How do we treat shingles? Treatments and care
[ad_1]
Shingles affects approximately 300,000 people each year in France. This disease caused by the varicella virus can be very painful. What are the treatments?
 100vw, 498px “src=” https://www.essentiel-sante-magazine.fr/wp-content/uploads/2023/01/zona-e1674466529225-498×281.jpg?is-pending-load=1 “/></p>
<p>8 in 10 people say they know about shingles, but only 1 in 2 know that shingles is linked to a reactivation of the virus responsible for chickenpox, the varicella-zoster virus (VZV). In any case, this is what a survey* revealed in 2016. Thus, shingles is a disease that we all know, at least by name, but in a vague and fragmented way.</p>
<h3>Shingles: the painful awakening of the varicella virus</h3>
<p>Shingles appears first as <strong>A burning sensation, tingling, and numbness followed by the appearance of red spots</strong> Which soon becomes covered with small vesicles on the course of the affected nerve. Sometimes other signs may also appear, such as fever or headache.<br />“People who had chickenpox in their youth keep this virus throughout their lives, which settles in some nerve ganglia,” says Dr. Antoine Aileen, general practitioner and algaeologist at the University Hospital of Toulouse and in Nilo / Saint-Leon (Haute-Garonne). ). Years after chickenpox, it can reactivate and affect a specific nerve area. Since nerves make their way to the surface of the skin through nerve endings, the virus attacks them in a limited area. »<br /><strong>Most often, shingles is located in the chest area</strong>. This is called intercostal shingles since the small intercostal nerves in this area are affected. But shingles can also be limited to the arm, thigh, calf, or even the face. “In about 20% of cases, shingles will affect the face, raising concerns of possible eye damage (ocular shingles), warns Dr. Elaine. Admittedly, <strong>Ocular shingles is a rarer form but also more severe</strong>. »<br />In addition to severe eye pain, ocular shingles can cause decreased visual acuity, sometimes due to inflammation of the optic nerve (optic neuritis), or even loss of the affected eye if the cornea is severely damaged (keratitis).</p>
<h3>Topical and oral pain management</h3>
<p>Possible at any age, the onset of varicella zoster virus occurs mainly in the elderly, generally after the age of 50, and / or in people exposed to stress or illness (depression, cancer, diabetes, etc.), who experience a decrease in their immune defenses Francis Abramovici, Secretary General of the College of General Medicine (CMG).<br />in the acute phase of shingles, <strong>Painkillers (such as paracetamol) and local treatments</strong> (bathing with lukewarm water and preferably ultra-fat soap, applying ice, simple dressings, using antiseptics, etc.) to reduce pain and prevent the risk of secondary infection of the vesicles.<br />“Where there is a high risk of complications, particularly in patients over 70 years of age, oral therapy of first choice is based on <strong>An antiviral drug, valacyclovir</strong>which must be taken no later than three days after the onset of the eruption to benefit from its full effectiveness, Dr. Abramovici insists.</p>
<h3>Consult your doctor quickly</h3>
<p>Blisters dry quickly and crusts form. They will fall off after about ten days, leaving only a few scars.<strong> Most shingles heal without effects within three to four weeks</strong> A bout of shingles is rare. “Provided you act quickly to avoid the risk of chronic disease, it’s all the higher because shingles is severe,” says Dr. Ellen. However, according to the French Public Health Agency, 40% of French people wait more than 72 hours before consulting a doctor. A very unfortunate situation because this waiting can contribute to an increased risk of post-herpetic pain. We talk about post-herpetic pain when the pain lasts for more than three months.<br />” <strong>It is difficult to relieve nerve pain</strong> Because the drugs only have a modest effect, notes Dr. Ellen. In localized lesions with a well-defined area, topical therapy should be offered as first-line treatment. Lidocaine is used in the form of patches for several weeks. If this is not enough, we can link a treatment to the family of antidepressants, such as amitriptyline, or the family of antiepileptics, such as gabapentin. »<br />These pains, which are admittedly relatively rare but sometimes very debilitating, nevertheless concern 25% of elderly people over 80 years of age after herpes zoster. At this age, it can lead to a loss of independence.</p>
<h3 class=)
When pain persists for several months after shingles, it is recommended that you be referred to specialized structures and pain centres. Don’t hesitate to talk to your doctor about it! Pain centers provide special care For the treatment of post-herpetic pain. Each patient, with the help of a multidisciplinary team, will be able to think about what works best for them. Complementary strategies may be suggested: transcutaneous electrical stimulation for analgesic purposes (TENS), botulinum toxin in some cases, capsaicin patches, hypnosis, psychological support therapies.
“Chronic pain often has a very devastating impact on patients’ quality of life,” notes Dr. Elaine. So we shouldn’t rule out anything in our arsenal to fully support it. »
Herpes zoster vaccination: on a case-by-case basis
Since 2016, it is located in France Herpes zoster vaccine is a single doseRecommended for adults ages 65-74. In this age group, it is reimbursed by health insurance. With an efficiency of nearly 70%, grafting is above all offerings Pain protection benefit That can sometimes last for months after shingles. However, it is still little practiced in France, unlike the UK.
“Perhaps establishing savings counseling at 25, 45 and 65 years old is an opportunity to alert our patients to the risks of chronic pain associated with herpes zoster and offer some of them vaccination,” says Dr. Abramovici. Indeed, we must not forget that this is a live vaccine containing an attenuated viral strain of varicella-zoster virus. For this reason, it is contraindicated for the elderly and/or those with a severely weakened immune system.
A new mRNA vaccine against shingles is still being studied However, it could give hope soon for a vaccine for the most fragile patients as well.
*Scanned for Sanofi Pasteur MSD Laboratory.
- Image credit: Getty Images
[ad_2]
Source link
