Herpes zoster has another name - herpes zoster. The causative agent of this infectious pathology is the herpes virus. The disease affects the skin and nervous system, and therefore therapy is carried out by both dermatologists and neurologists, depending on which clinical symptoms are most pronounced. Herpes zoster and chicken pox have a common etiology and pathogenesis. This is a secondary infection of endogenous origin in people who have previously had chickenpox in latent or clinical form. After chickenpox, viruses can persist in the body for a long time. They are localized in the ganglia of the cranial nerves and spinal ganglia, and under the influence of pathogenic factors, their reactivation occurs, which is most often observed when weakening cellular immunity.
Varicella-zoster viruses spread rapidly through the blood, cerebrospinal fluid, and nerve sheaths when they enter the human body. If they settled in the nerve cells of the spinal ganglia, they will persist there for life. Since they have a tropism for cells of the nervous system, varicella-zoster viruses cause diseases that often proceed as an infectious disease of the central and peripheral nervous systems.
About 20% of the inhabitants of our country who have had chickenpox in childhood have had hidden lifelong carriage of varicella zoster . Asymptomatic carriage of the "dormant" virus can be lifelong. The main refuge for him are the nerve cells of the body. Under the influence of internal and / or external agents, the virus activates.
Injuries, stress, hypothermia, infectious and somatic diseases can also activate herpes. The pathological anatomy of the disease in classical form is an inflammatory process in the spinal ganglia and in the areas of the skin adjacent to them. Sometimes, the front and rear horns of gray matter, the roots of the spinal cord, and the soft shells of the brain can be involved in the process.
The disease develops gradually, with common symptoms: dyspeptic disorders, headache, fever, malaise, and chills. In the future, itching and burning of the skin, rashes join. The intensity of these manifestations in each patient may vary.
After a short prodromal period, a sharp rise in temperature and symptoms of intoxication (loss of appetite, muscle pain) are observed. At the same time, a painful rash appears on the skin in the form of pink spots, with a diameter of 2-5 mm. Very often, herpes zoster on the back occurs. In children, the development of catarrhal inflammation of the respiratory tract (laryngitis, pharyngitis, rhinitis) is possible, which significantly complicates the course of the disease.
What is dangerous herpes zoster?
Herpes zoster, despite its prevalence, is considered a very dangerous pathology. In addition to neuralgia, numerous other complications are possible. With the development of rashes, ulcers can form, which leave scars and scars on the skin. This is due to a deep lesion of the skin.
But the main danger of herpes zoster is the development of meningoencephalitis, in which intense headaches, vomiting, photophobia occur, and loss of consciousness is possible. Such a disease often leads to disability of the patient. Herpes zoster is especially dangerous in the elderly.
With damage to the eyes and facial nerve, the patient may develop serious consequences in the form of blindness or glaucoma. In certain cases, herpes zoster can provoke the development of viral hepatitis and pneumonia.
The presence of the virus in the female body often leads to erosion of the cervix, problems with bearing a pregnancy, the development of infertility and cancer.
Recurrent herpes in the body of a man causes a weakening of immunity, which creates positive conditions for the development of many diseases. In men, prostatitis, vesiculitis, epididymorchitis, and bacterial urethritis are often diagnosed.
Neonatal herpes can result in the occurrence of serious neurological pathologies and even cause death. Often the consequences of such a viral infection in children are meningoencephalitis and hydrocephalus, which affect the brain. So, find out what treats herpes zoster.
Disease therapy
Etiotropic therapy of the pathological process is based on the use of selective inhibitors of the production of viral DNA, for example, acyclovir. Such treatment is effective in the initial stages of the disease. The drug “Acyclovir” is prescribed intravenously drip in a daily dosage of 15-30 mg / kg, which is divided into three injections with an interval of 8 hours. A single dose is diluted in isotonic solution. When prescribing tablet forms of this drug, a single dose is 800 mg 5 times a day, for 5 days.
It is not always possible to quickly treat medication of herpes zoster. Pathogenetic therapy is based on the use of dipyridamole, which slows down platelet aggregation. The course of treatment with this medicament should be at least 5-7 days. In order to dehydrate furosemide is prescribed. To enhance immunogenesis, homologous use of immunoglobulin is recommended (via intramuscular injection).
