How can Ayurveda Treat Herpes Zoster

What is Herpes Zoster?

Herpes Zoster, more commonly known as shingles, is a viral infection that presents as a painful rash. The culprit is varicella zoster virus (VZV) that also causes chickenpox. After contracting chickenpox, this virus stays inside the nerve cells of our body even after the symptoms of chickenpox subside. The immune system keeps the virus in check, preventing them from causing chaos in the body. However, as we get older and the immune system gets weaker, the virus may escape the nerve cells and manifest as shingles.

Although shingles is not life-threatening, the rash can cause intense pain. Vaccines have been developed to lower the risk of shingles. For those who develop shingles, herpes zoster treatment should be administered early as it has been proven to shorten the infection and lower the rate of complications.

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Who are at risk?

Essentially, everyone who has had chickenpox could develop shingles. Some factors that further increase the risk are:

●     People above the age of 50

●     Having diseases that weaken the immune system, such as HIV/AIDS and cancer

●     Those undergoing radiotherapy or chemotherapy

●     Certain medications like steroids. People who have received a transplanted organ may be taking steroid for a protracted period of time to prevent rejection. This can potentially impair the immune system.

What are the symptoms?

In shingles, the rash begins as raised reddish bumps which later turn into blisters. The rash is painful and may be accompanied by a stinging or burning sensation. Occasionally, the pain starts a few days before the appearance of the rash. Although the rash is classically found on either side of the torso, it can actually appear anywhere on the body. If it happens to involve the eyes, it has the potential to impair vision by causing scarring.

The blisters often crust over and fall off after 7 to 10 days. However, the colour changes of the skin underneath this blister may be permanent. The rash itself lasts a few weeks, but the pain may take longer to subside. For most patients, the pain goes away in 1 to 3 months. Most people only gets shingles once, but for some it may recur.

Shingles are contagious. This means that patients with shingles can pass the VZV virus to those who are not immune to it. The infection usually occurs through direct contact with the open sores of shingles rash. Of note, the infected person will develop chickenpox, not shingles.

The VZV virus is especially dangerous for certain groups of people. These include newborns, pregnant women and people with weakened immune systems. Hence, patients with shingles should avoid physical contact with these groups of people and with those who are not immune to VZV.

What are the complications?

●     The complications of shingles include:

●     Postherpetic neuralgia: These are cases where the pain last for a long time after the clearance of blisters. This happens due to exaggerated pain signals from the damaged nerve fibres.

●     Vision loss: Due to shingles that affects the eyes.

●    Neurological problems: These include inflammation of the brain, facial paralysis and problems with hearing or balance.

●   Skin infections: If the shingles sores are not properly cared for, local skin infections may ensue.

How is the diagnosis made?

In most cases, the history of pain and the characteristic rash would suffice for the diagnosis of shingles. For some, the attending doctor may take a tissue scraping or culture of the blisters for further confirmation.

What are the available treatment options?

Patients need to understand that there is no cure for shingles. However, antiviral medications, if administered promptly, can improve healing and reduce risk of complications. These antiviral medications include acyclovir and valacyclovir.

For pain, there are a lot more options available. Your doctor may prescribe topical agents like capsaicin patch and lidocaine. Treatment may also involve anticonvulsants (eg gabapentin) or tricyclic antidepressants (eg amitriptyline). For some, medications that contain narcotics (eg codeine) may be useful. Injected medications include steroids and local anaesthetics.

Do alternative treatment options help?

Because the pain takes a long time to subside, patients will likely try a few options to find out what works best. Some studies have shown that alternative treatment options, which include acupuncture and certain supplements, could offer relief. The research is not complete and more work still needs to be done to find conclusive evidence supporting the use of alternative treatment options. Nonetheless, some options show promise and may work well with western medicine. Please check with your doctor if you are planning to try something new.

The Ayurvedic approach

Some patients may prefer Ayurvedic treatment because of the purported low rate of side effects. Here is a list of possible Ayurvedic treatment for shingles:

●     Local application of a paste of turmeric powder to improve healing and provide pain relief.

●     Apply a paste (mixture of crushed aspirin and alcohol) applied onto the sores for pain relief. Similar topical agent is available in western medicine.

●     Cleaning the blisters with apple cider vinegar (1/2 cup of vinegar in 2 cups of water) to dry up the blisters.

●     Essential oils like chamomile oil that reduces inflammation and promote healing. Of note, many essential oils have not been approved for use by the FDA.

●     Colloidal oatmeal powder may moisten dry skin and reduce inflammation. The FDA has approved colloidal oatmeal as a safe treatment option.

●     Concoction of HypoxisRooperi (extract of African Potato), Agothosmabetulina (Buchu) and Oleaeuropea (extract of olive leaf) which is used to strengthen the immune system.

●     Pear juice for its antiviral properties.

●     Cinnamon, lobelia, ginger and valerian to improve healing.

Because of the lack of evidence and the possible interactions with western medications, patients should seek advice from their doctors before trying these options. In the meantime, patients are encouraged to try home remedies such as cold compresses and cool baths for pain relief. Other lifestyle changes that can be made include eating a balanced diet, stop smoking and reducing the amount of stress in life.