Herpes zoster (HZ) infection, commonly called shingles, is the reactivation of a latent varicella zoster virus (VZV) that caused an earlier episode of chicken pox. It is actually a complication of herpes infection. A few of the infected people are affected with this complication. As it is a severe and painful condition, most of the cases are managed as emergency. It is an infection of a nerve and the skin around the area of nerve course. It is characterised by pain or a tingling sensation, in a limited area on the side of the face or torso, followed by a red rash with blisters. The fluid filled blisters spread fast and are extremely painful.
SIGNS AND SYMPTOMS
Unilateral, fluid-filled blisters with severe pain and burning sensation. Sometimes itching is present.
The rash usually follows the course of the affected nerve.
CAUSES
It occurs over the dermatome innervated by the ganglion, where the virus(Varicella zoster) resides for life until stress, immunosuppression, or some other condition allows it to travel to the skin served by the affected nerve.
PATHOPHYSIOLOGY
Varicella-zoster virus is a highly contagious DNA virus. Varicella represents the primary infection in the nonimmune or incompletely immune person. During the primary infection, the virus gains entry into the sensory dorsal root ganglia. How the virus enters the sensory dorsal root ganglia and whether it resides in neurons or supporting cells are not completely understood. The varicella-zoster virus genome has been identified in the trigeminal ganglia of nearly all seropositive patients. The virus remains latent for decades because of varicella-zoster virus–specific cell-mediated immunity acquired during the primary infection, as well as endogenous and exogenous boosting of the immune system periodically throughout life. Reactivation of the virus occurs following a decrease in virus-specific cell-mediated immunity. The reactivated virus travels down the sensory nerve and is the cause for the dermatomal distribution of pain and skin lesions.
DIAGNOSIS
Clinical evaluation on the basis of the characteristic appearance of the rash.
TREATMENTS
A live, attenuated vaccine aimed at boosting immunity to Varicella zoster virus and reducing the risk of Herpes Zoster. The vaccine has been shown to reduce significantly the incidence of both HZ and Post Herpetic Neuralgia.
PROGNOSIS
Early recognition and treatment can reduce acute symptoms and may also reduce Postherpetic Neuralgia.
COMPLICATIONS
Serious nerve pain, called post herpetic neuralgia
Disease & Ayurveda
Baahyavisarpa
Nidana
Not mentioned separately.
Causative factors of Sopha can cause the same
Vidaahi food items
Purvaaroopa
Not mentioned.
Samprapti
When the vitiated one, two or three doshas get lodged inside or outside of the body, spread very fast and causes inflammation. In baahyavisarpa, the inflammation affects skin and nerves leading to severe pain and other discomforts.
Lakshana
Sopha – swelling
Sphurana – throbbing
Nistoda – piercing pain
Bheda – stabbing pain
Arthi – severe pain
Harsha – numbness
Divisions
- Vaatika
- Paittika
- Kaphaja
- Baahya
- Aabhyantara
- Baahya-aabhyantara
Prognosis
Krichhrasadhyam
Chikithsa
Treatment of visarpa should start with Langhana (fasting) and Rookshana (drying) therapies. After proper aamapaachana, bloodletting should be done to clean the circulation. After bloodletting, Vamana and virechana are indicated. In cases of Visarpa, snehana (use of oils/fats) therapies are contra indicated.
Samana
Lepanam with Rookshana dravyas
Parisheka with soolahara-rooksha & seethadravyas
Sodhana
Raktamokshanam
Vamanam
Virechanam
Commonly used medicines
Vilwadi gudika
Naalpaamaradi kwatham
Naalpaamarachoornalepam
Satadhoutaghrutam
Brands available
AVS Kottakal
AVP Coimbatore
SNA oushadhasala
Vaidyaratnam oushadhasala
Home remedies
Shingles cause severe pain & discomforts which cannot be managed at home. No home remedy is proven to cure shingles. Following herbs may help to lessen the suffering.
Cold compresses
Essential oils
Aloe vera
Witch hazel
Oatmeal
Turmeric paste
Diet
- To be avoided
Heavy meals and difficult to digest foods – cause indigestion.
Spicy and hot food items
Junk foods- cause disturbance in digestion and reduces the bioavailability of the medicine
Carbonated drinks – makes the stomach more acidic and disturbed digestion
Refrigerated and frozen foods – causes weak and sluggish digestion by weakening Agni (digestive fire)
Milk and milk products – increase kapha, cause obstruction in channels and obesity
Curd – causes vidaaha and thereby many other diseases
- To be added
Light meals and easily digestible foods
Gooseberry, pomegranate, grapes etc.
Green gram, soups, food items with cold potency.
Freshly cooked and warm food processed with minimal spices.
Behaviour:
Protect yourself from hot climate.
Better to avoid exposure to excessive sunlight wind rain or dust.
Maintain a regular food and sleep schedule.
Avoid holding or forcing the urges like urine, faeces, cough, sneeze etc.
Avoid sedentary lifestyle.
Yoga
Exercise is not advised in cases with severe pain and discomforts. Regular stretching and mild cardio exercises are advised in mild cases. Also, specific yogacharya including naadisuddhi pranayama, bhujangaasana, pavanamuktasana is recommended.
Regular exercise helps improve bioavailability of the medicine and food ingested and leads to positive health.
Yoga can maintain harmony within the body and with the surrounding system.
Pavanamuktasana
Nadisudhi pranayama
Bhujangasana
Simple exercises for lungs and heart health
All the exercises and physical exertions must be decided and done under the supervision of a medical expert only.
Research articles
A randomized, placebo-controlled, phase 3 study in 18 countries to evaluate the efficacy and safety of HZ/su in older adults (≥50 years of age), stratified according to age group (50 to 59, 60 to 69, and ≥70 years) was conducted. The HZ/su vaccine significantly reduced the risk of herpes zoster in adults who were 50 years of age or older.
In a clinical study, among adults who had undergone autologous hematopoietic stem cell transplantation-HSCT, a 2-dose course of recombinant zoster vaccine compared with placebo significantly reduced the incidence of herpes zoster over a median follow-up of 21 months.
These statements have not been evaluated by the Food and Drug Administration, United States. This product is not intended to diagnose, treat, cure or prevent any disease. Please consult your GP before the intake.
Expert,
Ayurveda Medicine, India
Writer:
Dr. Rajesh Nair, the co-founder and chief consultant of Ayurvedaforall.Com, is a graduate of prestigious Vaidyaratnam Ayurveda College (affiliated with the University of Calicut), Kerala, India. Additionally, he holds a Postgraduate Diploma in Yoga Therapy from Annamalai University.
Dr. Nair offers consultation at two busy clinics in and around Haripad, Alleppey, Kerala, the southern state famous worldwide for authentic ayurvedic treatment and physicians. While offering consultation on all aspects of ayurvedic treatments Dr. Nair has a special interest in Panchkarma, Yoga, and Massage.
Through Ayurvedaforall Dr. Nair offers online consultation to patients worldwide and has served hundreds of patients over the last 20 years. In addition to his Ayurvedic practice, he is the chief editor of ayurveda-amai.org, the online portal of Ayurveda Medical Association of India, and the state committee member of Ayurveda Medical Association of India.
Dr. Nair is a regular speaker at Ayurveda-related conferences and has visited Germany to propagate Ayurveda. You can write directly to him-
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