Symptomatic therapy of this disease is prescribed individually, and this depends on the severity of its course. To do this, use analgesics, restorative and antipyretic drugs, for sleep disorders - sleeping pills and sedatives, in some cases - antidepressants. If signs of intoxication are pronounced, detoxification treatment with forced diuresis is performed.
Locally, the rashes are treated with a solution of diamond greens, and during the formation of crusts - with dermatol ointment. When a secondary bacterial infection is attached, a course of antibiotic therapy is prescribed. What treats herpes zoster, the doctor will tell.
Drug Overview
The main medications for the occurrence of herpes zoster are:
- "Acyclovir";
- Famciclovir Teva;
- Amiksin;
- "Viferon" (a means to enhance immune defense).
The following types of medicines are used in the complex:
- antiherpetic;
- painkillers;
- antiviral;
- immunomodulatory;
- anti-inflammatory;
- relieves itching.
Acyclovir
This medication is an antiviral agent for parenteral, internal, external and local use. When treating this type of herpes, it is usually used in the form of “Acyclovir 200 mg” tablets. This is a synthetic analogue of an acyclic purine nucleoside. The drug has increased specificity for Herpes simplex viruses (HSV), Epstein-Barr virus (EBV), cytomegalovirus (CMV) and Varicella zoster virus (VZV). The highest activity of the main substance is observed in relation to HSV-1.
The mechanism of action of Acyclovir in herpes zoster is due to the penetration of the active element directly into cells infected with the virus and producing viral thymidine kinase, as a result of which it is phosphorylated to acyclovir monophosphate. The thymidine kinase functionality of the virus with respect to acyclovir is significantly higher than the effect of intracellular enzymes on it (the volume of acyclovir monophosphate in cells is 40-100 times higher). Subsequently, the formation of acyclovir triphosphate, which is a selective and extremely active inhibitor of DNA polymerase viruses.
According to the instructions, parenteral and inside, “Acyclovir 200 mg” is prescribed for the following pathologies during therapy: recurrent and primary genital herpes of severe forms, herpes zoster (Varicella zoster), herpes simplex with lesions of the skin and mucous membranes (Herpes simplex virus types 1 and 2), Herpes zoster with eye damage.
Contraindications
What treats herpes zoster, it is better to find out in advance, since the drugs have a lot of contraindications. Medication "Acyclovir" is not prescribed if there is:
- hypersensitivity to the elements of the composition;
- lactase deficiency, glucose-galactose malabsorption;
- age less than 3 years;
- lactation period.
Famciclovir Teva
This is a medication that is made on the basis of the same substance famciclovir. It is an antiviral agent. After oral administration, famciclovir is rapidly transformed into penciclovir, which has activity against human herpes viruses, as well as cytomegalovirus and Epstein-Barr virus.
Penciclovir penetrates into infected cells, where, under the influence of viral thymidine kinase, it is rapidly converted into monophosphate, which, with the participation of cellular enzymes, is converted to triphosphate. Penciclovir triphosphate in infected cells is more than 12 hours, suppressing the production of viral DNA in them. The concentration of this substance in uninfected cells is not higher than the minimum determined, therefore, in therapeutic doses, penciclovir does not affect uninfected cells.
The medicine "Famciclovir" significantly reduces the duration and intensity of postherpetic neuralgia in people with herpes zoster.
For the treatment of herpes zoster, it is recommended to take this medication in a dose of 250-500 mg. The duration and frequency of administration depend on the indications, renal function, immune status, and the effectiveness of therapy.
The medicine should be taken as soon as possible after the appearance of pathological symptoms, since in this case the therapy will be more effective.
Amiksin
This drug for the treatment of herpes zoster in adults and children belongs to the category of antiviral medications. It is a fairly effective synthetic inducer that stimulates the natural synthesis in the body of interferons belonging to the types of alpha, beta and gamma. The main active element of Amiksin is a tiporon. Hepatocytes (liver cells), granulocytes (white blood cells), T-lymphocytes (thymus cells) and intestinal epithelial cells respond to it.
