Care of Patient with Herpes Zoster

【Major points】

Herpes zoster is an infectious disease caused by varicella zoster virus.
Neurotic pain is one of the initial symptoms. The red rashes appear on skin, followed by vesicles and pustules.
Herpes zoster should be treated early with antiviral drugs.
Wear soft and comfortable clothes to prevent friction blisters and induced pain.

What is herpes zoster?

Herpes zoster is an infectious disease caused by varicella zoster virus.
After a patient is infected with varicella zoster virus, he or she gets chicken pox. The varicella zoster virus then incubates in the body after the patient recovers from chicken pox.
When the patient's immune system is weakened, the varicella zoster virus gets activated leading to herpes zoster onset in the patient.
Herpes zoster is often accompanied by rashes and stabbing pain which mainly appears on one side of the chest of a patient, followed by the head and neck, waist, and thigh.
Usually on one side of the body, limbs, hands or feet are less common. .

Symptoms of herpes zoster:

Neurotic pain is one of the initial symptoms. The pain may be sharp and involves any part of skin or can spread along nerve innervations.
A cluster of red rashes appears on skin, followed by vesicles and pustules, with band-like spread on one side of body.
Local lymph nodes may be swollen and painful. Fever may also occur.

Treatment of herpes zoster:

Antiviral Therapy: Antiviral drugs are effective if administered for three consecutive days after vesicles eruption, probably followed by inhibition until further eruption.
Pain Reliever: Painkillers can be used to relieve neuropathic pain.
Steroids: If patients with severe inflammation or ocular involvement, steriods can be used combing with antiviral drugs.
Antidepressant: Some types of antidepressants can also be prescribed if there is severe neurotic pain.

Self-care for managing herpes zoster:

Do not puncture the blisters to avoid transmission or secondary bacterial infection.
Clean gauze can be used to cover rashes to decrease rubbing. Avoid scratching rashes and wear gloves at night to prevent rubbing.
Wear soft and loose clothes to avoid the skin from being rubbed.
Apply a thin layer of the ointment prescribed by your doctor on the rashes. Rashes should be clean by normal saline water before the ointment is applied.
If rashes appear on your head, raise the head of bed when you sleep; if rashes appear on your four limbs, put pillows under your limbs to relieve the discomfort.
Keep a regular and healthy lifestyle in order to distract yourself from the discomfort.
Avoid drinking alcohol and spicy food.

Vaccination:

People over 50 years of age are advised to get the shingles vaccine to reduce their risk of contracting the disease, regardless of whether they have had chickenpox or shingles.
Individuals with immunodeficiency or weakened immune function (such as high-risk groups like those with chronic nephritis, diabetes, or cancer) must undergo medical diagnosis and treatment before receiving the injection. .
The shingles vaccine is an inactive recombinant vaccine that requires two doses, 2-6 months apart.

Reference

Chen, T., Chen,J ., Wu, Z. (2023). New knowledge about shingles and vaccines. Clinical Medicine Monthly. 92(2), 533-535. https://doi.org/10.6666/ClinMed.202308_92(2).0089
Stempniewicz, N., Davenport, E., Wang, J., & Sweeney, C. (2025). Herpes zoster vaccination: Primary care provider knowledge, attitudes, and practices. Human Vaccines & Immunotherapeutics, 21(1), 1- 10. https://doi.org/10.1080/21645515.2488093.
Tsai Minghang and Wang Jingxun (2025) . Introduction to shingles vaccine, Journal of Infection Control, 35(1), 33-41. https://doi.org/10.6526/ICJ.202502_35(1).0004.

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