possible if adequate treatment is not provided in time. Based on the dermatologist’s assessment, the fluid in the blisters can be sent to special laboratory tests.
If the disease is diagnosed in the early phase, antiviral medication can be prescribed which will prevent further propagation and spreading of the virus.

Newborns and persons with a significantly decreased immunity are at great risk of catching chickenpox from a person that has herpes zoster. In more severe cases and when the eye is caught in the infection, the dermatologist prescribes a combination of systemic corticosteroids and antiviral medication. Pain sometimes persists after the rash has gone, more commonly in people over the age of 50.
Very quickly, on top of the present redness there appear grouped blisters which last two to three weeks. Very rarely, herpes zoster can manifest it self only in pain and without blisters, or with blisters but with no sense of pain. A slight weakening of the immune system in older people may account for the virus reactivating and multiplying to cause shingles.) Shingles is also more common in people with a poor immune system (immunosuppression).
The rash looks like chickenpox, but only appears on the band of skin supplied by the affected nerve.
The soft tissues under and around the rash may become swollen for a while due to swelling (inflammation) caused by the virus.
In this person, it has affected a nerve and the skin that the nerve supplies, on the left side of the abdomen. In severe cases it can lead to inflammation of the whole of the eye which may cause loss of vision. People with a poor immune system (immunosuppression) who develop shingles have a higher than normal risk of developing rare or serious complications.

Pain may be eased by cooling the affected area with ice cubes (wrapped in a plastic bag), wet dressings, or a cool bath.
A non-adherent dressing that covers the rash when it is blistered and raw may help to reduce pain caused by contact with clothing. An antiviral medicine does not kill the virus but works by stopping the virus from multiplying. It had also been hoped that antiviral medicines would reduce the risk of pain persisting into PHN. However, the research so far has shown that the current antiviral medicines taken during an episode of shingles do not seem to have much impact on the prevention of PHN. Further research is needed in this area to determine if certain groups of patients do benefit and if newer antiviral drugs can prevent PHN. For example, young adults and children who develop shingles on their tummy (abdomen) very often have mild symptoms and have a low risk of developing PHN. In addition to easing pain during an episode of shingles, they may also help to prevent PHN. You will normally be given antiviral medication whatever your age, and will be monitored for complications.

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