What is the cause of shingles? Herpes zoster, commonly known as “snake sores”, occurs when the body’s immunity is reduced, such as trauma, fatigue, malignancy, post-illness weakness, use of immunosuppressive drugs, sun exposure, colds, stress, menstruation, etc. Herpes zoster is caused by varicella-zoster virus infection, which means that herpes zoster and varicella are the same viral infection and the two are related. The first exposure to the varicella-zoster virus is usually in early childhood, and there are two types of reversions when first infected with the virus. In the subsequent time, due to a decrease in the body’s immunity, the virus in both cases is reactivated and herpes zoster occurs. Therefore, herpes zoster is not a first infection, but a reactivation of the latent virus in the body. The way herpes zoster spreads Herpes zoster is a skin disease caused by varicella-zoster virus infection and is somewhat contagious, and is spread by direct contact, not the common respiratory droplet infection. Typically, herpes zoster occurs in a large number of blisters, and the blistering fluid contains the virus. If a young child who has not had chickenpox comes into contact with the blister fluid of a patient, he or she may become infected and develop chickenpox. After the blisters of shingles have crusted over, the infection disappears. Therefore, if you have young children at home, avoid close contact with them during the acute phase of the disease if possible. The chance of a child being infected with the virus and having chicken pox is not common. Can shingles be contagious? Herpes zoster is somewhat contagious and is transmitted by direct contact, not by respiratory droplets. The disease is caused by varicella-zoster virus infection, which means that herpes zoster is the same virus infection as chickenpox. However, compared to chickenpox, it is not very contagious. The disease has a very typical clinical presentation, with lesions distributed along the peripheral nerves as clusters of erythema and blisters arranged in bands, not exceeding the midline of the body surface, and accompanied by significant neuralgia. The blistering fluid of the disease contains varicella-zoster virus and is transmitted by contact. It is possible to get infected if you come in contact with the blistering fluid of a patient, and chickenpox may occur especially in young children. 4. Is there any sequelae to shingles? Herpes zoster is a viral infectious skin disease that can have sequelae under certain circumstances, the most common of which is post-herpetic neuralgia, and there are also sequelae depending on the location of the disease, such as loss of vision or even blindness due to involvement of the first branch of the trigeminal nerve, facial paralysis due to involvement of the facial nerve, hearing impairment due to involvement of the auditory nerve, and the spread of the motor nerve, resulting in Motor paralysis, inability to walk or lift the upper limbs. For this reason, it is important to actively treat the elderly, people who are physically weak and have underlying diseases, and the timing of the treatment of herpes zoster is very important. V. When to treat herpes zoster? Early and adequate antiviral treatment is necessary, especially for patients over 50 years of age, to reduce neuralgia, shorten the course of the disease and prevent the occurrence of sequelae. Antiviral treatment is usually started within 48 to 72 hours after the onset of the rash. How is herpes zoster treated? 1. Antiviral drugs: you can use acyclovir 800mg orally 5 times a day, or vaxilovir 1000mg orally 3 times a day, or 500mg orally 3 times a day, or bromovudine 125mg orally once a day. The course of treatment is about 7~10 days. For severe cases, sodium phosphonate intravenous drip can be used. 2. Nerve nutrition: vitamin B1, B12 or methylcobalamin, adenosine cobalamin orally. 3. Sedation and pain relief: diclofenac sodium or amitriptyline can be chosen for acute pain. Both domestic and international guidelines recommend gabapentin and pregabalin as the first-line treatment drugs for postherpetic neuralgia. 5% lidocaine patch plays a better role in both acute pain and postherpetic neuralgia. 4. Glucocorticoids: In the elderly and in special areas of herpes zoster, especially in the area of trigeminal innervation, the early use of small doses of hormones is recommended, provided there are no contraindications to hormones. Topical medications: acyclovir ointment, penciclovir ointment applied to intact lesions, topical mupirocin or fusidic acid ointment in case of co-infection, and wet compresses of 1:5000 furacilin solution in case of herpes rupture. 6. Physical therapy: ultraviolet light, ultrashort wave, semiconductor laser or helium-neon laser irradiation, etc., can also be combined with acupuncture treatment. Seven, how to choose drugs for patients with renal dysfunction? It is advisable to choose bromovudine, not acyclovir, oral acyclovir, famciclovir or valacyclovir, and adjust the dose downward accordingly. How to choose medication for herpes zoster in pregnant women? The pros and cons need to be carefully evaluated before using the medication. Acyclovir is relatively safe. ix. How do I choose medication for shingles in children? If there is no risk of complications, antiviral drugs are not recommended. If there are risk factors for a complicated condition, antiviral medications are recommended. Acyclovir is relatively safe. X. How do I choose a drug for refractory herpes zoster? In cases where acyclovir treatment has not been effective for 10 to 21 days, viral resistance should be considered and bromovudine or famciclovir should be selected. XI. Do I need to avoid eating for shingles? Herpes zoster is a viral infectious skin disease, not an allergic disease, and does not require any contraindication, but alcohol should be avoided during medication. Is shingles during pregnancy harmful to the fetus? Since herpes zoster is not a primary infection, but a reactivation of the virus latent in the body, it does not have the process of virus entering the bloodstream and causing viremia, so the risk of fetal infection from herpes zoster in pregnant women is low. Is it possible to get chickenpox from exposure to shingles? Herpes zoster contains varicella-zoster virus in the herpes zoster blister fluid, so there is a possibility of chickenpox if you come in contact with the patient’s blister fluid. 14. Can shingles directly cause other people to get shingles? Herpes zoster is not a primary infection, but rather a reactivation of the virus that is latent in the body, so a patient with shingles will not cause others to develop shingles.