When a medication enters the body, they begin to actively produce interferons, the maximum amount of which is produced within 24 hours. The drug has immunomodulatory and antiviral properties. Its use is effective in the treatment of many infections of viral origin, including herpes viruses, influenza, respiratory infections, and hepatitis viruses. The antiviral effect of the drug is due to its ability to inhibit the reproduction of pathogens by inhibiting the translation of virus proteins in infected cells.
Amixin remedy for herpes zoster is prescribed according to the following scheme: the first 2 days - 1 tablet, then 1 tablet once every two days. In total, the patient should take 10-20 tablets for the course of therapy, depending on the severity of the pathological process.
Viferon
Since herpes zoster appears with weakened immunity, Viferon helps to cure an ailment in a short time. This medication is allowed to be used in pediatrics, during pregnancy. However, despite the high effectiveness of the drug, self-medication is contraindicated for them.
The main elements in the composition of the drug are interferon - protein cells that do not allow viruses to multiply. In addition to interferon, ascorbic acid and tocopherol-alpha are present in the drug. Viferon is made in the form of ointments, gels and rectal suppositories.
In general, then, with what to smear herpes zoster, and the treatment regimen should be agreed with the doctor. Suppositories are considered more effective than ointment and gel. They are used rectally, the dosage depends on the weight and age of the patient. For adults, the medication is prescribed in the morning and evening, one suppository at a dose of 500 thousand IU. It is very important to use this tool for 5 days. The Viferon ointment is applied externally; it is recommended to lubricate skin rashes with it.
To treat this pathology as effective as possible, it is recommended to start taking it as soon as possible. In addition, complex therapy is important - a combination of Viferon and antiviral agents.
This medicine has virtually no contraindications and has no side effects. In rare cases, a slight burning sensation may occur at the site of application of the ointment.
Painkillers
Find out why painkillers are needed for herpes zoster. In addition to medications that directly eliminate the virus, medications that relieve pain are often prescribed. As they are most often assigned:
- "Analgin";
- "Paracetamol";
- Nurofen
- "Indomethacin";
- Butadion.
If the soreness is too pronounced and does not resolve for a long time, some anticonvulsants, such as Gabapentin or Diazepam, can be used. In combination with tablets, ointments based on capsation and gels with lidocaine are used.
In severe cases, the doctor may recommend strong painkillers from the category of drugs or antidepressants. They are "Promedol", "Fortral", "Tramal", etc. Such drugs should be used strictly under the supervision of a specialist and only in the presence of appropriate symptoms. What other drugs for the treatment of herpes zoster in adults are used?
Immunomodulatory substances
Herpes zoster should also be treated with immunomodulating medications. They are prescribed in addition to antiviral treatment, and their action is aimed at suppressing the vital activity of the zoster virus.
Since the task of such medicines is to artificially stimulate the patient’s immune cells, they should be prescribed only in accordance with the indications and used according to the specified scheme.
Preparations of this group can be natural and synthetic. Both those and others actively use herpes zoster in cases of illness. In the treatment of pathologies provoked by herpes viruses, a good effect is possessed by:
- Lavomax is a drug based on the active element of tilorone, which is obtained as a result of the synthesis of interferon. The drug is produced in tablet form, it is contraindicated in lactation, pregnancy and under the age of 18 years. The negative effects that occur during administration are minor. These are dyspeptic disorders, allergies and short-term chills.
- “Proteflazid” is a medicine in the form of drops, which are based on wild cereal flavonoids that can suppress the DNA of viruses. The medication not only enhances local immunity, but also has antioxidant properties and helps eliminate lipid oxidation products. With caution, the drug is used during pregnancy. Contraindications to it are gastrointestinal ulcer in the period of exacerbation and sensitivity to the components.
Topical Medicines
What is the treatment of herpes zoster yet? People often suffer not only from pain, but also from severe skin itching that occurs in the rash zone. Therapy of this pathology requires the use of appropriate medications.
As a rule, they become gels, ointments and creams based on acyclovir:
- Zovirax
- "Herpevir";
- Virolex
- "Herperax" and others.
Medicines containing other active substances also fall into the category of anti-itch remedies for herpes zoster. These are, for example, Viru-Merz Serol, which is based on thromantadine hydrochloride, Panavir with plant extracts, Fenistil Pencivir based on penciclovir and others.