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What Are the Causes of Herpes Zoster?

Herpes zoster, also called zoster or shingles, is a painful skin rash that usually manifests in adults. Affected people rarely experience more than one episode of herpes zoster in their lifetime. The Centers for Disease Control estimates the number of U.S. cases at 1 million per year.

  1. Features

    • In the first three days, herpes zoster manifests as burning, itching or tingling skin rashes, which turn into two- to three-week-long painful blisters.

    Causes

    • Herpes zoster is caused by the varicella zoster virus (VZV), the same virus that causes chicken pox. Once a person has had chickenpox, the virus remains dormant in certain nerve cells. In about 20 percent of cases, VZV is later reactivated, escapes the nerve cells and travels to the skin to cause herpes zoster. This reactivation can have internal or external causes.

    Internal Factors

    • Anyone who has had chicken pox is at risk for herpes zoster. However, zoster is more common in people over the age of 50 and those with a weak immunity (the body's ability to fight infection). Trauma, stress and such illnesses as cancer and AIDS can weaken a person's immunity.

    External Factors

    • Some medical treatments can increase the risk of developing herpes zoster by weakening a person's immunity. These include chemotherapy, radiation, drugs given after an organ transplantation, steroids and cortisone when taken for a long time.

    Considerations

    • A person with herpes zoster can transmit the virus by direct skin contact if blisters break. However, the newly contaminated person will develop chicken pox---not zoster.

    Prevention & Treatment

    • The Zostavax vaccine exists for prevention. Covering the blisters until they "crust" can also help control the spread of herpes zoster. Treatment with antiviral drugs is most effective within three days of disease onset.

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