Can I drink alcohol during chickenpox?
Attack from the nerve node
The first sign of shingles is a general feeling of malaise with fatigue and fever. In addition, burning pain occurs in the supply area of the affected nerve, possibly also sensory disturbances and itching. The rash breaks out a few days after the initial symptoms.
Pathogens in the brain or spinal cord
Whether the rash manifests itself on the trunk or face depends on whether the pathogen has settled in the spinal cord or in the brain. The rash is so typical that it is usually sufficient to confirm the diagnosis: on swollen, reddened skin, blisters form that can take on the size of a pea and are filled with serous fluid or blood. Often the vesicles stand together in groups or rosettes. After a few days they burst, crust and heal within three to four weeks. Most of the time the healing process is scar-free - and the spook is over again.
In 10 to 15 percent of cases, however, the pain persists or recurs after the rash has disappeared. Then post-herpetic neuralgia developed as a result of ganglion cell necrosis. It usually manifests itself as excruciating, burning pain, which can be accompanied by an oversensitivity to the slightest touch. Sudden attacks of pain can also occur. The risk of postherpetic neuralgia is increased with pronounced herpes zoster, with manifestations on the face and with diabetes mellitus. The risk increases massively with age, up to 70 percent for 70 to 80 year olds.
If the viruses implant themselves in the brain ganglia, there is a risk that the eye will be affected when reactivated. This complication, also known as ophthalmic zoster, is rare, but can cause permanent visual disturbances and even lead to blindness. Herpes zoster around the ear is also dangerous. Such a so-called zoster oticus often leads to hearing loss and / or facial paralysis (facial paralysis). Disseminated zoster is life-threatening. As a result of an attack on the entire nervous system, the zoster can in this case spread over the entire skin and also spread to internal organs, but this only happens in the case of a very pronounced immune deficiency.
Danger from stress and sunlight
As a rule, a weakening of the immune system creates the prerequisite for sleeping chickenpox viruses to attack again. Such a weak immune system can already be triggered by stress or UV light, but immunosuppressive diseases such as leukemia or AIDS can also be behind it. Since the immune system worsens with increasing age, people from around the age of 50 in particular develop shingles.
Herpes zoster is treated with antiviral drugs that are given orally or, in severe cases, intravenously. Therapy should begin immediately after the onset of the disease. Then there are good chances for a quick and uncomplicated healing process. In mild cases, the doctor may refrain from antiviral therapy. To relieve symptoms, the affected areas of the skin can be treated topically with drying, antiseptic preparations.
In any case, adequate pain therapy is important, not least because it reduces the risk of postherpetic neuralgia. In addition to classic analgesics, anti-epileptics such as carbamazepine or pain-relieving antidepressants such as amitriptyline are used for acute zoster pain. If postherpetic neuralgia develops nonetheless, treatment is difficult. Antidepressants are the drugs of first choice here, and opioids may also have to be used. Often multimodal therapy concepts that include non-drug methods are required. /
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