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If the above diagnoses are inconclusive or if a treatment regimen has already been started, a biopsy of the affected skin (i.e. Spray tub and bathroom floor with disinfectant after each use to help prevent reinfection and infection of other household members. Wash feet, particularly between the toes, with soap and dry thoroughly after bathing or showering. If you have experienced an infection previously, you may want to treat your feet and shoes with over-the-counter drugs. Dry feet well after showering, paying particular attention to the web space between the toes.
Try to limit the amount that your feet sweat by wearing open-toed shoes or well-ventilated shoes, such as lightweight mesh running shoes. After any physical activity shower with a soap that has both an antibacterial and anti-fungal agent in it. Herpes Zoster Oticus (HZ oticus) is a form of shingles that is restricted to the area of the ear and its surroundings.
Figure 1: Herpes zoster oticus typically results in an itchy rash that is characterized by fluid filled bumps (vesicles)1. After an initial chicken pox infection, typically during childhood, the virus will remain dormant within the nerve centers of the body.
Herpes Zoster Oticus can potentially affect anyone that has had a previous chicken pox (varicella-zoster) infection. If not treated in a timely manner, HZ oticus can lead to potential nerve damage and subsequent dysfunction.

Figure 2: The facial nerve can be affected by inflammation due to a herpes zoster oticus infection. HZ Oticus is typically treated with antiviral medications and corticosteroids to suppress viral activity and decrease inflammation. All cases of suspected Herpes Zoster Oticus should be promptly evaluated and treated by a qualified otolaryngologist.
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Shingles and Herpes Zoster Oticus are a reactivation of the Varicella-Zoster Virus, also known as the chicken pox virus. In normal situations, the body’s immune system keeps the virus at bay and the patient symptom free. Because the immune system is able to suppress shingles infections (including HZ oticus) those with weakened immune systems are more likely to develop HZ oticus. As the diseases progresses, inflammation of underlying nerves can result in moderate to severe pain as well as changes in hearing, facial muscle control, and taste disturbances.
Because of their close anatomical relationship, the nerves of hearing, facial sensation, and taste can all become simultaneously affected during an HZ oticus infection.
Prompt evaluation and treatment is recommended to avoid or decrease the complications associated with nerve damage such as severe pain, hearing loss, and facial distortion.
These specialists have experience in recognizing this condition and initiating appropriate treatment to decrease the likelihood of complications and permanent injury. It is designed to provide reliable medical information in a format that is easy to understand.

Raphael Nach is board certified in plastic surgery and otolaryngology and has been in practice for over 30 years.
Occasionally, when the immune system has been weakened, the virus will emerge and cause a painful chicken pox like rash. The immune system can typically be weakened by situations including: chemotherapy, radiation therapy, cancer, autoimmune disorders, stress, and chronic illness. Inflammation caused by the virus leads to compressive damage of the delicate nerves of the face and ear. In some cases pain medication is also prescribed to address pain due to neurological injury. As Chief of Medical Resources, I hold an undergraduate degree in Neuroscience from the University of California, Los Angeles and a graduate degree in Medical Science from the University of Southern California. In addition, because the efficacy of the immune system decreases with age, HZ Oticus is disproportionally seen in older age groups vs. Nach became an American citizen in 1978 and has been in practice across the country since then.

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